I'll try to answer your questions @JinglingHellsBells.
As a little background my grandmother had a dowagers hump from her mid 70s although never formally diagnosed and never complained of any pain. She was in her mid 70s in the mid 80s. Mother developed back problems and joint issues in her mid 40s and was diagnosed in her late 40s/early50s and was put on calcium and also took HR. It is relevant that mother was a trained ballerina and professional dancer, due to wear and tear but also due to a life time of meeting weight bearing exercise. Mother is now 84 and apart from a little arthritis is as as fit as a fiddle. Noting also she is a hypochondriac and I vowed never ever to breathe a word of my own menopause. She has never had a broken bone - we would have known. Both grannie and mother were/are small - 4'11 and 5'3 respectively but not small boned.
I am 5'7" and equally large boned, (broad shoulders/hips). In my 20s I lived on the edge of an eating disorder and probably was anorexic but not diagnosed at 25/27 when I was under 7st7lb - then it's a bit hazy because I was diagnosed with Graves disease at 30 and suspect I had had it for some time because even when I ate better in my 20s it was very hard to stay above 8st/7lb. If only the same were true now. So three big risk factors.
In 2015 at 55 I had a fall and twisting my foot fractured the 5th metatarsal. Outpatients regarded it as a low impact fracture and referred me for a dexa scan which identified osteoporosis in my hips and lower back. Not horrendous but beyond osteopenic. I started oral bisphosphonates. 6 months later I had a bad fall, at I think quite high velocity, on slippery and frozen ground - I do not think it wasnlow impact but it was classed as such by medics. I wedged by more than 50% my L1 the tip of which angles onto the spinal canal meaning kyphoplasty for example was out of the question.
Because I insisted 8bdays later, dr referred me to a neurologist (same old - we don't usually refer unless pain hasn't resolbed in 10 weeks; ah what's the waiting time, oh about 10 weeks. So I had to respond "I have a professional job, are you suggesting I am potentially on sick leave for 20 weeks, receiving public money for doing nothing and may then lose my job and stop funding the NHS through taxation". Cobbily referred me but again an example of zero understanding about the importance of women working and paying tax for society.
As it was referral came through in a week and I saw a marvellous neurologist Miss Ann Mitchener. She organised further XRays and an MRI - it really helped to know exactly what I'd done and have a report re the rest of the spine which had a bit of wear and tear around L4/5. She got me referrednto a rheumatologist at a London teaching hospital where I started annual infusions of zolendronate for optimal treatment. After three years the osteoporosis returned normal readings and I am now on maintenance zolendronate every 18 months. Have had one so far with another due April.
I think it's worth mentioning that the NHS wanted to sign me off for 4 weeks over the foot and prescribe o-codamol. I had half a day off work and took four paracetamol on the first day.
Re the back on day 8 GP wanted to sign me off for 3 weeks in first instance. I was off work for 9 working days. The first week it was excruciating but the next day I had to get myself to the GP for a prescription which I did using a mini cab and walked to the pharmacy and got a cab from there. TBF not sure how I got myself off the bed and upright that day but knew I had to. Had 30/500 co-codamol for the first week with 500 naproxen night and morning. The first 3/4 days were hard. By day 6 I was gingerly loading and unloading the washing machine. On day 6 DH drove me to work to collect my car and I drove it home OK. By day 7 I was doing dd's school runs and gentle housework. Day 15 I returned to work. After e weeks tapered off the cocodamol but took narrowness for about 8 weeks.
Apologies for going on but the pain resolved quickly and mobility was quick to return but I am convinced it was because I fought through the pain and stayed mobile and therefore kept my spirits up. Also had some private physio and started a regular pilates regime. Still do three exercises every morning.
Came off HRT when zolendronate started on dr's advice.
I am sorry it's long but hope it was helpful. Something that really supported me was a backpack thread led by @MathildaTheCat - not sure if she's still around but she was bloody wonderful.
Hope you are OK BTW.