Home :: Osteoporosis

Osteoporosis - Causes, Symptoms And Treatment

Osteoporosis, or porous bone, is a disease in which there is a loss of bone mass and destruction of bone tissue. This process causes weakening of the bones and makes them more likely to break. The bones most often affected are the hips, spine, and wrists.

Osteoporosis frequently affects the spinal column. As bone porosity increases, the vertebrae can collapse (in a compression fracture) and cause sudden and severe back pain. Gradual collapse contributes to the loss of height that comes with age. Wrist and hip fractures are also common to people suffering from osteoporosis.

There is no cure for osteoporosis, but it can be controlled. Most people who have osteoporosis fare well once they get treatment. The medicines available now build bone, protect against bone loss, and halt the progress of this disease.

Causes

Loss of bony structure and strength. Factors include:

• Prolonged lack of adequate calcium and protein in the diet.
• Long-term, excessive exercise in women.
• Low estrogen levels after menopause.
• Decreased activity with increased age.
• Smoking (possibly).
• Use of corticosteroid drugs.
• Prolonged disease, including alcoholism.
• Vitamin deficiency (especially of vitamin D).
• Hyperthyroidism.
• Cancer that spreads to bone.
• Surgery to remove the ovaries.
• Radiation treatment for ovarian cancer.
• Chronic or recurrent urinary-tract or other pelvic infection.
• Family history of osteoporosis.
• Body type. Thin women with a small frame are more susceptible.
• Genetic factors. Caucasian or Oriental women are most at risk.

Signs and symptoms

In the early stages of bone loss, you usually have no pain or symptoms. But once bones have been weakened by osteoporosis, you may have signs and symptoms that include:

• Back pain, which can be severe if you have a fractured or collapsed vertebra
• Loss of height over time, with an accompanying stooped posture
• Fracture of the vertebrae, wrists, hips or other bones

Diagnosis

• X-rays of bones and blood studies.
• A spine or hip x-ray may show fracture or vertebral collapse in severe cases.
• A spine CT can show demineralization. Quantitative computed tomography (QCT) can evaluate bone density, but is less available and is more expensive than DEXA.

Treatment

Because lost bone cannot be replaced, treatment for osteoporosis focuses on the prevention of further bone loss. Treatment is often a team effort involving a family physician or internist, orthopaedist, gynecologist and endocrinologist.

Estrogen replacement therapy (ERT) is often recommended for women at high risk for osteoporosis to prevent bone loss and reduce fracture risk. A measurement of bone density when menopause begins may help you decide whether ERT is for you. Hormones also prevent heart disease, improve cognitive functioning and improve urinary function. ERT is not without some risk, including enhanced risk of breast cancer. It should be discussed with your doctor.

Calcitonin. A hormone produced by your thyroid gland, calcitonin reduces bone resorption and may slow bone loss. It may also prevent spine fractures, and may even provide some pain relief from compression fractures. It's usually administered as a nasal spray and causes nasal irritation in some people who use it, but it's also available as an injection. Because calcitonin isn't as potent as bisphosphonates, it's normally reserved for people who can't take other drugs.

Alendronate (sold under the name Fosamax) is the first nonhormonal medication for osteoporosis ever approved by the FDA. It attaches itself to bone that's been targeted by bone-eating osteoclasts. It protects the bone from these cells. Osteoclasts help your body break down old bone tissue.

Home Treatment

• If you already have osteoporosis, avoid all circumstances that may lead to injury. Stay off icy streets and wet or waxed floors.
• Use heat or ice in any form to ease pain.
• Sleep on a firm mattress.
• Use a back brace, if prescribed by your doctor.
• Use correct posture when lifting.

Prevention

• Moderate exercise helps prevent or reverse osteoporosis by making bones thicker and stronger. Begin an exercise program before menopause and continue for life. Get clearance from your doctor before beginning.
• Ensure an adequate calcium intake-approximately 1500mg a day-with milk and milk products or calcium supplements.
• Protect yourself against falls, especially in the home.
• Consult your doctor about taking estrogen, calcium and fluoride after menopause begins or the ovaries have been removed-even if you have no signs of osteoporosis.
• Eat a well-balanced diet, especially with foods rich in calcium (like milk, cheese, yogurt, green leafy vegetables, and citrus fruit).
• Don't smoke.