By Dr Ishwar Keerthi

Mangaluru, Dec 12: Osteoporosis is one of the common bone diseases resulted due to loss in bone mass. This disease starts developing when the body consumes more bone tissue than it produces; thus, this reduces the bone strength and its porosity. According to the International Osteoporosis Foundation, about 6.3 percent men and 21.2 percent women aged 50 years and more from the global population have been diagnosed with osteoporosis. More than 200 million have been diagnosed worldwide with this condition. In India, about 50 million people suffer from osteoporosis; a greater percentage of this population comprises postmenopausal women and men.

The patients with osteoporosis are also at increased risk of suffering from fractures. Much more commonly, it affects the spinal vertebrae, peripheral joints like the wrist, and the hip. Such fractures in the spinal vertebrae produce deformity due to changes in posture in the form of curvature of the spine and reduction in height. Osteoporosis develops silently, and patients may not even be aware of the condition until they break from a non-traumatic, ordinary event. People sometimes discover they have osteoporosis when they fracture bones during a sneeze or cough.

Osteoporosis is an important health concern to millions worldwide. It is indispensable for one to be aware of the causes and risk factors of the condition, and its symptoms in the hope of early detection and prevention of fractures.

Symptoms

Osteoporosis is described as a "silent disease" and often has no overt symptoms until it is too late. However, the following are some symptoms that may appear:

Early stages:

There might not even be any outward signs. They slowly start losing height over time. This loss could translate into a stooping posture or dowager's hump.

Later stages:

Back discomfort brought on by collapsing or shattered vertebrae. They tend to break bones much more frequently than people would have expected. Loss of height is common as much as 6 inches can be lost. A stooping posture, which can also be described as dowager's hump.

Risk Factors

There are many reasons you may be at increased risk for osteoporosis.

1. Age: As you get older, your risk grows, especially after 50 years.

2. Gender: Women are more likely to be afflicted with this condition, particularly after menopause.

3. Family history: If one of your parents or siblings is affected, it raises your chances of getting osteoporosis.

4. Body frame size: Those with smaller body frames have a higher risk because they might also use fewer bones in their lifetime.

5. Hormonal imbalances: In women, too little estrogen can cause osteoporosis, while in men, too little testosterone does the same.

6. Diet

• Calcium insufficiency

• An eating disorder, like anorexia nervosa

• Gastrointestinal surgery

7. Lifestyle

• Sedentary lifestyle

• Too much alcohol consumption

• Cigarette smoking

8. Medical conditions

• Celiac disease

• Inflammatory bowel disease

• Kidney or liver disease

• Cancer

• Rheumatoid arthritis

9. Medications: Long-term use of corticosteroids and other drugs that slow down bone tissue repair.

Treatment Available

Osteoporosis cannot be cured, but patients with this disease can receive a lot of relief through the following treatments:

1. Bisphosphonates: are one of the most commonly prescribed drugs in the treatment of osteoporosis. They slow the rate at which bone loss occurs and have the benefit of fracture prevention.

2. Hormone-related therapy: a. Females: estrogen b. Males: testosterone

3. Biologics: Denosumab, a monoclonal antibody, promotes the prevention of loss of bone

4. Anabolic agents: Such drugs are teriparatide and abaloparatide. These agents induce bone formation.

5. Selective estrogen receptor modulators (SERMs): These may reduce the risk of spine fractures in elderly women.

Treatment is often provided on individual grounds, taking into account age, gender, a woman's risk for fractures, and general health.

Preventive Strategies

Prevention is better than cure. The following are some preventive techniques:

1. Calcium and Vitamin D:

• Ensure adequate intake: diet and supplements
• Dairy products, leafy greens, and fortified foods would serve as a good source for these nutrients.

2. Exercise regularly:

• Weight-bearing activities walking, jogging, dancing
• Resistance training weightlifting
• Activities to improve balance and prevent fractures

3. Lifestyle Recommendations

• Smoking abstinence
• Avoid excessive alcohol intake
• Healthy weight

4. Regular follow-up

• Bone density testing for those with risk factors
• Testing of levels of various hormones

5. Fall prevention

• Improved home lighting and hazard removal
• Devices for support

6. Medications: The physician may provide preventive medications for some patients depending on the level of risk.

Understanding osteoporosis and the risk factors, we can take proactive steps in the direction of stronger bones and healthier lives. Never too early to begin or too late to be started, caring for bone health is on everyone's mind. Consult your healthcare provider if you have questions about osteoporosis-specific advice and care.

Dr Ishwar Keerthi, Consultant Spine Surgery, KMC Hospital Dr B R Ambedkar Circle, Mangaluru.