Millions of people in the UK could benefit from reduced pain and a lower risk of future bone breaks under new draft guidance from the National Institute for Health and Care Excellence (Nice).
What is the Proposed Spine Check?
The health watchdog is recommending that a swift spinal assessment be incorporated into routine bone density scans for individuals aged 50 and above. This check would be performed during a standard dual energy X-ray absorptiometry (DXA) scan, which measures bone strength.
The primary aim is to identify hidden vertebral fractures, which are common in people with osteoporosis but frequently go undiagnosed. These fractures can occur with minimal force and are often missed, yet they severely impact mobility and quality of life. Furthermore, they serve as a critical warning sign, indicating a significantly higher risk of subsequent, more serious breaks, such as in the hip.
Expanding Access to Vital Scans
In addition to the spine check proposal, Nice's draft guidance suggests automatically offering DXA scans to specific high-risk groups. This includes people who have experienced two or more fractures from minor falls, or who have suffered a break in the hip or spine.
By proactively identifying these patients, the NHS hopes to intervene earlier with appropriate treatments, such as bone-strengthening medications, to prevent further deterioration.
Expert Welcome and Call for Action
The Royal Osteoporosis Society has welcomed the draft guidance, which was published on Tuesday 13 January 2026. The charity stressed that while detection is a crucial first step, it must be followed by swift access to treatment and proper follow-up care to make a real difference to patients' lives.
The condition's severity was recently highlighted by the Queen Consort, Camilla, who revealed her mother was so ill with osteoporosis that her rib broke from a hug.
If finalised, this simple addition to a routine scan could transform the management of bone health for older adults, potentially sparing countless individuals from preventable pain and disability.
