Osteoporosis

Osteoporosis or porous bone, is a disorder of the bones characterized by a progressive loss of bone tissue, with a resulting increase in the risk of bone fractures.

What are the risk factors for osteoporosis?

Gender - Your chances of developing osteoporosis are greater if you are a woman. Women have less bone tissue and lose bone more rapidly than men because of the changes involved in menopause.

Age - the older you are, the greater your risk of osteoporosis. Your bones become less dense and weaker as you age.

Family history - people whose parents have a history of fractures also seem to have reduced bone mass and may be at risk for fractures.

Ethnicity - Caucasian and Asian women are at highest risk.

Life style risk factors

1. Cigarette smoking
2. Excessive alcohol
3. Caffeine consumption
4. Lack of exercise
5. A diet low in calcium
6. Use of certain medications, such as glucocorticoids or some anticonvulsants.

What are the symptoms of osteoporosis?

Osteoporosis is often called the "silent disease" because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a hip fracture or a vertebra to collapse. Collapsed vertebra may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis, or severely stooped posture.


How is osteoporosis diagnosed?

Following methods are used to diagnose osteoporsis :
1. X-ray examination - a routine x-ray examination can reveal osteoporotic bones. Unfortunately, by the time x-rays can detect osteoporosis, at least 30% of the bone mass has already been lost.

2. CT scans - Computerized tomography or CT scans are useful in evaluating the spine.

3. Bone densitometry - can be used to calculate the bone density and can detect osteoporosis earlier than routine x-rays.
Management of osteoporosis

Treatment of osteoporsis involves a multi-pronged approach. Many modalities are ususally combined to manage osteoporosis, these include :

Nutrition - A variety of minerals and nutrients are required for a balanced diet but in particlur calcium and vitamin D are needed for strong bones. Calcium supplements may be required in menopausal women and elderly.

Exercise - Exercise not only improves your bone health, but it increases uscle strength, coordination, and balance and leads to better overall health. While exercise is good for someone with osteoporosis, it should not put any sudden or excessive strain on your bones.

Estrogen - Estrogen replacement therapy (ERT) has been shown to reduce bone loss, increase bone density in both the spine and hip, and reduce the risk of hip and spinal fractures in postmenopausal women.

What could be done to prevent osteoporosis?

A combination of lifestyle changes, proper nutrition (including supplements), exercise and medications can help in prevention of osteoporosis.

1. Nutrition

Calcium- n inadequate supply of calcium over the lifetime is thought to play a significant role in contributing to the development of osteoporosis. Good sources of calcium include low fat dairy products, such as milk, yogurt, cheese and ice cream; dark green, leafy vegetables. Depending upon how much calcium you get each day from food, you may need to take a calcium supplement.

Vitamin D - Vitamin D plays an important role in calcium absorption and in bone health. It is synthesized in the skin through exposure to sunlight. Elderly and housebound people may require supplements.

2. Exercise : Like muscle, bone is living tissue that responds to exercise by becoming stronger. The best exercise for your bones is weight-bearing exercise, that forces you to work against gravity. These exercises include walking, hiking, jogging, stair-climbing, weight training.

3. Smoking : Smoking is bad for the bones as well as for your heart and lungs. Smokers also may absorb less calcium from their diets. Postmenopausal women who smoke may require higher doses of hormone replacement therapy and may have more side effects.

4. Alcohol : Those who drink heavily are more prone to bone loss and fractures.

5. Medications : Various medications are available for the prevention, as well as treatment, of osteoporosis :

Estrogen Replacement Therapy - experts recommend Estrogen Replacement Therapy ERT for women at high risk for osteoporosis

Alendronate - is a medication from the class of drugs called bisphosphonates. alendronate is used for both the prevention and treatment of osteoporosis.

Calcitonin - Calcitonin is a naturally occurring non-sex hormone involved in calcium regulation and bone metabolism. In women who are at least 5 years beyond menopause, calcitonin slows bone loss, increases spinal bone density.