A woman's seemingly minor injury during a Pilates class led to the discovery of osteopenia and a concerning lack of access to vital bone health services within the NHS. This story highlights the importance of recognizing fragility fractures and seeking early diagnosis and treatment to prevent osteoporosis.
I was kneeling on my mat in a Pilates class.
‘Now let’s move into a bird-dog rotation,’ said the teacher. I dutifully copied her, bringing one knee to the opposite elbow and out again, until... Ouch. The strangest sensation shuddered in my lower back.
What had I done? Something definitely wasn’t right. I sat out the rest of the class and assumed I’d pulled a muscle. Little did I know this was the point at which I fractured my spine.
I was 62 at the time, and it was the start of years of agony before finally an investigation concluded I had poor bone density or, to give it its medical name, osteopenia. It is very far from usual to sustain a fracture doing Pilates, of course. But when your bones are losing density, almost anything can trigger a stress fracture. A simple twist, even a sneeze.
The fact is, I should have known that my bone health was poor, but I didn’t. In 2019 – three years before that Pilates class – I’d tripped over my trousers and face-planted into a kerb. It was a small fall, yet I fractured both arms and had to undergo extensive surgery on my right wrist.
I now know these are called ‘fragility fractures’– the type that come from minor falls that shouldn’t break bones, and they’re a strong sign that bone density is compromised. Indeed, according to NHS guidelines, if you’ve broken a bone from a minor fall and are aged 50 or over, you should be referred to the local fracture liaison service for further tests.
If osteopenia is found, treatment can be started to stop it turning into the more serious osteoporosis, where bone loss is advanced and breakages can be catastrophic. But that didn’t happen to me in 2019. In fact, it transpires that my hospital in Devon doesn’t have a fracture liaison service. According to the Royal Osteoporosis Society, only half of NHS trusts do, making diagnosis and treatment of poor bone density the subject of a horribly unfair postcode lottery.
The Royal College of Physicians estimates that 90,000 people are in the same boat –unaware that they have osteopenia and are therefore at very high risk of osteoporosis with all its nasty implications for future quality of life. The weeks that followed that Pilates class in 2022 were agony. My back kept going into spasm and I was living on painkillers. With the benefit of hindsight, I should have sought medical help.
However, I didn’t go to my GP at the time because I thought my problem was purely muscular, and eventually, after several months, the pain eased off and I got back to normal life, albeit cautiously. Of course, the serious, yet hidden, weakness of bone loss remained. A year later, in 2023, I picked up a skipping rope at a circuits class, took one skip and felt that telltale ‘wrongness’ in my back again. The spasms returned.
I confess I didn’t go to my GP that time either. I didn’t think they could do much and, like many people, I didn’t want to ‘overburden’ the NHS. The following year, in April 2024, I was helping a friend move and, you’ve guessed it, my back went into spasm again. This time was the worst of all.
I couldn’t walk or even stand for very long and the pain was terrifying. So, this time I made an appointment with my GP the following month hoping I could get some stronger pain relief and was referred to the practice physio who got me on codeine, and booked me in for an X-ray. That’s when I found out I had several fractures of the thoracic spine – the middle section.
‘No wonder you were in such pain,’ my GP said. ‘You’ve been walking round with a broken back! ’ And then, finally, the magic words: ‘We need to talk about bone density scans and treatment. ’ My DEXA scan (a low-dose X-ray scan that measures bone strength and mineral density) showed I was only a hair’s breadth away from full-blown osteoporosis.
I was prescribed a calcium and vitamin D3 supplement and told the scan would be repeated in a few years. Two years after the Pilates class, I visited the GP and was told I had been walking around with a broken back It really shook me. If you can’t rely on your bones, your very foundation, the world feels precarious. I was terrified of falling again, petrified of my back going into spasm.
My faith in the NHS also faltered. Was a vitamin and mineral supplement really enough? I decided to get a second, more detailed and comprehensive investigation, and booked an evaluation at private London health clinic Reborne Longevity. They ran blood and urine tests and gave me a DEXA scan that offers full body scanning (not just looking at bone density but also at the breakdown of fat, muscle, and bone in arms, legs and trunk).
And here the diagnosis was again terrifying.
‘You’re one-tenth of a point away from osteoporosis and have a high risk of future fracture,’ said Dr Hind Abdulkader, one of the clinic’s GPs
Osteopenia Osteoporosis Bone Density Fragility Fractures NHS Fracture Liaison Service
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