Bones are living tissue. They are constantly undergoing a state of regeneration where the old tissue bone breaks down and is replaced with new tissue.
Osteoporosis occurs when the creation of the new tissue doesn’t keep up with the loss of the old tissue. When this happens, the bones become weak and may break from a fall. In fact, very weak bones can break spontaneously or from the normal stress of standing and walking, leading to a fall (fragility fracture).
In Osteoporosis, the bone density, the amount of mineral in the bone tissue is decreased, but also the structure of bone is abnormal, which leads to increased broken bones. Bone density measurements are used to diagnosis Osteoporosis.
Osteoporosis affects men and women of all races. White and Asian women are at highest risk, especially older women who are post-menopausal and over age 65. The first few years after menopause there is a rapid decrease in bone loss because of the loss of estrogen. This loss of estrogen is what puts women at a greater risk. Men with low testosterone levels are also at increased risk of Osteoporosis and fractures.
Most bone mass is built when one is in their 20s and 30s, and as women and men get older, they gradually lose bone density over time. People who are sedentary, especially in their youth, are at risk of not building enough healthy bone and developing Osteoporosis related fractures younger than expected.
About 54 million Americans have Osteoporosis according to the National Osteoporosis Foundation. Studies show that approximately one in two women and up to one in four men age 50 and older will break a bone due to Osteoporosis.
Other health factors increasing risk of Osteoporosis are chronic kidney disease, diabetes, hyperthyroid, cigarette smoking and excessive alcohol use. Some medications that can lead to bone loss include corticosteroids, long-term heparin use, some antiepileptic drugs, and some medications used for the treatment of breast cancer that work by blocking estrogen production. Previous fractures, especially if unprovoked should prompt investigation for bone loss.
Bone breaks related to this disease are most likely to occur in the hip, spine or wrist. Breaking a bone can be a serious complication of Osteoporosis especially with older patients. Hip fractures caused by a fall can result in disability. Also, Osteoporosis affects the ability and quality of healing of a bone fracture due to the deterioration of the bone tissue.
Osteoporosis causes some patients to lose height. When the vertebrae or bones of the spine are affected it often leads to a stooped or hunched posture. Anyone who has noticed a loss in height or curving of the spine should contact their healthcare professional right away. Another clue is unexplained, unprovoked back pain along the spine.
Good nutrition and regular exercise are essential for keeping bones healthy. People who spend a lot of time sitting have a higher risk than those who are active. Activities that promote balance and good posture are beneficial for good bone health such as walking, climbing stairs, playing tennis and dancing. Improving balance, coordination and muscle strength helps reduce the risk of falling and breaking a bone. Walking as little as three to five miles a week can build bone health. Exercises like swimming and cycling, while they are good for the heart do not improve bone health.
Patients who are concerned about Osteoporosis should talk to their primary care physician about a bone density test. This is a safe and painless test that will provide your physician important information on your bone health.
The bone density test uses X-Ray to measure how many grams of calcium and other bone minerals are in a segment of bone. The bones most commonly tested are spine, hip and sometimes forearm. The higher the bone mineral content the denser the bone. The denser the bone, the stronger they are and the less likely to break.
There is a very good online calculator called a FRAX score (Fracture Risk Assessment Tool) that you and your primary care physician can use to help determine whether you need a bone density test. This test can be found at: www.sheffield.ac.uk/FRAX/tool.aspx?country=1.
Osteoporosis is a disease that can be prevented and treated but early diagnosis makes the difference. Talk to your primary care physician if you have any of the following conditions or risk factors:
Osteoporosis can be treated and reversed with appropriate medications and lifestyle changes. It does not need to sentence a person to debilitating fractures that cause pain, limit mobility and quality of life, and threaten independence. The best treatment is always prevention. A bone density screening that shows lower than normal bone mass but not yet Osteoporosis, should lead to a talk with your primary care physician on lifestyle modifications, including weightbearing exercise and supplemental calcium and vitamins, when appropriate. Home safety measures such as removing throw rugs and other slippery surfaces and if needed using walking aides are important prevention tools to reduce the risk of accidental falls and fractures.
Talk to your primary care physician about your risk factors for Osteoporosis and together you can create a plan for protecting your bones.
In addition to caring for patients at the McLeod Family Medicine Center, Dr. Lisa Lanning is a faculty member for the McLeod Family Medicine Residency Program. She is Board Certified in Family Medicine. Dr. Lanning is accepting new patients. Appointments can be made by calling (843) 777-2800.