Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to more porous bone, and consequent increase in fracture risk. It is the most common reason for a broken bone among the elderly.Bones that commonly break include the vertebrae in the spine, the bones of the forearm, the wrist, and the hip. Until a broken bone occurs there are typically no symptoms. Bones may weaken to such a degree that a break may occur with minor stress or spontaneously. After the broken bone heals, the person may have chronic pain and a decreased ability to carry out normal activities.
Primary osteoporosis :-
Primary osteoporosis has no known definite cause, but there are many contributing factors associated with the disorder. These include prolonged negative calcium balance, impaired gonadal and adrenal function, oestrogen deficiency, or sedentary lifestyle.
Types of primary osteoporosis:-
Postmenopausal osteoporosis is associated with increased bone loss due to decreased production of oestrogen.Women commonly lose 1% per year after peak bone density has been met, for up to 8 years after menopause.
Senile osteoporosis is an age-related bone loss that often accompanies advanced ageing.
Idiopathic juvenile osteoporosis
Secondary osteoporosis :-
Secondary osteoporosis is caused by prolonged use of medications or secondary to another disease or condition which inhibits the absorption of calcium or impedes the body’s ability to produce bone.
Low calcium intake or absorption can greatly increase one’s risk of developing osteoporosis. Life-long calcium intake is crucial in building up bone stock prior to peak levels of bone mass, as well as to maintain bone mass after the age of 20. Excessive alcohol consumption can decrease the body’s ability to absorb calcium.
Bone responds to the load applied to it. Physically active individuals typically have higher bone density, than those who have a sedentary lifestyle.
Hormone levels, either too little or too much, can impede the body’s ability to produce and maintain adequate bone mass. Dysfunction with sex glands, thyroid, parathyroid, or adrenal glands is often associated with osteoporosis.
Types of secondary osteoporosis :-
Endocrine origin
Hypogonadism/Hypogonadal state
Hypercortisolism
Hyperthyroidism
Hyperparathyroidism
Hyperprolactinemia
Diabetes mellitus
Gastrointestinal diseases
Chronic inflammatory bowel disease
Malabsorption/Deficiences
Malnutrition
Primary biliary cirrhosis
Lactose intolerance
Rheumatological and connective tissue diseases
Inflammatory diseases
Hematological and neoplastic disorders
Medications –
eg.Glucocorticoids, Chemotherapeutic/transplant drugs, Anticonvulsants
Immobilisation
Chronic alcoholism
Organ Transplantation
Genetic/congenital – eg. Marfan syndrome, Osteogenesis imperfecta, Glycogen storage disease, etc.
Complications of osteoporosis :-
Osteoporosis also poses a series of threats to both your bone and overall health. Here are just a few of the problems this disease can cause.
Frequent fractures
As your bones erode, there’s not much stopping them from snapping unexpectedly. The flexibility and strength that made them capable of bearing extreme stress has all but disappeared. The most unassuming action, like a simple misstep, could result in a broken bone.
Osteoporosis-related fractures happen most frequently in high-impact, load-bearing areas like your hip, wrist, and spine.
Unexplained pain
There are lots of reasons why you might experience pain — from an irritated nerve to a sore muscle, for example.
When you have osteoporosis, however, your pain stems from a broken bone. Even a small fracture can cause a significant amount of pain. Because this can happen at any time, you might not know that a fracture is the reason you’re in pain.
Loss of height
Much of your stature comes from your spine. As osteoporosis slowly deteriorates your bones and breaks down your vertebrae, you’ll notice that you’ve lost an inch or two in height.
Posture problems
With healthy bones, you’re able to bear your body weight and stand tall. As osteoporosis develops, the spine and other parts of your skeleton buckle under the pressure, giving you a stooped posture.
Treatment :-
There is no cure for osteoporosis, but the symptoms of your disease can be managed with medicines and lifestyle changes.
Depending on your age, sex and medical history, your doctor will recommend different treatments to help you.
The aim of treatment is to:
strengthen your bones so that they are less likely to break
prevent falls that could damage your bones
Your doctor may complete an osteoporosis risk assessment to help decide which treatment would be best for you.
You should be able to continue to work when you have osteoporosis.
Even after getting an osteoporosis diagnosis, many Australians don’t get treatment.
Changing your lifestyle :-
Lifestyle changes you can make include:
exercise can strengthen your bones and muscles
stop smoking
eating a healthy diet with plenty of calcium-containing foods, such as dairy products
having moderate exposure to sunlight (but avoid sunburn) so you get enough vitamin D
Your doctor or physiotherapist can help you build a safe exercise plan which:
suits your needs, reduces your risk of fracturing your bones
Medicines :-
If you have osteoporosis, you doctor may recommend medicines to strengthen your bones. These medicines can include:
Bisphosphonates — to slow down the natural bone density loss process. These are either taken as pills or injected once a year.
Denosumab — an injection given twice a year. This can also slow down the development of osteoporosis.
Raloxifene — reduces post-menopausal bone loss.
Menopause hormonal treatment (MHT) — can be given to females with osteoporosis.
Teriparatide — can be helpful if you’ve had bones break when taking other medicines for osteoporosis.
Can osteoporosis be prevented?
Osteoporosis can’t be prevented, but there are some things you can do to reduce your risk of developing the disease. These are:
eating foods containing calcium and protein
getting enough vitamin D from the sun
stopping smoking
maintaining a healthy weight — this can mean losing or gaining weight, depending on your BMI
cutting back on alcohol — drink no more than 2 standard drinks a day
exercising — brisk walking and strength training can help your bones become stronger