Osteoporosis

• Symptoms: Back pain, stooped posture, fragile bones, bone fractures
• Causes: Certain medical conditions, family history of osteoporosis, long-term use of steroids, heavy alcohol consumption, poor eating habits, not getting enough exercise
• Risk Factors: Individuals who smoke cigarettes and drink too much alcohol, women going through menopause, individuals with low-calcium and Vitamin D diet
• Severity: Mild to Severe
• Which doctor to consult: Orthopaedic

Overview:

The word osteoporosis means 'porous bones.' It is a bone disease causing the bones in the body to become brittle and weak.

The body continually absorbs old bones and forms new bones. This keeps the bones healthy and strong. But after individuals reach the age of 25, this process slows down. The bones begin to lose mineral density. Losing bone is a natural process of ageing. Sometimes the body loses more bones than it can form. This makes the bones weaker and results in osteoporosis.

The loss of bones may be due to natural causes, medical causes, or an insufficient diet. A diet low in calcium and vitamin D is one of the primary causes of osteoporosis. Women experiencing menopause also lose bone density rapidly. This makes them more susceptible to osteoporosis than men.

The disease develops slowly over the years and is often called the 'silent' disease as the symptoms appear much later in life. It can affect men and women of all ages, but individuals above fifty are more at risk.

The condition results in brittle bones that break easily. As a result, sudden movement can fracture bones. Fractures in the hip, wrist, or spine are common due to osteoporosis.

This condition cannot be cured, but there are ways to prevent the disease or manage the symptoms.

When to Consult a Doctor?

Osteoporosis symptoms go unnoticed until it's too late. If individuals experience any symptoms, which they will in the fourth stage, they should immediately consult an orthopaedic.

The typical warning signs of osteoporosis include:

• Receding gums
• Frequent fractures in bones
• Height loss
• Stooped posture
• Weak vertebrae
• Lower back pain

Diagnosis:

There are different ways to measure bone health that determines osteoporosis before any symptoms arise. Doctors usually consider family history, risk factors and the current medical condition of an individual to diagnose the disease.

Lab Tests: Doctors who suspect osteoporosis recommend a bone mineral density test, often called a bone density test. If the mineral content is high, the bone density will increase, indicating strong bones.

Doctors usually suggest bone density tests as part of regular check-ups. The test can also help to monitor the treatment of osteoporosis.

The doctor also recommends different blood or urine tests to understand markers such as enzymes, protein levels, vitamin D levels and other essential blood components. These tests help to identify other problems associated with the disease.

Treatment:

Treatment cannot cure osteoporosis or reverse bone damage. But it can prevent the further loss of bones and boost calcium to keep the bones healthy. Depending on the age, health condition, and family history, the doctor draws up the best treatment plan for the patient.

• Home Care: Changing diet and exercising regularly can manage osteoporosis at home. Home remedies, followed by medication, can prevent issues like back pain or fractures.
• Diet: Try to get daily source of calcium from food. Eat food fortified with calcium. Include low-fat yoghurt, cheese, milk, eggs, and other calcium-rich food in the diet. Vegetables like broccoli, kale, and leafy green vegetables are good sources of calcium that can be incorporated into the daily diet as well.
• Exercise: Daily exercise to avoid weight gain can help patients with osteoporosis. Also, strength training exercises to improve bone and muscle strength are recommended for patients with osteoporosis.Regular physical activity can prevent the condition of weak bones in older women and men. However, if an individual starts exercising after being diagnosed with osteoporosis, he/she should be careful with the activity plan he/she has decided to follow. The individual should find exercises that are safe for him/her and will not damage the bones further. Consulting a doctor for a proper exercise program before starting anything, is recommended.
• Things to avoid: If an individual has the habit of smoking or drinking, cutting down on alcohol consumption or cigarettes is advisable. Avoiding consuming excessive sugar or salt in daily diet is also a must.

An individuals should not practice any high-impact exercises that can increase the risk of fractures.

Medication: Different medicines like Alendronate (Binosto, Fosamax), Ibandronate (Boniva), Zoledronic acid (Reclast, Zometa), and Raloxifene (Evista) are used to treat the condition of osteoporosis.

To help build strong bones, doctors often prescribe vitamin D and calcium supplements. These are some of the primary medications that a general practitioner may also prescribe after going through the test reports.

Surgical Treatment: When options like medication, dietary changes, exercise, and other methods fail after months of treatment, the doctor may resort to surgical treatment for issues like hip fracture or spine fracture.

The two most common surgical procedures for fractures due to osteoporosis include kyphoplasty and vertebroplasty.

Kyphoplasty is a procedure used to repair damage in vertebrae. This method involves creating space in the vertebrae using a balloon-like device. This helps to bring the fractured pieces close to their original position. The surgeon then performs vertebroplasty, inserting a cement-like liquid to heal the fracture and the pain.

These procedures are minimally-invasive as they do not involve making a primary incision in the skin.

Alternative Management:

Menopausal Hormone Therapy (MHT) or hormone replacement therapy can help prevent osteoporosis symptoms. Estrogen hormone therapy, if started soon after menopause, reduces the risk of bone fractures and delays the onset of osteoporosis.

Although vitamin supplements and lifestyle changes remain the most commonly adopted treatment for osteoporosis, many individuals try alternative management for the disease.

Traditional Chinese medicines, which employs different herbs like Drynaria fortunei, Bushen Yigu and Migu, are used for treating osteoporosis.

Acupuncture is another therapy predominantly used in traditional Chinese medicines to manage osteoporosis. This therapy involves the insertion of needles through the skin at strategic points in the body. This therapy can be used alone or with herbal treatment.

Most alternative methods aim to manage osteoporosis symptoms and reduce pain.

Risks & Complications if Left Untreated

If osteoporosis is left untreated, it worsens. It increases the risk of fractures. Regular movements like bending down, bumping into a hard object, sneezing or coughing, and a sudden jerk can result in bone fractures.

Osteoporosis usually results in bone fractures in the hip or back area. A hip fracture or a fracture in the spine takes time to recover, and individuals will have to experience other problems. The age and history of health influence the process of recovery.

Additional Information

1. Stages of Osteoporosis

Osteoporosis progresses gradually, and the symptoms often remain undiagnosed until a bone is fractured. This can be prevented if the disease is diagnosed in its early stage.

Osteoporosis goes through four different stages before the disease becomes severe. The body's bone density determines the disease's condition and each stage. The different stages of osteoporosis include:

• First stage: In this initial stage, the body's bone formation and the loss of bone are equal. No significant disease symptoms exist, and the bone density score is not too low.
• Second stage: In this stage also, no significant symptoms appear except osteopenia, a condition where the body does not make new bones as quickly as it loses. The loss of bone mineral density weakens the bone. There are no visible indications of this condition. A bone density test can reveal low scores.
• Third stage: This stage is when the individual is at a high risk of fracture even from performing daily activities. There are no additional symptoms. Bone loss increases in this stage, and the bones become very weak.
• Fourth stage: This is where osteoporosis symptoms like stooped posture and back pain are visible. Due to extreme bone loss, the risk of fracture becomes high. Individuals may already have a fracture or two before reaching this stage.

2. Types of Osteoporosis

There are different types of osteoporosis that affect individuals. These types include:

• Primary Osteoporosis: This is the most common form of osteoporosis affecting elderly individuals. Middle-aged and young adults can also be at risk if they follow poor lifestyles and dietary choices.This type of osteoporosis occurs due to age and nutritional deficiency.
• Secondary Osteoporosis: This form of osteoporosis is similar to the primary, except that it occurs due to a disease or health condition. Women experiencing menopause or hormonal changes can get this condition after a few years. This form of osteoporosis is usually treated by hormone therapy.