Bone disease is an umbrella term for conditions that cause weakened bone, loss of bone, and frequent fractures, such as osteoporosis, osteopenia and Paget’s disease of bone.
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Bone disease, or bone disorders, are conditions that cause weakened bone, loss of bone, and frequent fractures (bone breaks). While the most common disorder to affect the bones is osteoporosis, there are many other conditions that fall under the umbrella of bone diseases, including osteopenia, Paget’s disease of bone and bone cancers.
Osteoporosis and osteopenia, osteomalacia, and Paget’s disease of bone are considered to be the most important bone diseases. This is due to their prevalence, impact on bone health, and their potential to lead to serious complications such as fractures and deformities.
Osteoporosis and osteopenia are closely linked. Both occur due to low bone density, with this reduction in bone density being more severe in osteoporosis than in osteopenia.
Osteoporosis is a condition where bones become weaker and break easily, even after a minor bump or fall. The condition causes your bones to become brittle, weak and fragile to the point that even minor bumps, falls, or stresses can result in a fracture.
Similar to osteoporosis, osteopenia is a condition where your bone density is lower than it should be for your age. While osteopenia is the stage before osteoporosis, it’s less severe and does not always lead to it.
Osteoporosis and osteopenia are very common and can affect anyone, but your risk of developing them increases with age. 1 in 2 women and 1 in 5 men over 50 will experience bone breaks due to the conditions.
Osteomalacia (rickets in children) is the softening of the bones. It’s most commonly the result of vitamin D and calcium deficiency. Symptoms include bone pain, poor growth and soft, weak bones that can lead to bone deformities, including bowing of the legs. It can also increase the risk of fractures.
Paget’s disease of bone is a fairly common condition in the UK, particularly in people over 50 years old. The condition disrupts the normal cycle of bone renewal, weakening your bones, which can lead to deformity and also increases the risk of fractures. Symptoms can include bone or joint pain, warm skin over the affected bone, changes in bone shape, peripheral neuropathy, and balance problems.
Osteoarthritis is a degenerative joint disease where the protective cartilage at the ends of your bones breaks down, causing pain, swelling, stiffness and reduced mobility. It’s very common, with research suggesting that up to 80% of people over 55 have the condition. While osteoarthritis is not technically a bone disease, it can cause changes to the joint bones, and is commonly seen and treated by a specialist rheumatologist.
Osteogenesis imperfecta, or brittle bone disease, is a genetic disease that causes weak bones prone to breaking easily. It’s a rare condition, affecting around 1 in every 20,000 people worldwide. This condition is also treated by a specialist rheumatologist.
Osteogenesis imperfecta can be passed on through genes – it can be inherited from one or both parents. In some cases, the gene can also be passed on from an unexplained change (spontaneous mutation) of a gene.
Avascular necrosis, also called osteonecrosis, occurs when blood flow to one of your bones has been cut off. It can affect bone tissue in any joint, but is most common in the hips.
Fibrous dysplasia happens when abnormal scar-like (fibrous) tissue replaces healthy bone, leading to weakened, misshapen and fracture-prone bones.
Osteosarcoma, also called bone sarcoma, is a type of primary bone cancer. It usually begins in the arms or legs. It’s very rare, with fewer than 3 out of every million people developing the disease.
Osteomyelitis is a painful inflammation or swelling that occurs in the bone. It often starts as a result of an injury to the bone, but can also occur due to an infection somewhere else in the body. It can be easily treated with antibiotics, but without treatment, it can have serious long-term complications.
Myeloma, also known as multiple myeloma, is a type of blood cancer that originates in the bone marrow, arising from abnormal plasma cells. As a result of myeloma, you may have anaemia, kidney impairment, high calcium and/or bone pain. This condition is usually treated by a haematologist.
Many people will have no symptoms of a bone disorder until they experience a fracture.
Symptoms that may be present in those with bone disorders include:
painful or aching bones, especially in the back, hips and legs
joint pain and weakness
fractures from low-impact falls or bumps
curving of the spine
loss of height due to compression of vertebrae
dental problems
bowed or 'knock' knees
If you’re experiencing any of these symptoms, we recommend making an appointment to see one of our specialist endocrinologists or rheumatologists as soon as possible.
Bone disorders are caused by metabolic abnormalities as a result of factors including:
parathyroid disorders
vitamin and mineral deficiencies
calcium metabolism disorders
thyroid abnormalities
adrenal dysfunction
hormone imbalances
Risk factors that can increase your likelihood of developing a bone disorder include:
lifestyle factors – including low levels of physical activity, smoking and drinking alcohol to excess
glucocorticoid (steroid) use - medications often used to treat inflammatory conditions
genetics – gene mutations or a family history of bone disease
ageing – bone density begins to decrease with age, making them more fragile
nutrition – a balanced diet is critical to having sufficient levels of calcium and vitamin D to keep bones healthy and strong
hormonal changes – such as low oestrogen levels in perimenopause or during menopause, low testosterone or elevated cortisol
certain medications – corticosteroids, thyroid medicines, and drugs that affect sex hormones can impact bone health and accelerate the progression of bone disease
certain cancer treatments - some treatments for breast and prostate cancer can cause rapid bone loss
autoimmune conditions – bone disorders can develop as a result of conditions such as type 1 diabetes, rheumatoid arthritis and coeliac disease
At Welbeck, our consultants perform a detailed assessment of your bone strength as part of a standard assessment and a tailored treatment regimen will be discussed and offered depending on the underlying diagnosis.
Some of the tests that are used in the diagnosis of metabolic bone diseases and their cause include:
DEXA scans – a dual-energy X-ray absorptiometry scan, is a type of X-ray that measures mineral content in the bones. At Welbeck, as well as measuring your bone mineral density (bone quantity), our DEXA scans also measure trabecular bone score (TBS). This measures the quality of your bone, allowing your consultant to accurately predict your risk of bone fracture
blood test – to assess levels of calcium, phosphate, vitamin D, hormone levels, and bone turnover markers (how quickly your body makes and breaks down bone)
CT, ultrasound or MRI scans – to assess bone density and identify areas of bone loss
The most appropriate treatment depends on the type of bone disorder you have and its cause.
For high-risk osteoporosis patients, anabolic bone-building medication is available - your consultant will discuss this treatment option with you. First-line treatments for osteoporosis are directed at slowing down the breakdown of bone.
For Paget’s disease of bone, the first-line treatment is an intravenous (IV) bisphosphonate infusion called Zoledronic acid.
In many cases, a combination of a good diet, positive lifestyle changes and prescribed medications is the recommended course of treatment. It’s also important to put measures in place to reduce the risk of falls to help prevent fractures.
To help you get your medications as easily as possible, our on-site pharmacy offers a seamless prescription fulfilment process. We stock products recommended by our consultants and can promptly send your prescription after your consultation for immediate dispensing.
At Welbeck, our endocrinologists and rheumatologists are experts in their field and are dedicated to providing world-class care to every patient.
With access to colleagues across other specialities, our consultants are also able to refer within the Welbeck ecosystem if needed to ensure you receive the best possible treatment as quickly as possible, all under one roof.
All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.
Your health is important to us, so we strive to offer same-day appointments whenever possible.
Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.
A bone mineral density (BMD) test measures calcium and other minerals in your bones. The results are delivered as a ‘T-score’.
Your T-score compares your bone density to that of someone of the same sex as you, at the peak of their bone mass (in their late 20s to early 30s).
The lower your T-score, the higher your risk of bone fracture. If your T-score is more than -1, your bone density is considered normal. If it’s between -1 and -2.4, this indicates osteopenia. A score of -2.5 or lower suggests you may have osteoporosis.
There are many causes of high ALP, broadly split between bone and liver conditions. These include Paget's disease of bone, osteomalacia, and fractures.
Bone density tends to change very slowly, so in most cases, surveillance or follow-up scans are recommended every 18 months to 2 years, or sometimes even less regularly. Your consultant will recommend the most appropriate frequency depending on your individual case.
Glucocorticoids can cause a rapid loss of bone, so a bone health assessment should be done as soon as possible.
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