Osteoporosis weakens bones throughout the body, including vertebrae in your spine. This makes them vulnerable to fractures from minimal trauma or even normal activities like bending or lifting. Vertebral compression fractures are common in osteoporosis, causing sudden back pain, height loss, and progressive spinal curvature. Multiple fractures over time can create a rounded upper back called kyphosis. The weakened bone also complicates spinal surgery if needed, as screws and implants don’t hold as securely. Osteoporosis typically develops silently without symptoms until a fracture occurs, which is why screening and prevention are so important, particularly for postmenopausal women.

Yes, though osteoporosis presents challenges. Weakened bone doesn’t hold screws and implants as firmly, increasing risks of hardware loosening or failure. Surgeons may use special techniques like cement augmentation to improve fixation. The benefits of surgery must be carefully weighed against risks. Sometimes treating osteoporosis medically before planned surgery improves bone quality. For emergency situations like fractures with nerve compression, surgery proceeds despite osteoporosis, with techniques adapted accordingly. If you have osteoporosis and require spinal surgery, your surgeon will discuss the additional considerations and may work with your endocrinologist to optimise bone health around the time of surgery.

New, sudden back pain in someone with osteoporosis should be evaluated promptly, as it may indicate a vertebral fracture even if no significant trauma occurred. An X-ray or MRI can identify fractures. Most compression fractures heal with pain management, bracing, and time, though some may benefit from procedures like vertebroplasty or kyphoplasty. Chronic back pain in osteoporosis might relate to spinal deformity or muscle strain from altered posture. Treatment focuses on pain relief, appropriate exercise to strengthen muscles without risking further fractures, and optimising osteoporosis treatment to prevent future fractures. Physical therapy can improve posture and function whilst respecting bone fragility.

Managing osteoporosis through medication prescribed by your doctor is fundamental to preventing fractures. Ensuring adequate calcium and vitamin D intake supports bone health. Weight-bearing exercises like walking strengthen bones, whilst balance training reduces fall risk. Avoiding movements involving forward bending or twisting helps protect your spine. Making your home safer by removing trip hazards and using adequate lighting prevents falls. Some patients benefit from spinal bracing for support during activities. Treating the underlying osteoporosis aggressively gives the best chance of avoiding fractures. Regular bone density monitoring tracks treatment effectiveness.

Osteoporosis medications can’t reverse compression fractures that have already occurred, but they can strengthen remaining bone and significantly reduce the risk of future fractures. Some medications like bisphosphonates reduce fracture risk by up to 50 per cent. Newer treatments may even build new bone. Starting treatment after a first fracture is crucial, as having one fracture substantially increases the risk of others. While existing deformity from healed fractures persists, preventing new fractures stops further height loss and worsening curvature. Combined with appropriate exercise, osteoporosis treatment improves overall spinal health and quality of life.