- Nextcare

What is osteoporosis?

Osteoporosis is a condition that causes the bones to become thin, so they break more easily.

Its name comes from the Latin for “porous bones.” If you have the disease, you are at a greater risk of sudden and unexpected bone fractures.

Osteoporosis is called a silent disease because it can develop over many years often without any symptoms or pain until a bone breaks. In some cases, the bones become so brittle that even a mild fall, coughing or sneezing can cause a fracture.

Fractures due to osteoporosis can result in chronic pain, disability, loss of independenceand premature death.

We should all be concerned about osteoporosis and mindful of the things we can do to prevent it throughout our lives.

Who is at risk of developing osteoporosis?

Osteoporosis can develop at any age but most cases are reported in older adults, especially in women. Age and gender, however, are not the only risk factors for the condition. Lifestyle choices, certain diseases and even medications can lead to osteoporosis. The following factors can increase your risk of developing osteoporosis.

Age:

Bones typically become thinner and weaker with age. After age 30, the rate at which your bone tissue dissolves and is absorbed by the body slowly increases, while the rate of bone building decreases. So overall you lose a small amount of bone each year after age 30.

Gender:

Women are more likely to develop osteoporosis than men, because women have less bone tissue, and lose bone faster after menopause.

Getting little or no exercise:

Not getting enough physical activity or too much bed rest following an injury, illness or surgery weakens bones over time.

Body size:

Petite and thin people are at greater risk of this condition because they have less bone to lose than people with larger frames and more body weight.

Nutrition:

Having a diet that’s low in calcium and vitamin D increases osteoporosis risk.

Medical problems:

Some health conditions such as hyperthyroidism, hyperparathyroidism, early menopause or diabetes put you at greater risk for osteoporosis.

Unhealthy habits:

Research indicates that smoking and consuming too much alcohol can both lead to bone loss and an increased risk of fracture. Heavy alcohol use is more than 2 drinks a day for men and more than 1 drink a day for women.

Medications:

Using certain drugs on a long-term basis can lead to bone loss. These medicines include corticosteroids such as prednisone; heparin, a blood thinner; selective serotonin re-uptake inhibitors (SSRIs), a class of antidepressants; and aromatase inhibitors, used to treat breast cancer.

Having a family history of osteoporosis:

If your mother, father or a sibling has been diagnosed with osteoporosis or has experienced broken bones from a minor injury, you are more likely to develop osteoporosis.

Ethnicity:

White and Asian women have the highest risk of osteoporosis, while African American and Hispanic women have a lower risk.

What can you do to reduce your chances of developing osteoporosis?

Osteoporosis is a pediatric disease with geriatric consequences. Peak bone mass is achieved at an early age (16-20 in young women and 20-25 in young men), so building strong bones during childhood and adolescence can be the best defense against developing osteoporosis later in life.

Preventing osteoporosis starts in childhood, when physical activity and a healthy diet rich in calcium, vitamin D, and sufficient calories build strong bones. These need to be continued throughout life, while also avoiding smoking and limiting alcohol intake.

A healthy lifestyle goes a long way in preventing and helping to treat osteoporosis.

Here are some things you can do:

Be physically active

Include weight-bearing and resistance exercise in your regular workout. Any kind of exercise that puts stress on the bones including aerobics, jogging, walking, tennis, climbing stairs, dancing and weight training can improve bone density.

Aim for at least 2½ hours a week (30 minutes a day five times a week or 50 minutes a day three times a week), or as much as you can.

Ensure you are getting enough calcium in your diet

The total daily calcium recommendation for adults is around 1,000 to 12,000 mg per day.

The best sources of calcium are:

Dairy products such as milk, cheese and yogurt – low fat ones are best
Dark green leafy vegetables such as kale, broccoli and cabbage
Calcium-fortified foods such as orange juice, cereal, bread, soy beverages and tofu products
Nuts, seeds and dried fruits
Fish that are eaten with the bones (such as tinned sardines
If you don’t eat many dairy products or calcium-enriched substitutes, then you may need a calcium supplement.

Prevent falls

Wear low-heeled shoes with nonslip soles and check your house for electrical cords, rugs and slippery surfaces that might cause you to trip or fall. Keep rooms brightly lit, install grab bars inside and outside your shower door, and make sure you can get in and out of your bed easily.

Get a Bone Density Test

A simple and quick test can measure your bone mineral density and determine if treatment is necessary to improve your bone health.

Vitamin D intake

Vitamin D is needed for the body to absorb and process calcium and there’s some evidence that osteoporosis progresses more quickly in people who don’t have enough vitamin D. Although our bodies can produce this vitamin on exposure to sunlight, taking a vitamin D supplement may be necessary to ensure the proper absorption of calcium to strengthen the bones.

Vitamin D can also be obtained from the diet (especially from oily fish) or from supplements such as fish liver oil.

Signs and symptoms

Osteoporosis often has no symptoms. Quite often the first sign that you may have it is when you break a bone in a relatively minor fall or accident (known as a low-impact fracture).

Fractures are most likely to happen at the hip, spine or wrist. Other signs you should watch out for include:

Loss of height (getting shorter by an inch or more).
Change in posture (stooping or bending forward).
Shortness of breath (smaller lung capacity due to compressed disks).
Bone
Pain in the lower

How is osteoporosis diagnosed?

Your doctor will discuss your medical history, signs, symptoms and family history. If osteoporosis is suspected a specialised x-ray to measure bone density is usually recommended.

The main test for diagnosing osteoporosis is called a DXA (dual energy X-ray absorptiometry) scan. It is a type of X-ray that measures the density of bone.

Scans are normally carried out in women over the age of 65, men over the age of 70, and postmenopausal women under the age of 65 who have other risk factors for the disease.

A DXA scan is usually taken of the spine and hips and is the best way to predict your risk of fracture as it measures the calcium content of bone, but it doesn’t directly measure the strength of the bone.

Treatment

Before your doctor prescribes medication for osteoporosis, he or she will try and reverse the risk factors. For example, if you smoke you should quit and if you drink heavily you should stop drinking.

You should also take plenty of weight bearing exercise, which is exercise during which you put your foot to the ground, such as walking as opposed to swimming or cycling.

As well as attempting to cut out risk factors, you will be advised to maximise your dietary intake of calcium and vitamin D, which are essential for bone health.

Postmenopausal women and men over 50 should be eating 1,200 milligrams of calcium a day. To guide you, a glass of milk contains 300 mg of calcium as does a matchbox size piece of cheese. A standard portion of yogurt contains between 250 and 300 mg of calcium.

Medication

There is a reasonable choice of drugs at the moment to treat osteoporosis and these are broken down into two types; those that effectively stop the breakdown of bone, and those that can build and reduce bone breakdown at the same time.

The drugs which stop the breakdown of bone are called bisphosphonates, which come in oral and injectable forms.

Other drugs which help stimulate the production of bone are called anabolic agents. One of these can be given orally, and another by a self-administered injection once a day for two years.

However the first line treatment for most patients is correcting the calcium intake through diet and possibly a calcium supplement, and the use of an oral bisphosphonate.

Outlook

Osteoporosis can be a debilitating condition. There’s no way to completely prevent it, but there are risk factors that you can be aware of.

By knowing what factors increase the likelihood of developing osteoporosis, you can take steps to reduce your risk and take an active role in building your bone health.

Did you know?

Bone mass decreases after 30 years of age, and bone loss occurs more rapidly in women after menopause.

Interesting fact

One in 5 men and 1 in 2 women over the age of 50 will develop a fracture due to osteoporosis in their lifetime and the disease can also affect children.