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Osteoporosis
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Osteoporosis is characterized by low bone mass. It is a condition that makes the bones weak and brittle, thus making them more prone to fractures. In advanced osteoporosis, something as innocuous as bending over or coughing can cause a fracture. Fractures often occur in the spine, hip or wrist. Osteoporosis affects about 8 million American women and 2 million American men. About 18 million Americans may have low bone density, the underlying cause of full-blown osteoporosis.
Symptoms
Who Gets Osteoporosis?
Causes
Diagnosis
Treatment
Additional Information
Symptoms
Often, the first sign of osteoporosis is a bone fracture. There are no signs in the early stages of bone loss, but once osteoporosis develops, a person they may experience one of more of the following:
- Back pain- A regular or persistent backache occurs in people with osteoporosis because small sections of their spine collapse over time.
- Loss of height over time - A loss of more than 2 inches may mean a person is experiencing spinal crush fractures brought on by osteoporosis.
- Stooped posture, known as Dowager's hump - This is a protrusion in the upper back. The collapse of vertebrae causes your head to move forward, shortening the chest area and reducing lung capacity.
- Stooped posture and other spinal deformities.
- Recurrent bone fractures, especially of the vertebrae, wrists, hips or other bones
Who Gets Osteoporosis?
About 10 million Americans have full-blown osteoporisis, and some 18 million have low bone density, the major risk factor for developing osteoporosis. Although, both men and women may get osteoporosis as they age, it is most common in post-menopausal women. Women have less bone mass than men and lose it at a much faster rate than men do. Caucasian or Asian women also are more likely to have osteoporosis than African American or Hispanic women. One out of every two women and one in eight men over 50 will have an osteoporosis-related fracture in her or his lifetime. Osteoporosis is responsible for more than 1.5 million fractures annually, including 300,000 hip fractures, approximately 700,000 vertebral (spinal) fractures, 250,000 wrist fractures, and more than 300,000 fractures at other sites, according to the National Institute of Arthritis and Muscloskeletal and Skin Diseases (NIAMS).
In the presence of osteoporosis, fractures can occur from normal lifting and bending, as well as from falls. Osteoporosis is genetic, so children of parents with osteoporosis are more likely to have it. People who smoke or drink excessively are more prone to osteoporosis. Also, people who use steroids for longer than six months have an increased risk of developing osteoporosis. Most men who develop it had a long-term treatment with steroids.
Causes
Osteoporosis is linked to the natural process of aging. Women produce less estrogen when they reach menopause and men produce less testosterone as they get older. Both hormones help prevent osteoporosis. Loss of bone mass begins at age 30 and if a person does not have enough bone mass by then he or she may be at a higher risk for osteoporosis. Lack or deficiency of calcium and phosphorous, two minerals that are essential for building bones, are also linked to osteoporosis. Vitamin D deficiency can also contribute to the development of low bone mass. People who suffer from anorexia are more prone to osteoporosis, as are people with small frames. Sedentary lifestyle can exacerbate the condition.
Diagnosis
Osteoporosis is detected through a bone-density test. There are two common tests for bone density, a Dual Energy Absorptiometry or a Sonometer test. The first is an X-ray test that can show thinning bones, but by the time osteoporosis is evident in X-rays, bones are weak and the disease is at an advanced stage. The Sonometer sends sound waves through the bones to detect density. The less dense a bone is, the faster the waves will pass through it. The National Osteoporosis Foundation recommends screening for all women who have risk factors for osteoporosis. Some of these risk factors include a family history of osteoporosis, taking certain medications like corticosteroids and postmenopausal women older than 65 who have never had a bone density test before.
Treatment
Treatment of osteoporosis requires both medication and lifestyle changes.
Calcium, vitamin D, and protein Calcium supplements and low doses of vitamin D have been shown to reduce the risk of hip fracture in elderly women living in nursing homes (who are often vitamin D deficient). In addition, calcium and vitamin D supplementation is often part of the treatment regimen for osteoporosis in younger patients. Sufficient protein intake is mandatory to help maintain muscle function and bone mass.
Exercise Regular strength training has been shown to help maintain and build up bone mass. Exercise helps develop stronger muscles, better balance and agility, which can help in fall prevention. The type of exercise should be tailored to the individual's needs and abilities. People with osteoporosis must take special care when exercising to reduce the risk of fracture due to impact or falls.
Antiresorptive Drugs Hormone replacement therapy (HRT) is the one of the best ways to prevent osteoporosis in women. The approach, however, can have considerable side effects, which include increased risk for stroke and heart attack. Before recommending HRT, a doctor must carefully evaluate the potential benefits against the possible side effects for each patient.
Additional Information
The National Insitute of Arthritis and Muscloskeletal and Skin Diseases at http://www.niams.nih.gov
The Arthritis Foundation at http://www.arthritis.org
The National Osteoporosis Foundation at http://www.nof.org
International Osteoporosis Foundation at http://www.osteofound.org
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