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.