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Osteoporosis

 

What is Osteoporosis?

Osteoporosis, also known as degenerative joint disease, is a bone disease that leaves your bones fragile and brittle. Young, healthy bones constantly make new, strong tissue when you lose it. With osteoporosis, your body doesn’t create new bone tissue fast enough to replace the old, dying tissue. This leads to your bones becoming less dense and lack the structural support needed to support your body and absorb impact. When you fall or take a blow to a part of the body, your weakened bones are more likely to fracture or break.

Osteoporosis develops gradually over many years. It is classified into four stages, ranging from normal bone density and development (Stage 1) to severe, physically noticeable bone loss and deformities (Stage 4). As you hit more serious stages, your risk of fractures rises – even from minor falls or normal movements.

Causes and Risk Factors of Osteoporosis

Some bone density loss is normal. As we age, our body produces less bone tissue. By the time you turn 40, your body is probably losing more bone tissue than it’s producing.  How likely you are to develop osteoporosis can depend on how much bone mass you attained in your youth. Bone mass is genetic and varies by ethnic group. The more bone mass you have, the less likely you are to develop osteoporosis. Some factors, like genetics and ethnicity, are factors that you cannot control that put you more at risk for developing osteoporosis. Others include:

  • Sex – women are much more likely to develop osteoporosis.
  • Age – the older you are, the more likely you will develop osteoporosis.
  • Race – People of white or Asian decent are at greater risk.
  • Family history – people with a family history of osteoporosis, especially a parent or sibling, puts you more at risk. People whose mothers have had a hip fracture are also more at risk.
  • Body frame – smaller body frames tend to have a higher risk due to less bone mass.

Hormone levels can also be a contributing factor in developing osteoporosis. Lowered sex hormones can weaken bones, especially the fall in estrogen levels in women at menopause. Other treatments for prostate cancer or breast cancer can significantly lower these hormones and lead to a greater risk. Too much thyroid hormone due to overactive thyroid can also cause bone loss.

Certain dietary factors can make someone more at risk for developing osteoporosis. Calcium, which contributes to bone strength, can play a role in the development of osteoporosis if levels are too low. This also contributes to diminished bone density, early bone loss and an increased risk of fractures.

Some medical conditions and medications used to treat those conditions can be a contributing factor in the development of osteoporosis:

  • Celiac disease
  • Inflammatory bowel disease (IBD)
  • Kidney or liver disease
  • Cancer and medications used to treat cancer.
  • Rheumatoid arthritis
  • Seizures and medications used to treat them.

Lastly, certain lifestyle habits can greatly increase your risk, including:

  • Inactive lifestyle – those who spend a lot of time sitting rather than being active have a much higher risk of development. Any exercise, especially weight-bearing, promotes healthier bones, good balance, and posture.
  • Smoking and excessive drinking – Both cigarettes and excessive alcohol use decrease the amount of calcium your body absorbs, which affects bone health.

Symptoms of Osteoporosis

Osteoporosis happens silently and slowly inside your body. You don’t notice any signs of bone density loss or have a sense that your bones are weaker. Most times, the only way you find out you have osteoporosis is after you break a bone. Breaking or fracturing a bone from something that wouldn’t normally have a huge impact can also be a sign of osteoporosis.

Sometimes, there are noticeable physical changes that can indicate the development of osteoporosis, including:

  • Back pain, especially lower back pain.
  • Loss of height over time.
  • Stooped posture.
  • Bones that break easier than expected.

Diagnosing Osteoporosis

Your provider will perform a physical examination and review your medical history during your evaluation. A bone density scan will be performed to help with the diagnosis.

A bone density scan is the primary form of diagnosing osteoporosis and determining your risk for bone fractures. This scan, also called a dual-energy X-ray absorptiometry or DEXA scan, uses a small dose of ionizing radiation to measure the amount of calcium and other minerals in your bones. The more minerals present, the more energy absorbed by the bones, showing the level of density. This scan often takes less than 30 minutes and is noninvasive.

Your provider will review the bone density scan results and tell you whether you have normal bone density, low bone density or osteoporosis.

Treatment for Osteoporosis

The first step in treating osteoporosis is reversing the trend of bone density loss. While you can’t reverse the effects of aging, you can still change other factors that contribute to bone weakness:

  • Exercise regularly – Light, weight-bearing exercises like walking, pilates and yoga help to strengthen your bones and the muscles around them without stressing them.
  • Quit smoking and drinking – both cigarettes and alcohol decrease the amount of calcium that your body absorbs.
  • Maintain healthy eating habits – excessive or restrictive dieting can leave you deficient in the minerals, vitamins and protein your bones need.
  • Take vitamin and mineral supplements – your provider may recommend certain vitamins or minerals you need to take to encourage healthy bones.

Depending on the severity of your osteoporosis, your provider may also prescribe other treatments to build back your bone density. The right treatment for you depends on what factors are causing your bone density loss. Common treatments include:

  • Hormone therapies for low estrogen or testosterone levels.
  • Injections to reduce your risk of fractures.
  • Bone-building medications for severe cases.

Your healthcare provider is an important partner in managing osteoporosis throughout your life. It can also help you prevent osteoporosis long before a diagnosis. Bone density scans are an important screening tool to monitor your bone health. If you are 50 years or older and have recently broken a bone, have a history of fractures, know family members with osteoporosis or have a health condition that causes bone density loss, contact your healthcare provider. From there, they will assess your risk to determine whether bone density testing, or other osteoporosis treatments are right for you.