Osteoporosis Care
Osteoporosis is the thinning of bone tissue and loss of bone density over time. It is the most common type of bone disease.
Causes and risk factors of Osteoporosis
Osteoporosis occurs when the body fails to form enough new bone, when too much old bone is reabsorbed by the body, or both. Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, your body uses these minerals to produce bones. If you do not get enough calcium, or if your body does not absorb enough calcium from the diet, bone production and bone tissues may suffer.
Other causes of osteoporosis include:
- Being confined to a bed
- Chronic rheumatoid arthritis, chronic kidney disease, eating disorders
- Taking corticosteroid medications (prednisone, methylprednisolone) every day for more than 3 months, or taking some antiseizure drugs
- Hyperparathyroidism
- Vitamin D deficiency
- White women, especially those with a family history of osteoporosis, have a greater than average risk of developing osteoporosis.
Other risk factors of osteoporosis include:
- Drinking a large amount of alcohol
- Family history of osteoporosis
- History of hormone treatment for prostate cancer or breast cancer
- Low body weight
- Smoking
- Too little calcium in the diet
Symptoms for Osteoporosis
There are no symptoms in the early stages of the disease. Osteoporosis symptoms occurring late in the disease include:
- Bone pain or tenderness
- Osteoporosis fractures with little or no trauma
- Loss of height (as much as 6 inches) over time
- Low back pain due to fractures of the spinal bones
- Neck pain due to fractures of the spinal bones
- Stooped posture or kyphosis, also called a "dowager's hump"
Osteoporosis and Treatment
Self-Care at Home
If you suspect that you have signs or symptoms of osteoporosis or have risk factors for osteoporosis, see your doctor for further evaluation and treatment.
Medical Treatment
Treatment for osteoporosis focuses on slowing down or stopping the mineral loss, increasing bone density, preventing bone fractures, and controlling the pain associated with the disease.
- Diet: Young adults should be encouraged to achieve normal peak bone mass by getting enough calcium (1,000 mg daily) in their diet (drinking milk or calcium-fortified orange juice and eating foods high in calcium such as salmon) and maintaining normal body weight.
- Specialists: People who have spinal, hip, or wrist fractures should be referred to a bone specialist (called an orthopedic surgeon) for further management. In addition to fracture management, these people should also be referred to a physical and occupational therapist to learn ways to exercise safely.
- Exercise: Lifestyle modification should also be incorporated into your treatment. Regular exercise can reduce the likelihood of bone fractures associated with osteoporosis. Some of the recommended exercises include weight-bearing exercise, riding stationary bicycles, using rowing machines, walking, and jogging. Before beginning any exercise program, make sure to review your plan with your doctor.
- Medications:
1. Estrogen: For newly menopausal women, estrogen replacement is one way to prevent bone loss. Estrogen can slow or stop bone loss. And if estrogen treatment begins at menopause, it can reduce the risk of hip fracture up to 50%. It may be taken orally or as a transdermal (skin) patch.
2. SERMs: For women who are unable to take estrogen or choose not to, selective estrogen receptor modulators (SERMs) such as raloxifene (Evista) offer an alternative.
3. Calcium for Osteoporosis: Calcium and vitamin D are needed to increase bone mass in addition to estrogen replacement therapy.
4. Bisphosphonates: Other treatments for osteoporosis are available. Bisphosphonate medications taken by mouth include alendronate, risedronate, etidronate; intravenous medications include bisphosphonate, zoledronate (Reclast). These drugs slow down bone loss, and in some cases, they actually increase bone mineral density.
Surgery for Osteoporosis
There are no surgeries for treating osteoporosis itself. However, a procedure called vertebroplasty can be used to treat any small fractures in your spinal column due to osteoporosis. It can also help prevent weak vertebrae from becoming fractured by strengthening the bones in your spinal column.
The procedure involves injecting fast-hardening glue into the areas that are fractured or weak. A similar procedure, called kyphoplasty, uses balloons to widen the spaces that need the glue. (The balloons are removed during the procedure.)
Prevention of osteoporosis
Some of the most important treatments for osteoporosis prevention include diet, exercise, and not smoking. These recommendations apply to men and women.
Authored By: Dr. S. V. Santpure
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