Osteoporosis is a bone disease that commonly affects older adults; post-menopausal women and elderly men are most often at risk. However, Osteoporosis can be managed. Osteoporosis means that your bones do not have the strength they used to have. This might be from not having enough bone or not enough minerals in your bone. Your bones go through a natural process of being built up and broken down. This process is called ‘remodeling’. However, in osteoporosis, the normal remodeling process is out of balance. This makes your bones weak, fragile, and more likely to break. Osteoporosis can be treated with medications, dietary supplements, and exercise.
Women are particularly at risk for osteoporosis. Generally, women gain less bone mass than men when they are younger. So, as women age, they have less bone to lose. Also, estrogen – a female hormone tied to bone-building – is lost as women age. Women are more likely to suffer from osteoporosis when estrogen becomes low after menopause.
Certain medications, long-term anticoagulant use, steroids, alcohol, and tobacco can be causes of osteoporosis. So can poor nutrition. Poor nutrition when you are young can lead to osteoporosis when you are older. If you do not build enough bone mass by the time you are 30, you may be at greater risk for osteoporosis. You may also be at risk for osteoporosis if you have low calcium or low vitamin D. Both of these minerals are important for strong, healthy bones.
Family history is important to decide if you are at high risk for osteoporosis. Patients of European or Asian descent are more likely to have osteoporosis than patients from other backgrounds.
Signs & Symptoms
Most often the first sign of osteoporosis is a broken bone. The spine is a common site for fractures. As the bones of the spine become weak from osteoporosis, they lose the ability to hold up to daily stresses. They simply crack under the pressure. The result is often a ‘compression fracture’ and may occur without a fall or other injury. Other sites where fractures commonly occur are the bones of the arms, legs, and hips.
Your health care provider may recommend a bone density scan if you are at risk for osteoporosis. The U.S. Preventative Services Taskforce also recommends screening for bone density in all women at age 65. A bone scan is a simple test that uses a special x-ray machine to measure the quality of your bones. You may hear it called a DEXA scan.
Treatment & Prevention
Osteoporosis can be managed by daily exercise, taking vitamins with vitamin D and calcium, and in some cases a prescription. By now you probably know that exercise is good for you. But regular, weight-bearing exercise is very important for both the treatment and prevention of osteoporosis. Weight-bearing exercise includes walking, strength training, and yoga. If you think you don’t like exercise, do something fun like dancing or playing golf. These are both weight-bearing exercises and don’t feel so much like work. Click for more weight-bearing exercise ideas.
There are several medications used to treat osteoporosis. Fosamax, Boniva, and Actonel have commonly used drugs in a class of medications called bisphosphonates. Typically, these are the first drugs used for both treatment and prevention of osteoporosis. Common side effects from these medications include irritation or ulcers of the esophagus.
A newer treatment for osteoporosis is a drug called Prolia (denosumab). This is given by injection every 6 months. Prolia is an antibody that turns off the body’s mechanism for breaking down bone, helping to restore balanced remodeling. Prolia is used for post-menopausal women who are at high risk for osteoporosis, or for whom other treatments have failed.
Your health care provider may also give you calcium and vitamin D supplements to help strengthen your bones. Continuing good nutrition as you age can help osteoporosis. So can quitting smoking and drinking alcohol.These risk factors are things you can take control of to reduce your chances of osteoporosis.
Talk to your health care provider at Chickahominy Family Practice about your risks for osteoporosis and determine what preventative steps you can take to avoid injury. Be open to changing diet, exercise, and addictive behaviors. With your knowledge about the risks and treatment options for osteoporosis, you and your provider can create a plan that will work best for you.
Dr. Anup Gokli