Dr Zameer Ali
Osteoporosis is a bone disease, the name of which means “porous bones’’ in Latin. The inside of a normal bone has small spaces, like a honeycomb. Osteoporosis increases the size of these spaces so that the bones lose strength and density. At the same time, the outside of the bone also grows weaker and thinner.
Osteoporosis is often considered to be a condition that frail elderly women develop. However, the damage from osteoporosis begins much earlier in life. Because peak bone density is reached at approximately 25 years of age, it is important to build strong bones by that age, so that the bones will remain strong later in life. Adequate calcium intake is an essential part of building strong bones.
Osteporosis is a generic term referring to state of decreased mass per unit volume of normally mineralized bone due to loss of bone proteins.
It is most common skeletal disorder in world, next only to arthritis. In osteoporosis there is a long latent period before clinical symptoms develop. Most prevalent complications are fractures of vertebral bodies, ribs, proximal femur, humerus and distal radius with minimal trauma.
Most common cause of osteoporosis is involutional bone loss in permenopausal women.
Osteoporosis is a disease of the bones. It happens when one looses too much bone mass and make too little bone or both. As a result, ones bones become weak and may break from a minor fall or, in serious cases, even from simple actions, like sneezing or bumping into furniture.
Osteoporosis, or thinning bones, is a serious condition that can result in teremendous pain with fractures. Risk factors for osteoporosis include aging low body weight, low sex hormones such as during menopause, and smoking. Even some medicines like steroids can cause osteoporosis.
Osteoporosis is often considered to be a condition that frail elderly women develop. However, the damage from osteoporosis begins much earlier in life. Because peak bone density is reached at approximately 25 years of age, it is important to build strong bones by that age, so that the bones will remain strong later in life. Adequate calcium intake is an essential part of building strong bones.
Dietary calcium and vitamin D deficiencies are important factors in the risk for osteoporosis.
Women, who smoke, particularly after menopause, have a significantly greater risk of spine and hip fractures than those who do not smoke. Men who smoke also have lowest bone density.
Excessive alcohol consumption increses osteoporosis risk.
Lack of exercise and a sedentary lifestyle can increase the risk of osteoporosis. Engaging in regular weight-bearing and resistance exercises (such as walking or strength training) can help prevent it.
Symptoms
There typically are no symptoms in the early stages of bone loss. But once bones have been weakened by osteoporosis, you may have signs and symptoms that include.
Early symptoms : The patient complains of pain in middle or low thoracic region or high lumbar region.
Sudden movement e.g Sitting, sneezing, cough increases pain. It is usually relieved by rest.
Most common symptom of osteoporosis is back pain secondary to vertebral compression fractures. Deformity in back like gibbus may be seen in osteoporotic patients.
* Back pain, caused by a fractured or collapsed vertebra.
* Loss of height over time.
* A stooped posture.
* A bone fracture that occurs much more easily than expected.
Osteoporosis can sneak up on you
Osteoporosis is often called a silent disease because you can’t feel your bones getting weaker. Breaking a bone is often the first sign that you have osteoporosis or you may notice that you are getting shorter or yor upper back is curving forward. If you are experiencing height loss or your spine is curving, be sure to talk to your doctor.
Treatment
Osteoporosis treatments include the -Adequate diet, calcium, vitamin-D, Calcitonin, Calcitriol, Teriparatide, weight bearing exercise, prevention of Falls/injuries.
A good calcium intake is essential throughout life for healthy bones.
There is good evidence that the adequacy of a child’s diet at least partially determines their osteoporosis risk in adulthood.
Hormone replacement therapy replaces estrogen and so reduces the rate of bone loss.
Estrogen, especially when started soon after menopause, can help maintain bone density. However, estrogen therapy can increase a woman’s risk of bllod clots, endometrial cancer breast cancer and possibly heart disease.
Bisphosphonates
This is a group of medicines that slows the rate at which bone is dissolved, thus favouring a buildup in bone strength over time. Two types are in common use alendronates, ibandronates, risudronates etc.
Sticking to treatment
Compliance is the business of sticking to the prescribed treatment, to the prescribed treatment, whether it be tablets or protective clothing.
Because osteoporosis treatment and prevention needs to be taken for years, poor compliance can be a major issue in treating the condition.
Elderly people are the most at risk of falls. They are also the most likely to become muddled about pills and suffer more severe side effects from them.
Those in sheltered or supervised environments can be given help to remember their medication.
Where this is not possible, and someone is forgoteful, using a weekly or monthly dose form of bisphosphonate, supervised by a nurse, might be more reliable than a daily dose.
(The author is Registrar orthopaedics Skims Medical College Srinagar)
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