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By Louise Drysdale, Physiotherapist

What is the difference?

Osteopenia and Osteoporosis are two conditions on a continuum. Osteopenia is explained as low bone mass and is the precursor to Osteoporosis. Imagine your bone like a sponge, with some air pockets available to absorb impact forces. Bone tissue is constantly evolving, and the quality of this spongy bone tissue can deteriorate over time as bone cells die and the rate of new bone cell development is lesser.  A DXA scan (bone density scan) must be had to diagnose these conditions and is usually ordered by your GP. Osteoporosis typically affects peri and post-menopausal women, however men and women of all ages can experience issues with bone density.

What do my DXA results mean?

Ultimately, your GP should explain your results to you after having a DXA scan. Usually a Z-score and a T-score are reported on your results. These compare your own results to different normative data. T-scores are a comparison of your results to a normal 30-year-old woman, which is helpful… if you are a 30-year-old woman OR if a diagnosis of osteopenia/ osteoporosis is made it can describe the severity. In other situations, a Z-score is more useful, because it is a comparison of your result to someone of the same sex and age. Both T-scores and Z-scores are expressed as a standard deviation (s.d.) from 0.

In the diagram below, 0 is right on average and the classification windows for osteopenia and osteoporosis are also pictured.

You may also have results for different body areas, commonly the hip (femur) and lumbar spine. Often whole-body bone mineral density is also reported.

What if I have low bone density?

Essentially, those with low bone density may be at higher risk of bone fracture. You may have been referred for the scan in the first instance because you have experienced previous fractures. Your GP should discuss treatment options with you, including dietary intervention (usually to improve your intake of calcium and Vitamin D), they may take blood tests to check for hormone levels that influence bone health and discuss other contributing factors. In some cases, specific medication is prescribed to prevent further decline in bone density. Bone building (osteogenic) exercise is also recommended.

What about Physiotherapy?

Physiotherapists can prescribe safe and effective exercise to stimulate bone and prevent further decline in bone mineral density. The best type of exercise for bone health includes lifting weights and jumping type activity. For older people, this may not be the first port of call, especially if you haven’t exercised regularly for a long while. However, slowly progressed exercise of this nature guided by a health professional can be safe and highly beneficial.

What about swimming and cycling?

Unfortunately, due to the low/ non- impact nature of these activities swimming and cycling aren’t very useful for stimulating bone. They can improve cardiovascular fitness and muscular endurance, but resistance training should be part of your exercise routine if you are looking to enhance bone density.

Other resources

If you would like to learn more about Osteopenia, Osteoporosis and related conditions, head to

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