FEW women - and men - know they have osteoporosis until they fracture a bone.

Until then they will feel no symptoms, aches or pain.

"It is common misconception that the condition is painful," said Dr Sue Knight, a consultant rheumatologist. "But it doesn't become so until a fracture occurs - then they suffer a considerable amount of pain."

Everyone loses bone as they get older.

The small struts of hard tissue within the honeycomb structure start to break down, making the bone more fragile.

But women who have been through the menopause are particularly affected because of the loss of oestrogen - the female hormone.

"Oestrogen is quite important for bone health and strength," said Dr Knight.

"But after the menopause the body hardly produces any oestrogen, resulting in more rapid bone loss."

Men can also suffer, but with a naturally stronger skeleton, it's far less common.

But for women, the combination of fragiles bones with a fall or heavy lifting can easily lead to a fracture.

Commonly affected bones include the spine, hip and wrists, which can take a long time to heal.

The frequency of breaks will vary from person to person.

But crush fractures of the spine are particularly distressing for women.

"A person can actually lose height and it can lead to having a curved spine," said Dr Knight.

"This makes it more difficult to find flattering clothes that fit well."

The most serious break is a hip fracture which affects 60,000 patients a year in the UK. Most of them are women.

Surgery is often required and a long period of convalescence is needed to regain mobility.

Macclesfield-based Dr Knight became interested in osteoporosis many years ago and is now an expert.

Osteoporosis, she stresses, is incurable.

"There are some drugs which may increase the bone density a little but they will not replace the bone already lost," she said.

But a healthy lifestyle can help prevent the condition.

"It is important that we try to change lifestyle so that people protect their bones," she said.

"People need plenty of calcium, vitamin D and exercise."

On Monday, Dr Knight hopes to increase public awareness and identify those at highest risk at an osteoporosis roadshow at Knutsford Civic Centre.

"Women who have had an early menopause and those who have been on low-dosage steroids for a long time are at high risk," she said.

Risk is also increased if a family has a strong history of osteoporosis.

Smoking, poor nutrition, heavy alcohol consumption and a slight build can also be contributory factors.

Dr Knight said HRT (hormone replacement therapy) could help to protect bones after the menopause - particularly if it had occured early in life.

"The big worry about HRT is the increase in the risk of breast cancer," said Dr Knight.

"So it is a constant balancing act between the benefits for osteoporosis and the increased risk of breast cancer."

Elderly people are also at risk because they do not absorb much calcium - essential for strong bones.

"Lack of calcium and lack of sunlight to make vitamin D makes the elderly prone to fragile bones," said Dr Knight.

"So it is important to make sure they get outside and eat a balanced diet."

But during the last 10 years the medical profession has made some exciting developments into treating debilitating osteoporosis.

Dr Knight also believes she is now in a much better position to tackle it.

"The National Osteoporosis Society has done some tremendous promotional work," she said.

"I am very optimistic that we are becoming more and more experienced to make life better for osteoporosis sufferers."

The Osteoporosis Roadshow will be held at Knutsford Civic Centre on Monday October 12 from 7.30pm.

Dr Knight and two nursing sisters will be there to answer questions and warn women of all generations about the dangers.

Dr Sue Knight: 'It is important that we try to change lifestyle so that people protect their bones'

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