Decreasing levels of bone mineral density have been associated with increased risk of fracture, however, these predictions remain preliminary. Therefore, widespread bone mineral density screening to identify those at increased risk of fracture is not advised at this time. Note that osteoporosis and diet are discussed briefly in Chapter 49 and the benefits of exercise in Chapter 47 . The most common age-related fractures are those of the distal forearm, vertebrae, and hip. These fractures rarely cause death or long-term disability and most need no rehabilitation.
Vertebral fractures are the most common of the osteoporotic fractures.
Vertebral collapse is often asymptomatic and found incidentally on x-ray. In others, vertebral fracture may cause back pain which generally lasts a few months and can be managed with bed rest and analgesics. The course of spinal osteoporosis is very unpredictable. The proportion of those who are symptomatic with vertebral deformity or collapse is not known. Hip fractures are associated with more death, morbidity and medical costs than all other osteoporotic fractures combined.