Introduction
Osteo means bones, and porosis refers to "holes" or "porous structures." Osteoporosis is a silent health condition. It is a common and chronic metabolic bone disease that weakens the bones, making them porous and fragile, and increased fracture risk. However, it doesn't have symptoms, develops slowly over several years, and is often only diagnosed when a fall or sudden impact causes a bone to break (fracture). Broken wrists, hip fractures, and spinal fractures are the most common injuries in patients with osteoporosis.
Osteoporosis affects women and men of all races and ethnic groups at any age, while the chance of having the condition rises with age. The condition may manifest itself in many women a year or two before menopause. There are approximately nine million fractures per year as a result of osteoporosis.
“Idiopathic juvenile osteoporosis” is a rare type of osteoporosis that affects children and teenagers. The reason is unknown to doctors, but most children recover without intervention.
Causes of Osteoporosis
It develops when bone mass is lost and the structure of bone tissue changes. Certain risk factors may contribute to the development of osteoporosis or increase the chances of developing it.
-
Age- Bone loss accelerates with age, and new bone formation slows down. The bones might deteriorate over time, increasing the risk of osteoporosis.
-
Sex and Body frame- Women have a higher chance of suffering from osteoporosis since they have smaller bones, hormonal fluctuations, and a lower peak bone mass than men. However, men are still at risk, particularly after 70 years of age. People having thin bone structures and low body weight are more likely to develop osteoporosis.
-
Family history of osteoporosis or fragility fractures- Suppose one of the parents has had osteoporosis or multiple fractures, there are increased chances of developing osteoporosis and fractures in such cases.
-
Hormonal changes- An overactive thyroid gland contributes to bone loss. Additionally, dropping estrogen levels in females and testosterone in males due to age also contributes to the concern.
-
Medical condition- Specific hormonal and endocrine disorders can lead to osteoporosis. Diabetes and elevated thyroid levels (hyperthyroidism) are two common endocrine diseases. Hormones required for the correct amount of bone growth and development are disrupted in such conditions.
-
Lifestyle- Long periods of inactivity or immobilization, frequent alcohol consumption (> 4 drinks per day for men; > 2 drinks per day for women), smoking and tobacco intake, caffeine intake (> 2.5 units [e.g., cups of coffee] per day), etc. are the risk factors for developing the condition.
-
Diet- Chronic dieting, large deficits, a diet low in calcium, vitamin D deficiency increases the risk for bone loss and osteoporosis.
Diagnosis of Osteoporosis
In case of multiple risk factors for osteoporosis, it's essential to get a bone checkup done by the doctor. The doctor may ask for history and can conduct physical screening to analyze the condition. Multiple assessment tools like DEXA scan, blood test, X-ray, and BMD are used for the diagnosis.
As per WHO guidelines, a doctor can confirm osteoporosis when the bone mineral density (BMD) is 2.5 standard deviations or more below. The typical value for young and healthy females is a T-score of -2.5 SD
Table: Adapted from Who
Bone turnover markers and radiological evaluations are commonly used to identify osteoporosis in clinical trials and research rather than regular diagnosis.
Management of Osteoporosis
-
Physical therapy and Exercise
-
Walking has been shown to maintain or enhance bone density. Strengthening activities with weights or resistance bands have also been found to maintain or enhance bone density where the targeted muscle attachments are located. Maintaining bone health is critical, especially in the elderly group, because bone mass normally declines with age.
-
Balance exercises are important to reduce the risk of falls and fractures. Incorporating flexibility and strengthening exercises like yoga, tai chi, etc. can help improve overall physical function and postural control.
-
Dietary modifications
-
Eating a healthy, balanced diet, that includes fruits, veggies, food rich in calcium and vitamin D, and sufficient protein intake, can help prevent bone loss and is an essential aspect of treating osteoporosis.
-
Calcium and vitamin D are the most critical nutrients for those suffering from osteoporosis. Calcium is an important component of bone structure and vitamin D aids calcium absorption in the body.
-
Medications & Supplements
-
Medications can enhance bone density, and while these improvements may seem little, they can have a significant impact on fracture rates.
Osteoporosis can be treated in a variety of ways, including medical treatment. Daily exercise, proper diet (including appropriate calcium and vitamin D), quitting smoking, and limiting alcohol consumption is also helpful.
References-
- Jeremiah, M.P., Unwin, B.K., Greenawald, M.H. and Casiano, V.E., 2015. Diagnosis and management of osteoporosis. American family physician, 92 (4), pp.261-268.
- Sözen, T., Özışık, L. and Başaran, N.Ç., 2017. An overview and management of osteoporosis. European journal of rheumatology, 4 (1), p.46. ****
