Osteoporosis is a condition characterised by weakened bones, making them fragile and more prone to fractures. It develops when the creation of new bone tissue doesn’t keep up with the removal of old bone tissue. While osteoporosis can affect any bone in the body, fractures most commonly occur in the spine, hip, and wrist.
Causes of Osteoporosis
Here are what causes osteoporosis:
- Ageing – As people age, bone density naturally decreases, increasing the risk of osteoporosis.
- Hormonal Changes – Reduced estrogen levels in women after menopause and decreased testosterone levels in men can contribute to bone loss.
- Low Calcium and Vitamin D Intake – Inadequate intake of calcium and vitamin D, essential for bone health, can lead to weakened bones.
- Physical Inactivity – Lack of weight-bearing exercise can result in bone loss and weaken bones.
- Certain Medications – Long-term use of corticosteroids and certain medications used to treat other conditions can increase the risk of osteoporosis.
- Medical Conditions – Certain medical conditions like rheumatoid arthritis, celiac disease, and hyperthyroidism can affect bone health.
Risk Factors for Osteoporosis
What are the risk factors for osteoporosis? Here’s a list:
- Age – Risk increases with age, especially after menopause in women and after age 50 in men.
- Gender – Women are more likely to develop osteoporosis than men.
- Family History – A family history of osteoporosis or fractures increases the risk.
- Body Weight – Being underweight or having a small body frame increases the risk.
- Smoking and Alcohol – Smoking and excessive alcohol consumption can weaken bones.
- Certain Medications – Long-term use of corticosteroids and some other medications can increase the risk.
Symptoms of Osteoporosis
Osteoporosis is often called a “silent disease” because it progresses without symptoms until a fracture occurs. Common symptoms include:
- Fractures – Fragility fractures, especially in the spine, hip, and wrist, are often the first sign of osteoporosis.
- Loss of Height – Over time, compression fractures in the spine can cause a gradual loss of height and a stooped posture (kyphosis).
Diagnosis of Osteoporosis
Here are what is used to diagnose osteoporosis:
Bone Density Tests
- Dual-energy X-ray Absorptiometry (DXA) – This test measures bone mineral density (BMD) and is the gold standard for diagnosing osteoporosis.
- Quantitative Ultrasound – An alternative to DXA, particularly for peripheral bone density testing.
Fracture Risk Assessment
- FRAX® – A tool used to calculate the 10-year probability of a major osteoporotic fracture or hip fracture based on various risk factors.
Osteoporosis Treatment and Management
Medications
- Bisphosphonates – These drugs slow bone loss and reduce the risk of fractures.
- Calcium and Vitamin D Supplements – Important for bone health, particularly in individuals with low dietary intake or absorption.
- Hormone Therapy – Estrogen therapy for postmenopausal women can help prevent bone loss.
- Other Medications – Depending on individual factors, other medications may be prescribed.
Lifestyle Changes
- Dietary Changes – Consuming a balanced diet rich in calcium and vitamin D.
- Weight-Bearing Exercise – Regular weight-bearing and muscle-strengthening exercises can help maintain bone density and strength.
- Fall Prevention – Taking measures to prevent falls, such as removing tripping hazards and installing handrails.
- Smoking Cessation and Limiting Alcohol – Quitting smoking and limiting alcohol intake can help preserve bone health.
Monitoring
- Regular Follow-up – Periodic bone density testing and assessment of fracture risk.
- Medication Review – Regular review of medications and potential side effects on bone health.
Prevention of Osteoporosis
- Dietary Calcium and Vitamin D – Adequate calcium and vitamin D intake through diet and supplements.
- Weight-Bearing Exercise – Engaging in regular weight-bearing and muscle-strengthening exercises.
- Fall Prevention – Minimise fall risks at home and wear appropriate footwear.
- Healthy Lifestyle – Avoid smoking, limit alcohol intake, and maintain a healthy weight.
Osteoporosis is a serious condition that can have significant consequences, but with early diagnosis, appropriate treatment, and lifestyle modifications, its progression can be slowed, and fractures can be prevented. It’s essential for individuals, particularly those at risk, to prioritise bone health through proactive measures and regular monitoring.
