Osteoporosis

OSTEOPOROSIS

CONDITION

Osteoporosis is a disease in which your bones lose mass. They become porous, brittle, weak and more likely to break, even with little or no trauma. The bones of the wrists, hips and spine (vertebrae) are at greatest risk of fracture. Although men also get osteoporosis, it is four times more common in women.

NORMAL BONE
NORMAL BONE
OSTEOPOROTIC BONE
OSTEOPOROTIC BONE

The most accurate test to diagnose osteoporosis is a dual energy X-ray-absorptiometry (DEXA) scan. There is medical and surgical treatment available to help prevent and treat osteoporosis.

In the early stages of osteoporosis, there may be no symptoms. As the disease progresses, symptoms may include:

  • fractures of the spine, wrist, hip or other bones
    • a curving of the upper back called dowager’ s hump
    • loss of height
    • stooped posture, sloping shoulders and protruding abdomen
  • difficulty breathing when you have curvature of the back
  • back pain.
NORMAL SPINE                  OSTEOPOROTIC SPINE
NORMAL SPINE
OSTEOPOROTIC SPINE

CAUSES

Bone is living tissue made mostly of a soft protein framework (collagen) and a mineral (calcium phosphate) that adds strength and hardens the framework. During your lifetime, as old bone is broken down and resorbed, new bone is added. When you are young, new bone is added faster than old bone is resorbed, and your bones become larger and stronger. After age 30, however, bone is lost faster than it is replaced. In women, that loss occurs fastest in the first few years after menopause.

Some people, including Caucasian and Asian women, are at greater risk of developing osteoporosis. So are small, thin-boned women and those with a family history of the disease. Other factors that may contribute to the likelihood of your getting the disease include:

  • Poor nutrition and a diet too low in calcium. Studies show that an inadequate supply of calcium over a lifetime is associated with low bone mass, rapid bone loss and high fracture rates. Those with eating disorders such as bulimia and anorexia are therefore at increased risk.
  • Cigarette smoking. Smoking increases bone loss by lowering estrogen levels in your body.
  • Alcohol intake. Drinking too much alcohol prevents absorption of calcium.
  • Caffeine intake. Excessive caffeine intake may contribute to bone breakdown.
  • Sedentary lifestyle. An inactive lifestyle, whether by choice or because of a medical condition such as dementia or stroke that limits activity, tends to weaken bones.

In addition, some medical conditions (such as diseases of the liver, kidneys and thyroid) and certain medications (including some blood thinners, hormones, antiseizure drugs, steroids and anticancer treatments) may lead to bone loss.

A history of falls and fractures may be an indication that you have or are developing osteopenia (an early and less severe form of osteoporosis) osteoporosis.

WHEN TO CALL YOUR DOCTOR

Call 911 if:

  • You think you broke your hip, whether you fell or not.

Call your doctor right away (day or night) if:

  • You think you broke your wrist or another bone, whether you fell or not.

Call your doctor within 24 hours if:

  • You develop severe back pain, whether you fell or not.

Call your doctor during regular office hours if:

  • You need prescription medication for pain.
  • You need a prescription or a prescription refill for your osteoporosis medication.
  • You want a referral to a specialist, such as an orthopedic doctor, a neurologist, an arthritis doctor or a physical therapist.

SELF-CARE AT HOME

Take as directed any osteoporosis medications your doctor has given you.

  • Engage in weight-bearing exercise (such as walking, dancing, yoga, tennis) regularly.
  • Eat nutritious foods that are high in calcium, such as dairy products, cooked salmon, soy foods, nuts, leafy green vegetables, almonds, raisins and figs.
  • Women 19 to 50 years old should get 1,000 mg of calcium per day. Those 51 to 70 years old should get 1,200 mg per day. Menopausal women not on estrogen and those age 65 or older should get 1,500 mg per day.
  • If you do not get enough calcium in your diet, take calcium supplements. Research shows that calcium is best absorbed when taken in doses of 500 mg or less. If you need to take more, you should spread the doses out over the course of the day.
  • Vitamin D is needed for your body to absorb calcium. Getting sunlight on your hands, arms and face for 10 to 15 minutes two or three times a week will give you enough Vitamin D.
  • If you cannot get enough sunlight, take Vitamin D supplements. Up to age 50, take 200 IU per day. If you are age 51 to 70, take 400 IU per day. If you are 71 years old or older, take 600 IU daily.
  • Do not smoke.
  • Do not have more than one alcoholic drink a day (an eight-ounce glass of beer, four ounces of wine or one ounce of hard liquor)
  • Lift with your legs, not your back.
  • Try to prevent falls. Wear flat shoes, avoid walking in slippery areas and arrange your home so as to minimize the risk of falls by installing grab bars, using a rubber bath mat in the tub or shower and keeping floors clear of clutter.
  • Avoid consuming excessive amounts (more than 400 mg a day) of caffeine. A regular cup of coffee contains 200 mg of caffeine.
  • If you have dowager’s hump, see a physical therapist about use of a special harness, called a spinal weighted kypho-orthosis (WKO), that helps with this condition.
  • See your doctor regularly to make sure you are on the right medication.

For More Information

References

American College of Obstetricians and Gynecologists

  • ACOG Practical Bulletin, Number 50, January 2004
  • ACOG Precis V Osteoporosis Pages 36, 402
  • ACOG Patient Education Pamphlet, Osteoporosis, APO48, 2007

Metabolic Bone Disease and Clinically Related Disorders, Second Edition 1998 Pages 322, 388-395, 400-406, 654; Louis V. Avioili; Stephen M. Krane

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Disclaimer:

Peer-Reviewed by the Faculty of the University of Colorado Denver Department of Obstetrics and Gynecology

This content is reviewed periodically and is subject to change as new healthcare information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional