5 developments that could change the future of bone health

When I was diagnosed with osteopenia at 53, I found myself trying to piece together information from lots of different places. Guidelines, research papers, news articles…there was (and still is) limited information but things are improving.

I spend far too much time reading about bone health so here are five developments from the last year that I think are worth knowing about:

1.  NICE has completely rewritten how osteoporosis risk should be assessed (29 July 2026)

NICE is the UK body that provides to the Govt independent national guidance, advice, and quality standards for health, public health, and social care. The really interesting changes aren't just the new guidelines—they're what they signal.

Key points:

• It's the first major NICE update since 2012.

• It brings fracture risk assessment, DEXA scanning and vertebral fracture detection into one guideline.

• NICE is putting much more emphasis on finding people before they fracture, rather than afterwards.

• It specifically discusses using electronic health records to identify people who should be invited for fracture-risk assessment.

• It also recognises the potential role of AI in detecting vertebral fractures that are often missed on routine imaging.

• It reminds clinicians that HRT reduces fracture risk while it is being taken and this should be considered during risk assessment. 

Link to the research https://www.nice.org.uk/guidance/ng259

Your takeaway

This feels like a real shift from reactive care to prevention. There is a part 2 coming covering drugs, exercise & calcium & vit D but not date yet on when this will be released.

2. Artificial intelligence could help diagnose osteoporosis much earlier

AI seems to be everywhere at the moment, and bone health is no exception.

Research groups across Europe and North America are developing systems that can analyse routine CT scans and X-rays for signs of osteoporosis or previously unnoticed spinal fractures.

Imagine having a scan for an unrelated problem and, without needing another appointment, your doctor is alerted that your bones may need further investigation.

We're not there yet, but the technology is developing quickly and even NICE has recognised its potential in the new guidance.

Earlier diagnosis means earlier intervention—and that's good news.

3. Treatment is becoming much more personalised

For many years, osteoporosis treatment followed a fairly standard pathway.

Increasingly, experts are moving towards a more personalised approach.

Instead of asking, "Does this person have osteoporosis?", clinicians are asking:

How high is their fracture risk?

Have they already fractured?

What treatment is most appropriate for them?

This means decisions are becoming more tailored to the individual rather than applying the same approach to everyone.

What does that mean for you? Well my advice if you don’t feel like you are being given options and most importantly if you aren’t being told about the risks of any treatment then seek a second opinion, because there are options. And as always and make sure you do your own research from accredited sources.

Link to the research:

https://academic.oup.com/jbmr/article/39/10/1393/7723496

4. We're finally recognising the importance of silent spinal fractures

Here's a statistic that surprised me.

Many vertebral fractures are never diagnosed.

Unlike a broken wrist or hip, spinal fractures don't always happen after a dramatic fall, and they don't always cause severe pain.

Sometimes people simply notice they're becoming shorter, develop persistent back pain or assume it's "just ageing."

Recognising these fractures earlier is now becoming a much bigger priority because one vertebral fracture significantly increases the risk of another.

It's another reminder that osteoporosis often develops quietly.

Link to the research:

https://www.nogg.org.uk/full-guideline/summary-main-recommendations

5. Prevention is finally taking centre stage

Perhaps the biggest change I've noticed isn't one research paper or one guideline.

It's a change in mindset.

Whether you look at the latest UK guidance, international research or new technology, the message is becoming increasingly clear:

Don't wait for the first fracture.

Assess risk earlier.

Talk about bone health during menopause.

Identify people sooner.

Help them stay active and independent for longer.

As someone who wasn't diagnosed until my fifties, I find that incredibly encouraging.

There's still plenty of work to do, but I genuinely believe we're moving in the right direction.