What is Osteoporosis?
Osteoporosis develops when bone density decreases. The body reabsorbs more bone tissue and produces less to replace it. In people with osteoporosis, the bones become porous and weaker, increasing the risk of fractures, especially in the hip, spinal vertebrae, and some peripheral joints, such as the wrists.
Causes of Osteoporosis?
Osteoporosis occurs when there is an imbalance between new bone formation and old bone resorption. The body may fail to form enough new bone, or too much old bone may be reabsorbed, or both. Two essential minerals for normal bone formation are calcium and phosphate. Throughout youth, the body uses these minerals to produce bones. Calcium is essential for proper functioning of the heart, brain, and other organs. To keep those critical organs functioning, the body reabsorbs calcium that is stored in the bones to maintain blood calcium levels. If calcium intake is not sufficient or if the body does not absorb enough calcium from the diet, bone production and bone tissue may suffer. Thus, the bones may become weaker, resulting in fragile and brittle bones that can break easily.
Usually, the loss of bone occurs over an extended period of years. Often, a person will sustain a fracture before becoming aware that the disease is present. By then, the disease may be in its advanced stages and damage may be serious.
The leading cause of osteoporosis is a lack of certain hormones, particularly estrogen in women and androgen in men. Women, especially those older than 60 years of age, are frequently diagnosed with the disease. Menopause is accompanied by lower estrogen levels and increases a woman’s risk for osteoporosis. Other factors that may contribute to bone loss in this age group include inadequate intake of calcium and vitamin D, lack of weight-bearing exercise, and other age-related changes in endocrine functions (in addition to lack of estrogen).
Other conditions that may lead to osteoporosis include overuse of corticosteroids (Cushing syndrome), thyroid problems, lack of muscle use, bone cancer, certain genetic disorders, use of certain medications, and problems such as low calcium in the diet.
Symptoms of Osteoporosis
Osteoporosis develops slowly, and a person may not know they have it until they experience a fracture or break after a minor incident, such as a fall. Even a cough or sneeze can cause a break in osteoporotic bones.Breaks will often occur in the hip, wrists, or the spinal vertebrae for people who have osteoporosis.If a break occurs in the spinal vertebrae, it can lead to changes in posture, a stoop, and curvature of the spine. People might also notice a decrease in height or their clothes may not fit as well as they did previously.
How is Osteoporosis Diagnosed?
A doctor will consider family history and any risk factors. If they suspect osteoporosis, they will request a bone mineral density scan (BMD).Bone density scanning uses a type of X-ray known as dual-energy X-ray absorptiometry (DEXA).DEXA can indicate the risk of osteoporotic fractures. It can also help monitor a person’s response to treatment.
Two types of devices can carry out a DEXA scan:
- A central device: This is a hospital-based scan that measures hip and spine bone mineral density while the individual lies on a table.
- A peripheral device: This is a mobile machine that tests bone in the wrist, heel, or finger.
Treatment of Osteoporosis
Treatment for osteoporosis focuses on slowing down or stopping the mineral loss, increasing bone density, preventing bone fractures, and controlling the pain associated with the disease.
Some 40% of women will experience a broken bone (fracture) due to osteoporosis during their lifetime. In those who have a vertebral fracture (in their back), one in five will suffer another vertebral fracture within one year. This condition potentially leads to more fractures. This is called a “fracture cascade.” The goal of treatment is to prevent fractures.
- Diet: Young adults should be encouraged to achieve normal peak bone mass by getting enough calcium (1,000 mg daily) in their diet (drinking milk or calcium-fortified orange juice and eating foods high in calcium such as salmon), performing weight-bearing exercise such as walking or aerobics (swimming is aerobic but not weight-bearing), and maintaining normal body weight.
- Specialists: People who have spinal, hip, or wrist fractures should be referred to a bone specialist (called an orthopedic surgeon) for further management. In addition to fracture management, these people should also be referred to a physical and occupational therapist to learn ways to exercise safely. For example, someone with spinal fractures would avoid touching their toes, doing sit-ups, or lifting heavy weights. Many types of doctors treat osteoporosis, including internists, generalists, family physicians, rheumatologists, endocrinologists, and others.
- Exercise: Lifestyle modification should also be incorporated into your treatment. Regular exercise can reduce the likelihood of bone fractures associated with osteoporosis.
o Studies show that exercises requiring muscle to pull on bones causes the bones to retain, and perhaps even gain, density.
o Researchers found that women who walk a mile a day have four to seven more years of bone in reserve than women who don’t.
o Some of the recommended exercises include weight-bearing exercise, riding stationary bicycles, using rowing machines, walking, and jogging.
o Before beginning any exercise program, make sure to review your plan with your doctor.