What is Osteoporosis?
Osteoporosis is a disease characterized by reduced bone growth or bone loss. Your bones are living tissues, meaning they grow and change.
Throughout your lifetime, old bone tissue is removed through a process known as reabsorption. New bone replaces the old (formation).
Rapid reabsorption by itself or coupled with slow bone formation results in osteoporosis. The condition is more common in the elderly and women. (1)
Your bones provide support and structure to your entire body. They are also responsible for storing essential minerals.
Osteoporosis increases your risk of fractures as your bones grow weaker (brittle) due to the bone loss or a lack of new bone growth.
Breaking a bone is not only painful, but can be debilitating and require lengthy recovery. (2)
Osteoporosis can be a primary or secondary condition. Regardless of the type, the symptoms are identical.
As we age, the rate of bone loss gradually increases whereas bone formation decreases.
Menopause in women and declining testosterone rates in men contribute to bone loss and reduced bone growth.
However, osteoporosis is not a guaranteed result of aging. Your genetics, diet, and overall health all contribute to your risk of developing the disease.
Primary osteoporosis is more common in individuals over the age of 60. Women are more prone to the condition as they usually have lower bone density than men.
Secondary osteoporosis is a result of other medical conditions, such as hypothyroidism. Certain medications, such as corticosteroids, can also cause secondary osteoporosis. (3)
In rare cases, osteoporosis can be inherited (osteogenesis imperfecta) or occur in children (idiopathic juvenile osteoporosis). (4)
The disease is silent, meaning it can be years before you experience symptoms. The symptoms of osteoporosis can be described as follows:
Bone fractures are the primary symptom of osteoporosis. Wrist, spinal vertebrae, and hip fractures are the most common in individuals with the disease.
If osteoporosis is severe, even a cough or sneeze can provoke a fractured bone in your spine or ribs. (5)
A stooped posture could be a warning of osteoporosis. If your spinal vertebrae fracture, your spine may not be able to support your body weight.
Severe Back Pain
Severe back pain can indicate you have fractured one or more of your spinal vertebrae.
This is a common type of fracture due to osteoporosis. (6)
The severity of osteoporosis is based on bone loss and fragility. These criteria are measured with bone mineral density (BMD) tests.
These are imaging tests that can measure how dense your bones are. They can include x-rays, ultrasounds, or computed tomography (CT) scans. (7)
Bone mass density is then graded according to your T-score. This is a standard deviation system of measurement.
This means that it is graded according to how different it is from the average results. The average is based off typical bone density of healthy adults aged 30.
A difference of 10 to 12 percent in bone mass is equal to one standard deviation. T-score results can be classed as follows: (8)
High Bone Density
If your T-score is greater than +1, your bones are stronger and denser than average.
Normal Bone Density
A T-score of -1 or higher indicates normal bone density. This means that your bones are just as dense as those of the average 30 year old.
If your T-score is lower than -1 but higher than -2.5, you have osteopenia. This means that your bones are between 10 and 20 percent weaker than average.
Having 0steopenia does not guarantee that you will develop osteoporosis. However, your risk of the disease is higher than an individual with normal or higher bone density.
Any score that is lower than -2.5 is considered osteoporosis. This means your bones are 25 percent less dense than normal.
You are now at a greater risk for bone fractures. Treatment should begin as soon as possible.
If you present with the symptoms of osteoporosis, your doctor will recommend a bone mineral density (BMD) test. This is a test to measure how dense your bones are.
There are numerous types of BMD tests. Each measures bone density in specific regions of the body, for example in the wrists or the forearms.
The most common BMD performed is the dual energy x-ray absorptiometry (DXA) test. It is a highly sensitive x-ray that can determine even small amounts of bone loss.
It is also capable of measuring the bone density of your entire skeleton. As explained above, your results are graded according to your T-score, which will determine the severity of bone loss. (9)
If you have any risk factors of osteoporosis, your doctor may recommend regular BMD tests.
In the case of young adults, children, men under the age of 50 and pre-menopausal women a Z-score is calculated.
This is done when secondary rather than primary osteoporosis is suspected (e.g. caused by medications or diseases).
The Z-score compares BMD test results to a healthy individual similar to you rather than the average 30 year old, as with the T-score.
For example, if you are an adolescent, your BMD test results are compared to that of other healthy adolescents.
The aim of treating osteoporosis is to slow bone loss and promote bone density. If you have secondary osteoporosis, any other conditions provoking it will be addressed. (10)
Treatment for the disease can include one or more of the following options: (11)
If you have osteoporosis, it is important to take measures to improve your overall health. Particularly in the elderly, staying fit can help avoid the risk of falling over and fracturing bones.
You can also follow a diet which includes foods rich in calcium and vitamin D. Calcium promotes strong bones, and vitamin D helps your body absorb it.
Your doctor may also recommend taking vitamin D and calcium supplements. Vitamin D is difficult to acquire from foods alone.
Bisphosphonates are injections or tablets that decrease the rate of bone reabsorption. This lowers your chances of bone fractures and helps to maintain bone density.
You will have to take these drugs for six to 12 months before they begin to work. Most individuals are prescribed bisphosphonates long-term, for a period of years.
In some men, a lack of testosterone can worsen the progression of osteoporosis. Testosterone is a sex hormone that is found in both men and women, but is especially important in men.
Testosterone therapy works by increasing low levels of this hormone. Testosterone is administered by injections, gels, patches or tablets. (12)
Selective Estrogen Receptor Modulators (SERM)
Selective estrogen receptor modulators (SERM) mimic the beneficial effects of estrogen on bones. They contribute towards maintaining bone density, thereby reducing the risk of fractures.
The sole type of SERM for treating osteoporosis is raloxifene. It is taken in tablet form on a daily basis.
Side effects of raloxifene can include increased risk of blood clots, hot flashes, and leg cramping.
Teriparatide is a type of hormone found naturally in your body that stimulates bone growth. It is given by injection to eventually increase bone density.
This treatment is usually used as a last resort if other treatments are ineffective. It is also used in patients with extremely low bone density.
This drug causes nausea and vomiting in most individuals.
What is osteoporosis? Osteoporosis results in bone loss, reduced bone growth, or a combination of the two.
What are the signs of osteoporosis? The primary sign of osteoporosis is bone fractures. Other symptoms can include severe back pain and stooped posture.
How do you develop osteoporosis? Osteoporosis develops when new bone formation slows down, old bone reabsorption speeds up, or both.
How are you diagnosed for osteoporosis? A bone mineral density (BMD) test to measure your bone mass will be performed to determine if you have osteoporosis.
What is the best treatment for osteoporosis? Treatment for osteoporosis can include lifestyle changes, bisphosphonates, testosterone therapy, or selective estrogen receptor modulators (SERMs). Teripiradate may also be recommended.
What are the long term complications of osteoporosis? Osteoporosis can heighten your risk of bone fractures. (13)
Is osteoporosis considered a disability? If your osteoporosis is debilitating and impairs your ability to function due to fragile bones, it is considered a disability. You are also eligible if the disease has resulted in any broken bones. (14)
Is there any cure for osteoporosis? No, there is no cure for osteoporosis. Various treatments exist to manage the disease. (15)
Is osteoporosis life threatening? Osteoporosis in itself is not life threatening. However, depending on your health and age a broken bone can directly or indirectly increase your mortality risk. (16)
Certain risk factors related to osteoporosis can be avoided or reduced. For example, smoking and drinking alcohol to excess increase your chances of developing the disease.
If your doctor has discovered you have low bone density, you should practice more healthy lifestyle habits.
Diet, exercise, and taking certain supplements can reduce your risk of osteoporosis later on. (17)
If you have been diagnosed with osteoporosis, it is important to begin treatment as early as possible.
Speak to your doctor or join support groups to learn how to decrease your risk of fractures, e.g. moving to a home without stairs. (18)