Osteoporosis

What is Osteoporosis?
Osteoporosis, or porous bone, is a disease in which bones become weak and fragile. Left untreated, osteoporosis can progress silently until a bone breaks. The good news is that there are steps you can take to prevent bone loss and decrease your risk of experiencing the disabling consequences of osteoporotic bone fractures.

It is easy to think of bones as hard, lifeless parts of the body. But in fact, bone is living, growing tissue. Throughout life, bone is constantly being formed and broken down, a process called bone remodeling. Early in life, more bone tissue is added than taken away. Later in life, however, the scale tips the other way, and old bone is removed faster than new bone is formed. This results in a loss of bone density and bone strength.

Bone loss begins as women move toward midlife and menopause and overall, women lose about one-third of their bone density between menopause and age 80. Men also experience bone loss with aging, but bone loss usually occurs more slowly in men than in women. However, one third of all hip fractures caused by osteoporosis occur in men.

Bone loss is a natural part of aging in all people but when it is severe, bones become fragile and at risk for fracture. The two most common sites for osteoporotic fracture are the hip and the vertebrae of the spine. Bone loss may actually increase with advancing age. This increase in bone loss may partially explain the increased risk of fractures in the elderly.

Scope Of The Problem
Osteoporosis is a major public health threat for more than 44 million Americans aged 50 or older. In the United States today, 10 million people already have osteoporosis. Approximately eighty percent of these people are women. Another 34 million people have low bone mass, placing them at increased risk of osteoporotic fractures in the future.

What are the Symptoms of Osteoporosis?
Osteoporosis is often called a "silent disease" because bone loss usually occurs without symptoms. People may not know they have this disease until their bones become so fragile that a sudden strain, bump or fall causes a bone to break. It is not uncommon for the first spine fracture to go unnoticed as it may not cause any symptoms. However, once a spine fracture happens, the risk of subsequent spine fractures becomes much higher. These multiple fractures can lead to chronic back pain, loss of height and stooped posture as a result of the spinal deformities.

How is Osteoporosis detected?
A Bone Mineral Density (BMD) test of the spine and hip is the most accurate way to measure the strength of your bones. This bone density test is a simple, painless procedure that can determine the presence and the severity of osteoporosis and can be used to predict the future risk of developing osteoporosis and fractures. Your healthcare provider may ask that you repeat the BMD test in the future to assess your response to therapy. Subsequent BMD tests, when performed at the spine or hip, can be used to monitor the treatment for osteoporosis. The effectiveness of treatment is best monitored by measuring bone density when treatment begins and again after 2 years of therapy. It is important that a repeat test be done with the same bone density machine if possible.

How is Osteoporosis treated?
There are five key elements in preventing and treating osteoporosis:

• Getting enough calcium and vitamin D with diet and supplements

• Doing weight-bearing exercise (such as walking) several times a week

• Limiting your use of substances harmful to bone such as alcohol, caffeine and smoking

• Correcting medical problems that promote bone loss such as Vitamin D deficiency

• Drug therapy when necessary to stop bone loss and reduce fracture risk

It is in your best interest to prevent and treat osteoporosis before a bone fracture occurs. Learning if you are at risk is the first step in preventing or limiting the severity of the disease. Talk to your healthcare provider about what is best for you.

What are the Risk Factors for Osteoporosis and Osteoporotic Fractures?
Certain genetic and environmental situations may increase your risk of osteoporosis and fractures such as:

• Low bone density
• Broken bone from a minor fall or injury after age 45
• Age greater than 65 years
• Low body weight (less than 127 pounds)
• Family history of fractures, especially a maternal history of hip fractures
• Early menopause (before age 45)
• Prolonged absence of menstrual periods
• Cigarette smoking
• Sedentary lifestyle - little or no exercise
• Excessive alcohol intake (more than 2 drinks per day)
• Use of certain medications, such as anti-convulsants, corticosteroids, thyroid hormone
• Height loss more than 2 inches
• X-ray that indicates low bone mass