Osteoporosis

What is osteoporosis?

The term osteoporosis is a gradual thinning of bones. In osteoporosis, the bones become weak and fragile increasing the risk of fracture. About half of all women and quarter of men who are above 50 years of age have fractures, generally on the hip, wrist and spine due to osteoporosis. Fortunately a better awareness of the condition, routine screening for the condition in high risk groups and supplementation with medication has greatly assisted in reducing complications like fractures.

What are the symptoms of osteoporosis?

Being silent in nature, an individual may have osteoporosis for decades without any symptoms. Slowly, over a period of time, a dull pain develops in the muscles or bones. The pain is prominent in the lower back and neck and coupled with vertebral collapse from micro-fractures, it leads to a peculiar stooped posture known as “dowager’s hump”. Beyond these changes, there is little other symptoms indicative of osteoporosis. It has to be diagnosed with the help of bone density scans as the symptoms are not a reliable indicator of osteoporosis.

What causes osteoporosis?

The human body maintains a balance between the formation and resorption of the bones. In osteoporotic condition, the body is unable to form new bones as well as excess old bone get resorbed. Calcium and phosphate in the body are two essential minerals that help in bone formation and maintenance of optimal bone density. With age, sometimes the body fails to absorb required minerals from the diet. Coupled with hormone-related changes, this results in gradual loss of bone, making them weak and brittle which tend to break easily.

Lowered levels of estrogen in women and testosterone in men are major cause of osteoporosis. Other possible factors which may result in osteoporosis include thyroid imbalance, bone cancer, genetic disorders, overuse of certain medications (corticosteroids and anticonvulsants) and dietary deficiencies such as low calcium in the diet.

A number of factors are responsible for increasing the likelihood of osteoporosis. In general, women at advanced age are at a greater risk than men. Women of white or Asian descent and those having thin and small frame are also at a greater risk and postmenopausal women are by far at the greatest risk of osteoporosis. Other significant factors :

  • Rheumatoid arthritis
  • Eating disorders
  • Low dietary calcium intake
  • Weight-loss surgery
  • Alcoholics
  • Heavy cigarette smoking
  • Sedentary lifestyle
  • Various diseases can contribute to osteoporosis

How is osteoporosis treated?

The treatment of osteoporosis is aimed to the prevent bone fractures by restoring bone integrity. Medication may be prescribed for easing bone pain, reducing bone loss and strengthening of the bone. Once osteoporotic, the completely building of the bone again is not possible. Therefore the early diagnosis and treatment of the condition is very important. Some of the prescribed medication for osteoporosis includes :

  • Biphosphonates: ibandronate, alendronate, risedronate
  • Calcitonin
  • Parathyroid Hormone: teriparatide
  • Raloxifene

Hormone replacement therapy (HRT) where estrogens either alone or in combination with progestin is used to prevent osteoporosis has become rare these days. Lifestyle changes, which include limiting excessive alcohol intake, quitting cigarette, regular exercise and diet balanced with adequate calcium and vitamin D is useful in the prevention and effective treatment of osteoporosis.

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