All about Osteoporosis

  •   Wed, Dec 11 2019
  •   By Dr Vivian Roshan D'Almeida

December 11, 2019

What is osteoporosis?

It is a disease of the bone where a simple or trivial injury can result in a fracture.

A violent road traffic accident can result in a fracture in most individuals, but people with osteoporosis are prone for fractures even from a simple fall at home on an outstretched hand or a thud in the wash room.

How common is osteoporosis?

A study has shown that 1 in 3 women and 1 in 5 men above the age of 50 years have this bone condition. In our very own country about 50 million have been estimated to suffer from this disease in 2013.

What are the causes of osteoporosis?

Osteoporosis can either be primary (without any cause) or secondary to some disease or condition.

Women after the age of menopause are prone to what is known as post-menopausal osteoporosis. The cessation of production of the female hormones which are protective in nature is the cause for this. Secondary causes can be due to diseases like diabetes , thyroid disorders , cancers, malnutrition, long term steroids, anti-seizure drugs, smoking, chronic alcoholism.

What happens to the bone in osteoporosis?

The bone is made up of two components. Organic which is principally collagen and certain proteins and in organic mainly calcium hydroxyapatite. When there is a deficiency in both these components it leads to the significant weakening of the strength of the bone resulting in osteoporosis.

What are the symptoms of osteoporosis?

Usually it is a silent disease and picked up after a fragility fracture. But the symptoms include and are not limited to generalised bone pain, muscle pain, fatigue, tiredness, loss of height as age progresses especially in elderly women, deformity of the back where it is bent forwards.

How is osteoporosis diagnosed?

The gold standard for the diagnosis of osteoporosis is DEXA scan. The classical T and Z scores are based on this scan. This scan measures the bone mineral density which indicates as to how strong the bone is. The other test that is usually done commercially ia QUS or the quantitative ultrasound which is commonly used in the free bone camps. While this is not an accurate test it does give us a basic understanding or an idea about one’s bone strength.

Can osteoporosis be prevented and how?

A healthy lifestyle goes a long way in reducing the chances of one developing osteoporosis:

Diet- Healthy food including green leafy vegetables, sea food, milk, ragi
Exercise
Avoid alcohol, smoking, tobacco and substance abuse
Regular health check-ups
Peak bone mass - It is very important that people have a good bone density at a younger age, especially women. The bone mass at the age of 30 determines the possibility of osteoporosis at a later date.

What are fragility fractures?

These are fractures which are caused by an injury or force which under normal circumstances would not result in the same. It is due to the weakened bones. Common sites include the wrist, spine, around the hip joints.

How do you treat osteoporosis?

Various medications are available for the treatment of osteoporosis:

1] Calcium. Basic requirement of calcium in an adult is 1 gm/day. The requirement increases in pregnancy and lactation. Various compounds in the form of carbonates and citrates are available.
2] Vitamin D. Exposure to sunlight is the key. If there is a documented deficiency supplementations are given in the form of tablets capsules or injections.
3] Bisphosphonates: Strong anti-osteoporotic medications given in the form of oral medications, injections at regular intervals.
4] Calcitonin nasal spray. Given over a two month period.
5] Anabolic steroids. Care must be taken while given them in diabetics.
6] Newer medications include injections like parathormone, denusomab.

Do all fractures need to be operated on?

Depends on the age and the type of fracture. Fractures around the hip joints usually need to be operated on. Wrist fractures need to operate on if grossly displaced. Spine fractures secondary to osteoporosis usually are managed without surgery.

By Dr Vivian Roshan D'Almeida
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Comment on this article

  • Pandu USA, USA

    Sat, Dec 21 2019

    Great information.

    Indian Medical society should work on creating guidelines for preventative health such as
    Early cholesterol screening for men and women to prevent heart disease. Colonoscopy at age 50, Prostate screening, DEXA scans etc.


    I know we in India think these are money making techniques but they do save a lot of money and life on the long run. The focus should be on preventing disease than curing it.


    Good luck Dr Vivian Roshan D'Almeida

  • Sr Virginia Sequeira, Bethany, Bendur, Mangalore

    Fri, Dec 13 2019

    Dear Sr Vivian, very informative article. It will be helpful to all suffering from osteoporosis. Thank you.

  • Roshika Dsouza, Abu Dhabi

    Thu, Dec 12 2019

    Informative article, very well explained !

  • Jeevan N V, Mangalore

    Wed, Dec 11 2019

    Thank you so much sir for giving this information, it is very clear and useful

  • Princy, Mangalore

    Wed, Dec 11 2019

    Thank you Dr Vivian, the article is simple and easy to understand, it's worth reading and information is helpful for awareness of people in their 50s. Well done.

  • Ryan, Mangalore

    Wed, Dec 11 2019

    Dear doctor , this article is extremely informative. my mother is suffering from this and I hope to meet you regarding this .

  • Dnyaneshwar, Latur, Maharashtra

    Wed, Dec 11 2019

    Nice article... Very much useful for elderly people

  • Sr Lily Fernandes, Mysuru

    Wed, Dec 11 2019

    Dr Vivian, very good information. Must read article! I wish that you write one more article on knee cap surgery.

  • Ryan Martis, Jeppu bappal

    Wed, Dec 11 2019

    Very good and useful article . Great job Dr Vivan ....

  • Corrine Rasquinha, Bendur, Mangalore

    Wed, Dec 11 2019

    Thank Dr Vivian for this information. I need to see you. God bless you


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