Osteoporosis Osteoporosis is a skeletal disease, marked by low bone mass and microarchictectural deterioration that leads to an increased susceptibility to fractures. Fractures are the single most important clinical consequence of osteoporosis and represent a major health problem in the elderly. Low bone mass, skeletal fragility and propensity to fall are the primary determinants of fracture risk in older persons. Bone density, a measure of bone mass, can be measured non-invasively using widely available densitometric techniques. The risk of most types of fractures in elderly women is related to low bone density. Approximately 90% of hip and spine fractures, 70% of wrist fractures and 50% of all other fractures in white women aged 65-84 years are attributable to osteoporosis. 1.3 million fractures per year in the United States are caused by osteoporosis. Hip fracture risk is strongly related to low bone density and is more strongly associated with bone density at the hip than at other sites. In contrast to hip, wrist and other long-bone fractures, a majority of vertebral fractures in women are asymptomatic or not diagnosed. Vertebral fractures that reach clinical attention usually cause severe back pain and physical disability. Wrist fractures, 90% of which are due to falls, are four times more common in women than in men. Factors that place a person at risk of developing osteoporosis include:
Acute symptoms from an osteoporotic fracture could include intense, localized pain and reduced motion. Interventions are intended to diminish pain and improve activity, and treatment usually requires a few days of reduced activity or immobilization, with analgesics as needed. In order to accurately diagnose osteoporosis, it is necessary to perform a bone density evaluation with a dual energy x-ray absorptiometer (DEXA) or other machine to assess bone mass. This test is painless and quick. The World Health Organization has defined low bone mass (osteopenia)
between 1.0 and 2.5 standard deviations below the mean for young adult women and
osteoporosis as a bone density equal to or greater than 2.5 standard deviations
below the young adult mean. Women who already have experienced one or more
fractures are considered to have “established” osteoporosis. |
Dr. Feldman sitting in front of a bone density testing machine. Persons who should be tested for bone mass include: · Women aged 65 and older · Postmenopausal women under age 65 with risk factors · Men aged 70 and older · Adults with a fragility fracture · Adults with a disease or condition associated with low bone mass or bone loss · Adults taking medications associated with low bone mass or bone loss, like corticosteroids or seizure medications · Anyone being considered for pharmacologic therapy · Anyone being treated to monitor treatment results Unfortunately, an individual can have no symptoms telling them they have osteoporosis. Consequently, if steps are not taken to strengthen the weak bones, osteoporosis could lead to fractures. A diet with ample amounts of calcium and vitamin D. Calcium is essential for bone formation. Vitamin D helps your body absorb calcium. Calcium rich foods include low fat dairy products, fish, legumes, and leafy vegetables. Vitamin D fortified milk and cereals, egg yolks, saltwater fish and liver are high in vitamin D. Fifteen minutes of direct sunshine may also meet your daily needs for vitamin D. Weight bearing exercise also strengthens bone mass. It is recommended to walk at least 40 minutes per session, at least four sessions per week. Spinal strengthening exercises are also advisable. Also, avoid cigarette smoking and other possible negative factors, such as high intake of caffeine, protein or phosphorus. For severe osteoporosis, medications can be used to increase bone mass and hopefully prevent fractures in the future.
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