Osteoporosis

Osteoporosis is a disease in which there is a loss of bone mass and destruction of bone tissue. This process causes weakening of the bones and makes them more likely to break. The bones most often affected are the hips, spine and wrists.

Who is affected by osteoporosis?

Osteoporosis affects more than 10 million Americans over the age of 50, with women four times more likely to develop osteoporosis than men.

Photo of older couple walking on path

Another 34 million Americans over the age of 50 have low bone mass (osteopenia) and, therefore, have an increased risk for osteoporosis. Estrogen deficiency is one of the main causes of bone loss in women during and after menopause. Women may lose up to 20 percent of their bone mass in the five to seven years following menopause.

Other risk factors for osteoporosis

Although the exact medical cause for osteoporosis is unknown, a number of factors contribute to osteoporosis, including the following:

  • Aging – Bones become less dense and weaker with age.

  • Race – Caucasian and Asian women are most at risk, although people of all races may develop the disease.

  • Body weight – Obesity is associated with a higher bone mass; therefore, people who weigh less and have less muscle are more at risk for developing osteoporosis.

  • Lifestyle factors – The following lifestyle factors may increase a person's risk of osteoporosis:

    • Physical inactivity

    • Caffeine

    • Excessive alcohol use

    • Smoking

    • Dietary calcium and vitamin D deficiency

  • Certain medications

  • Family history of bone disease

In 2006, the North American Menopause Society (NAMS) reviewed and updated its guidelines on the diagnosis, prevention and treatment of postmenopausal osteoporosis. Among its updated recommendations, NAMS suggests that physicians regularly review their female patients' lifestyles and encourage practices that reduce the risk for osteoporosis. Also, NAMS recommends that a woman's risk for falls be evaluated at least once a year after menopause has occurred. An additional recommendation is that a woman's height and weight be measured annually, as well as that she be assessed for kyphosis – development of a rounded humped spine – and back pain.

What are the symptoms of osteoporosis?

Osteoporosis is often called the "silent disease" because people with osteoporosis may not develop any symptoms. Some may have pain in their bones and muscles, particularly in their back. Occasionally, a collapsed vertebra may cause severe pain, decrease in height or deformity in the spine.

The symptoms of osteoporosis may resemble other bone disorders or medical problems. Always consult your physician for a diagnosis.

How osteoporosis is diagnosed

In addition to a complete personal and family medical history and physical examination, diagnostic procedures for osteoporosis may include the following:

  • X-rays (skeletal) – a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs on film

  • Bone density test (also called bone densitometry) – measurement of the mass of bone in relation to its volume to determine the risk of developing osteoporosis

  • Blood tests – to measure serum calcium and potassium levels

The effects of this disease can best be managed with early diagnosis and treatment.

More about bone density tests

Bone densitometry testing is primarily performed to identify persons with osteoporosis and osteopenia (decreased bone mass that has not yet reached the level of osteoporosis) so that the appropriate medical therapy and treatment can be implemented. Early treatment helps to prevent future bone fractures. It may also be recommended for persons who have already fractured a bone and are considered at risk for osteoporosis.

The bone densitometry test determines bone mineral density (BMD). Your BMD is compared to two norms – healthy young adults (your T-score) and age-matched adults (your Z-score).

First, your BMD result is compared with the BMD results from healthy 25- to 35-year-old adults of your same sex and ethnicity. The standard deviation is the difference between your BMD and that of the healthy young adults. This result is your T-score. Positive T-scores indicate the bone is as strong as a healthy young adult; negative T-scores indicate the bone is weaker.

Peoples Health recommends that women age 65 and over – as well as younger women with one or more risk factors – receive a bone mineral density test to establish a baseline, then follow up with another screening once every 24 monthsThis helps a doctor advise a woman on how often she should receive subsequent tests. Peoples Health also recommends that any woman age 65 and older receive a test within six months of a fracture.

Treatment for osteoporosis

Specific treatment for osteoporosis is determined by your physician based on:

  • Your age, overall health and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

The goals of managing osteoporosis are to decrease pain, prevent fractures and minimize further bone loss. Some of the methods used to treat osteoporosis are also the methods to help prevent it from developing, including the following:

  • Maintain an appropriate body weight.

  • Increase walking and other weight-bearing exercises, which can keep your bones stronger and help prevent fractures should a fall occur.

  • Minimize caffeine and alcohol consumption.

  • Stop smoking.

  • Maintain an adequate intake of calcium through diet and supplements. Vitamin D is also necessary because it facilitates the absorption of calcium. The following foods are excellent sources of calcium: low-fat and skim milk, low-fat yogurt, low-fat cheese, sardines, legumes (such as beans and peas), seeds, nuts (especially almonds and pistachios), and green, leafy vegetables.

  • Avoid falls to prevent fractures. Use strategies such as installing hand railings or assistive devices in the bathroom and shower.

  • Consult your physician regarding a medication regimen.

© 2000-2014 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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