Types, causes, symptoms, complications, diagnosis and treatment
Things You Need to Know About Osteoporosis
What is osteoporosis?
Osteoporosis is a condition where the bones become thin, fragile, brittle and prone to fractures. Literally, osteoporosis means spongy bones.
What are the effects of osteoporosis on bone?
Bones are made up of minerals, mainly calcium that is bound together by collagen fibers. The bones have a thick hard shell (cortical bone) beneath which a softer honeycomb mesh of bone (trabecular bone) resides.
Bone remodeling is a natural process of replacing old bone tissue with the new one. With progressing age, bone begins to lose a little density. However, in patients with osteoporosis, the bone loss is severe (reduced density) and the holes in the honeycomb mesh become larger (porous), thus bones become weaker and prone to injuries.
What causes osteoporosis?
Osteoporosis or bone thinning occurs when the bone loss is not adequately resorbed (mineral uptake from blood) to form new tissue.
Peak bone mineral density is achieved by the age of 30 years, after which bone remodeling becomes poor, causing more bone tissue lost versus gained. In women, estrogen plays a major role in bone remodeling. Without estrogen, women lose out more bone cells leading to thinning of the bone.
What are the types of osteoporosis?
Senile osteoporosis: Age-associated osteoporosis that usually occurs in the people of age above 70 years. In most cases, it is related to hip and vertebral body fractures.
Post-menopausal osteoporosis: As the name suggests, it occurs in women after menopause.
What are the symptoms of osteoporosis?
The early phase of osteoporosis shows no symptoms. The identifiable symptom of osteoporosis is usually a fracture from a fall or accident. Symptoms of osteoporosis generally appear only when the bones get weakened. These include:
- Back pain due to a fractured or collapsed vertebra
- Vertebral crush and shortening; loss in height
- Breathing difficulty
- Decreased height over time
- Stooping of posture
- Spontaneous bone fractures
What are the risk factors for osteoporosis?
Some factors that increase the risk of osteoporosis include:
- Body mass index lesser than 18.5
- History of amenorrhea, i.e. irregularities of periods in women
- Insufficient calcium intake
- Personal habits like smoking, excessive alcohol intake etc.
- Someone in the family having osteoporosis
- Elderly and postmenopausal women, more so those with an early menopause
- Prolonged use of medications like steroids, medicines for treating medical conditions like asthma, lupus, deficiency of thyroid deficiencies, seizures etc.
- Not ambulatory; bed-ridden, restricted to wheelchair.
- Other medical conditions such as overactive thyroid, rheumatoid arthritis, celiac disease, Crohn’s disease, type 1 diabetes, chronic kidney disease, chronic liver disease.
- Small stature and thinness of body’s frame
How is osteoporosis diagnosed?
Diagnosis is made by your orthopedist by:
- A detailed medical history
- Medical examination
- Imaging tests:
- – Dual-Energy X-ray Absorptiometry (DEXA) to measure bone mineral density
- – Digital X-ray radiogrammetry (DXR)
- – Ultrasound scans
How is osteoporosis treated?
Osteoporosis without any fragility fracture can be managed in the early stages by:
- A diet rich in calcium and vitamin D
- Medications and physiotherapy as prescribed by the orthopedist
- Preventive care for falls and accidents – checks for vision, hearing and walking ability; reviewing home circumstances and medications.
- Use of hip protectors
- A healthy lifestyle and weight management prevent or delay the progression of the disease
Osteoporosis with fragility fracture requires treatment along with the above strategies:
- Medications that prevent and treat bone loss.
- Parathyroid hormone peptides
- Calcium and vitamin D
What can I do to prevent osteoporosis?
Osteoporosis may be prevented or delayed by slowing and reducing the extent of bone loss by:
- Regular exercise – weight-bearing and muscle strengthening exercises.
- Food and diet
- Hormone replacement therapy
- Quit smoking and drinking
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Osteoporosis and Arthritis: Two Common but Different Conditions. Available at: https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/osteoporosis-arthritis. Accessed on 28th December 2017.
- Mayo Clinic. Osteoporosis. Available at: https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968. Accessed on 28th December 2017.
- Medline Plus. Osteoporosis Symptoms. Available at: https://medlineplus.gov/osteoporosis.html. Accessed on 28th December 2017.
- Patient Info. Osteoporosis. https://patient.info/health/osteoporosis-leaflet. Accessed on 19th May 2018.
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