Guide to Managing Osteoporosis in Australia

By: Chronic Therapy Team

Navigating the world of osteoporosis can be challenging, but we're here to help. In this comprehensive guide, we'll break down everything you need to know about this common bone condition, with a particular focus on the Australian context.

We'll explore what osteoporosis is, its prevalence in Australia, its causes, and risk factors. We'll also dive into the symptoms, diagnosis, and the connection between osteoporosis and chronic pain. You'll learn about osteoporosis as a disability in Australia and the various treatment options available, including the role of medical cannabis.

Furthermore, we'll provide practical tips for managing osteoporosis, supporting someone with the condition, and understanding the differences between osteoporosis and osteoarthritis. By the end of this guide, you'll be well-equipped with the information you need to make informed decisions about osteoporosis prevention, management, and care.


  1. What is Osteoporosis
  2. How Common is Osteoporosis in Australia?
  3. Causes of Osteoporosis
  4. Osteoporosis Risk Factors
  5. Symptoms of Osteoporosis
  6. How is Osteoporosis Diagnosed
  7. Is Osteoporosis a Type of Chronic Pain
  8. Is Osteoporosis a Disability in Australia?
  9. Osteoporosis Treatments
  10. Why is it Important to Correctly Diagnose Osteoporosis
  11. Medical Cannabis and Osteoporosis
  12. Tips for Managing Osteoporosis
  13. How to Support Someone with Osteoporosis
  14. Conclusion

1. What is Osteoporosis

Osteoporosis is a skeletal disorder characterised by a decrease in bone mass and a deterioration of bone tissue, leading to increased bone fragility and a higher risk of fractures [1]. The word "osteoporosis" comes from the Greek words "osteon," meaning bone, and "poros," meaning porous [2]. Essentially, osteoporotic bones become less dense, more porous, and weaker, making them prone to break even from minor impacts or normal daily activities [3]. The most common fractures associated with osteoporosis occur in the spine, hip, and wrist [4].


2. How Common is Osteoporosis in Australia?

Osteoporosis is a significant public health concern in Australia, affecting approximately 1.2 million people [5]. According to Osteoporosis Australia, two in three Australians aged over 50 have either osteoporosis or low bone density, placing them at an increased risk of fractures [6]. The incidence of osteoporosis is expected to rise due to the aging population, with projections estimating that by 2022, the number of Australians with osteoporosis or low bone density will reach 6.2 million [7].


3. Causes of Osteoporosis

Bone is a living tissue that is constantly being broken down and rebuilt through a process called bone remodelling [8]. Throughout life, new bone is formed by cells called osteoblasts, while old bone is broken down by cells called osteoclasts [9]. When we are young, our body builds more bone than it breaks down, leading to an increase in bone mass. However, as we age, bone remodelling becomes imbalanced, with bone resorption outpacing bone formation, leading to a decline in bone density [10]. This process is a natural part of aging, but certain factors can accelerate bone loss and increase the risk of developing osteoporosis.


4. Osteoporosis Risk Factors

There are many risk factors for osteoporosis, some of which are modifiable, while others are non-modifiable.

Non-modifiable risk factors include

Age: The risk of developing osteoporosis increases with age, as bone mass typically peaks in the early 20s and begins to decline gradually after the age of 30 [12].

Sex: Women are at a higher risk of developing osteoporosis than men, particularly after menopause, due to a decrease in the female sex hormone oestrogen, which plays a crucial role in maintaining bone density [13].

Genetics: A family history of osteoporosis or fractures can also increase an individual's risk [11,14].

Modifiable risk factors include

Lifestyle choices: Poor nutrition, low calcium and vitamin D intake, , lack of physical activity, smoking, and excessive alcohol consumption can contribute to the development of osteoporosis [15].

Medical conditions: Certain medical conditions, such as rheumatoid arthritis, inflammatory bowel disease, and eating disorders, can also increase the risk of developing osteoporosis [16].

Medications. Some medications, like corticosteroids and certain cancer treatments, can negatively affect bone health [17].

Addressing these modifiable risk factors through lifestyle changes and medical interventions can help prevent or manage osteoporosis.


5. Symptoms of Osteoporosis

Osteoporosis is often referred to as a "silent disease" because it can progress without any noticeable symptoms until a fracture occurs [27]. Many people are unaware they have osteoporosis until they experience a fracture or a bone density test reveals their low bone mass. In some cases, people with osteoporosis may experience back pain, loss of height, or a stooped or hunched posture due to spinal compression fractures [28]. These fractures can also cause a decrease in mobility, leading to a reduced quality of life and an increased risk of further fractures.


6. How is Osteoporosis Diagnosed

Osteoporosis is typically diagnosed through a bone mineral density (BMD) test, which measures the amount of bone mineral in a specific area of bone, usually the hip or spine [29]. The most common BMD test is dual-energy X-ray absorptiometry (DEXA), which uses low-dose X-rays to determine bone density [30].

The results of a BMD test are expressed as a T-score, which compares an individual's bone density to that of a healthy young adult of the same sex [31]. A T-score of -1.0 or above is considered normal, while a T-score between -1.0 and -2.5 indicates low bone density (osteopenia), and a T-score of -2.5 or below indicates osteoporosis [32].

In addition to a BMD test, healthcare providers may consider an individual's risk factors, medical history, and the results of other tests, such as blood and urine tests, to diagnose osteoporosis and assess fracture risk [33].


7. Is Osteoporosis a Type of Chronic Pain

Osteoporosis itself does not cause chronic pain, but the fractures that result from the condition can lead to persistent pain and discomfort [34]. Compression fractures in the spine are particularly problematic, as they can cause nerve compression, limit mobility, and lead to chronic back pain [35]. Early diagnosis and appropriate treatment of osteoporosis can help prevent fractures and reduce the risk of chronic pain.


8. Is Osteoporosis a Disability in Australia?

Osteoporosis is not considered a disability in Australia under the Social Security Act 1991 [36]. However, the complications arising from osteoporosis, such as fractures and chronic pain, may qualify as a disability if they significantly impact an individual's ability to work or carry out daily activities. In such cases, individuals may be eligible for financial assistance through the Disability Support Pension or other government support programs [37].


9. Osteoporosis Treatments

Addressing osteoporosis involves a multifaceted approach, combining medications, lifestyle changes, and supportive therapies to optimise bone health and minimise the risk of fractures. Here are some key components of osteoporosis treatment:

  • Medications: Various medications, such as bisphosphonates, hormone replacement therapy (HRT), selective estrogen receptor modulators (SERMs), and monoclonal antibodies like denosumab, can help slow bone loss, increase bone density, and reduce fracture risk [18, 19, 20, 21]. Your healthcare provider will recommend the most appropriate medication based on your specific needs and risk factors.
  • Lifestyle changes: Adopting healthy habits can play a significant role in preventing and managing osteoporosis. Consuming a balanced diet rich in calcium and vitamin D is crucial for maintaining strong bones [22]. Weight-bearing exercises, such as walking, jogging, or dancing, and resistance training can help increase bone strength and improve balance and posture [23]. Quitting smoking and limiting alcohol intake can also improve bone health [24].
  • Supportive therapies: In some cases, individuals with osteoporosis may benefit from additional therapies to manage pain and improve mobility. Physical therapy, occupational therapy, and pain management interventions can help address issues related to fractures, chronic pain, and limitations in daily activities [25].
  • Fall prevention: Preventing falls is essential for individuals with osteoporosis, as falls are a leading cause of fractures. Simple measures like removing tripping hazards, installing grab bars, and wearing non-slip footwear can help reduce the risk of falls [26].

10. Why is it Important to Correctly Diagnose Osteoporosis

An accurate diagnosis of osteoporosis is crucial for several reasons:

  • Early intervention: Timely diagnosis allows for early intervention, which can slow bone loss, preserve bone density, and prevent fractures. Early treatment can also reduce the risk of complications, such as chronic pain and disability, and improve overall quality of life.
  • Tailored treatment: A correct diagnosis enables healthcare providers to develop a personalised treatment plan that addresses an individual's specific needs, risk factors, and medical history.
  • Monitoring: Regular monitoring of bone density and response to treatment helps ensure that interventions are effective and allows for adjustments as needed to optimise bone health and prevent fractures.

11. Medical Cannabis and Osteoporosis

Recent research has suggested that medical cannabis may play a role in the management of osteoporosis. Some studies have shown that cannabinoids, the active compounds in cannabis, can stimulate bone formation and inhibit bone resorption, potentially improving bone density and reducing fracture risk [38, 39]. However, more research is needed to fully understand the potential benefits and risks of using medical cannabis for osteoporosis, and it is not currently a standard treatment option. Always consult with a healthcare professional before considering any alternative or complementary therapies for osteoporosis.


12. Tips for Managing Osteoporosis

Follow your treatment plan: Adhere to your prescribed medications and follow your healthcare provider's recommendations for lifestyle changes and supportive therapies.

Prioritise nutrition: Consume a balanced diet rich in calcium, vitamin D, and other essential nutrients for bone health. Consider supplements if you're unable to meet your nutritional needs through diet alone.

Stay active: Engage in regular weight-bearing exercises and resistance training to maintain or improve bone strength, balance, and posture.

Limit alcohol and quit smoking: Excessive alcohol consumption and smoking can both have detrimental effects on bone health. Limit alcohol intake and quit smoking to protect your bones.

Monitor your progress: Schedule regular check-ups with your healthcare provider to assess your bone density and adjust your treatment plan as needed.


13. How to Support Someone with Osteoporosis

  • Offer emotional support: Living with osteoporosis can be challenging and may lead to feelings of anxiety or depression. Listen to your loved one's concerns and offer reassurance and empathy.
  • Encourage healthy habits: Support your loved one in adopting a nutritious diet, engaging in regular exercise, and quitting smoking or limiting alcohol consumption.
  • Assist with daily activities: Offer help with tasks that may be difficult or risky due to osteoporosis, such as heavy lifting, reaching high shelves, or navigating stairs.
  • Accompany them to appointments: Offer to attend medical appointments with your loved one to provide support, ask questions, and help them remember important information from their healthcare provider.
  • Educate yourself: Learn about osteoporosis, its risk factors, and treatment options to better understand and support your loved one's needs.
  • Help create a safe environment: Assist in making their home environment safer by removing tripping hazards, installing grab bars, and ensuring adequate lighting to reduce the risk of falls.

13. Conclusion

Osteoporosis is a prevalent and serious health concern in Australia, impacting the lives of millions of people. Understanding the causes, risk factors, and symptoms of this condition is crucial for early diagnosis and intervention. By adopting a comprehensive treatment approach that includes medications, lifestyle changes, and supportive therapies, individuals with osteoporosis can optimise their bone health and minimise the risk of fractures.

If you or a loved one is suffering from osteoporosis and are interested in exploring medical cannabis as a potential treatment option, consider booking a teleconsultation with a Chronic Therapy doctor. Our experienced team can assess your eligibility for cannabis medications, and if approved, we can arrange for these medications to be delivered directly to your door. Don't let osteoporosis hold you back from living a full and active life – take control of your bone health today.


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