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Osteoporosis

Osteoporosis means "porous bones".

Osteoporosis causes bones to become weak and brittle, so brittle that even mild stresses like bending over, lifting a vacuum cleaner or coughing can cause a fracture. A common result of osteoporosis is fracture, mostly in the spine, hip or wrist. Although it's often thought to be women's disease, osteoporosis also affects many men.

What is Osteoporosis?

Bone is a living tissue which is continuously changing, new bone is made and old bone is broken down by a process called remodeling or bone turnover.

When you're young, your body makes new bone faster than it breaks down old bone, and your bone mass increases. You reach your peak bone mass in your mid-30s. After that, bone remodeling continues, but you lose slightly more than you gain. At menopause, when oestrogen (female hormone) levels drop, bone loss in women increases dramatically. Your risk of developing osteoporosis depends on how much bone mass you attained between the age of 25 and 35 (peak bone mass) and how rapidly you lose it later. The higher your peak bone mass, the more bone you have "in the bank" and the less likely you are to develop osteoporosis with age.

What are the Complaints of a Patient with Osteoporosis?

Osteoporosis is often called the "silent disease" because bone loss occurs without symptoms. People may not know that they have osteoporosis until a sudden strain, bump or fall causes a fracture of a vertebra (backbone) or other bone.

In the early stages of bone loss, you usually have no pain or other symptoms. But once bones have been weakened by osteoporosis, you may have complaints 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

Who Gets Osteoporosis?

A number of factors can increase the likelihood that you'll develop osteoporosis, including :

Your sex
Fractures from osteoporosis are about twice as common in women as they are in men.

Your Age
The older you get, the higher is your risk of osteoporosis. Your bones become weaker with age.

Family History
Osteoporosis runs in families. For that reason, having a parent or sibling with osteoporosis puts you at greater risk, especially if you also have a family history of fractures.

Some medications
Long-term use of some medications which are common treatments for conditions, such as asthma, rheumatoid arthritis, psoriasis etc.

Smoking
Smoking hampers the work of bone-building cells and increases the risk of osteoporosis.

Low calcium intake
Low calcium intake contributes to poor bone density, early bone loss and an increased risk of fractures.

Sedentary lifestyle
An inactive lifestyle may increase your chances of osteoporosis.

Chronic alcoholism
Excess consumption of alcohol reduces bone formation and interferes with the body's ability to absorb calcium.

Early Menopause
If you achieve menopause before age 45 due to surgical removal of ovaries.

Chronic diseases
If you are suffering from diseases like rheumatoid arthritis, hyperthyroidism, you are at a greater risk of osteoporosis. Consult your doctor for the same.

How Can Your Doctor Determine if You Have Osteoporosis?

As there are no obvious signs of osteoporosis, the only way to find out the strength of the bones is to measure your Bone Mineral Density (BMD).

The options that you have are:

  1. USG :
    It is a simple test that measures bone mineral density (BMD) at the heel and forearm. It is a screening test for osteoporosis.
  2. Dual Energy X-ray Absorptiometry (DEXA)
    It measures BMD at different parts of your body, such as your spine and hip.
    DEXA is the Gold Standard for diagnosing osteoporosis. It helps in confirming the diagnosis of osteoporosis. The test is quick and painless and uses much less radiation.

Should You Have a BMD Test?

You should consider meeting a doctor and getting a BMD test done if:

  • You are older than 65 years, regardless of risk factors.
  • You are postmenopausal and have at least one risk factor for osteoporosis, including having fractured a bone.
  • You use medications that can cause osteoporosis.
  • You have diabetes, liver disease, kidney disease, thyroid disease or a family history of osteoporosis.
  • You experienced early menopause.

What are the Complications of Osteoporosis?

Fractures are the most frequent and serious complication of osteoporosis. They often occur in your spine or hip. Hip fractures usually result from a fall. Wrist fractures due to falls are also common. In some cases, spinal fractures can occur without any fall or injury simply because the bones in your back (vertebrae) become so weakened that they begin to compress. If you have many such fractures, you can lose several inches of height as your posture becomes stooped.

Once Diagnosed, Can Osteoporosis Be Treated?

Several medications are available that can either maintain or even increase bone density, when taken in combination with calcium and vitamin D. Please ask your doctor to know more about these medications.

Living with Osteoporosis: How Can You Reduce Complications of Osteoporosis?

If you have osteoporosis, it is important not only to help prevent further bone loss, but also to prevent a fracture.

A variety of factors contribute to healthy bones.

Exercise

Exercise helps to reduce the risk of falls as it strengthens muscles, increases flexibility, and improves coordination and balance. Regular physical activity on a long-term basis maintains the benefits for bone health.

Weight-bearing exercise is good for bone health. This type of exercise includes walking, jogging, stair climbing, aerobics etc.

It is important that the exercise you choose is suited to your age and health condition. People with osteoporosis or previous fractures should consult their doctors before embarking on an exercise program.

Diet and Lifestyle

The food choices we make can have a long-term impact on health. There is good evidence that eating a healthy balanced diet can reduce the risk of osteoporosis.

Calcium & Vitamin D Requirement

  • Adults under age 50 yrs need 1,000 mg of calcium and 400-800 IU of vitamin D3 daily.
  • Adults of age 50 yrs and over need 1,200 mg of calcium and 800-1,000 IU of vitamin D3 daily.

In case your dietary intake is not sufficient to meet your daily requirements your doctor might prescribe you Calcium and Vit. D supplements.

Food Sources Rich in Calcium

Maintain a sufficient supply of vitamin D through adequate safe exposure to the sun, through diet or through supplements.

Enjoy a balanced, nutritious diet including adequate protein, and plenty of fresh fruits and vegetables for both bone and general health benefits.

Safeguard a healthy body weight, as being underweight is a risk factor for osteoporosis.

Avoid smoking as it hampers the work of bone building cells and increases the risk of fracture.

Avoid excessive alcohol consumption. as high intakes have been linked to increased risk of hip and other osteoporotic fractures.

Use salt and caffeine in moderation, as these can promote calcium loss from the body, especially if calcium intake is inadequate.

Self-Care

Fractures occur in the elderly because of skeletal fragility and increased risk of falls. Some risk factors for falls in elderly people include poor muscle strength, postural instability, visual impairment use of certain medications causing dizziness and drowsiness, and indoor and outdoor hazards. Once one fracture has occurred, the chances of having another fracture are much higher compared to someone who has not had any fractures.

Fall Prevention Tips

Do regular physical activity, including exercises for balance, strength and posture.

Use a walking aid (walker, cane) if needed for balance.

Have your eyes tested on a regular basis.

Talk to your doctor if you suffer from dizziness or feel unsteady at times. Review all medications with your doctor on a regular basis.

Wear shoes with a broad heel and nonslip soles. Choose shoes that offer good foot support.

If you wear glasses, make sure you use them as directed.

Eliminate Common Household Fall Hazards

Floors: Try to keep furniture in its usual place, remove cords, loose wires and clutter. Ensure that rugs and mats are securely fixed and smooth.

Bathrooms:
Install handrails and a nonskid mat or tape in the bathroom.

Lighting:
Keep steps, entries and halls well lit. If you get up during the night, turn on lights.

Stairs:
Ensure clear lighting, check that handrails are secure.

For More information on Osteoporosis, You May Visit the Following Links:

2. www.nof.org
3. www.osteoporosis-info.com
4. www.osteoporosisindia.com
5. www.orthoinfo.aaos.org
6. www.nos.org.uk
7. www.arc.org.uk
8. www.iofbonehealth.org
9. www.womenhealthfocus.com
10. www.familydoctor.org
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