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.
People with osteoporosis are at a high risk of suffering fractures while engaged in routine activities like standing or walking. According to the National Institutes of Health (NIH), more than 40 million people either have osteoporosis or low bone mass (NIH).
The biggest risk factor for osteoporosis is age. As people grow older, the body goes through the process of breaking down old bone and growing new bone in its place. Around the age of 30, however, the body starts losing bone faster than it is able to replace it. In women, going through menopause can cause the body to lose bone even more quickly for a period of time. Men continue to lose bone during this time, but at a slower rate. By the age of 65 to 70, women and men are usually losing bone at the same rate.
Other risk factors include
- being female
- being older
- being Caucasian or Asian
- family history/genetics
- poor nutrition
- physical inactivity
- taking certain medications
- low body weight and/or small-boned frame
There are no symptoms or warning signs of the early stages of osteoporosis. In most cases, people with osteoporosis are unaware that they have the condition until they experience a fracture.
Some spinal fractures may occur without initial pain. In these cases, the chief symptoms that a fracture has occurred may be loss of height or a bent spine.
According to the Mayo Clinic, osteoporosis is diagnosed with a painless bone density scan called a dual energy X-ray absorptiometry (DXA). It is used to measure the density of the wrist, the hips, and the spine. These are the three areas most likely to experience osteoporosis (Mayo Clinic, 2011).
A doctor may choose to run a DXA on patients who are at high risk for developing osteoporosis. The doctor may also order a DXA to see if osteoporosis played a part in a fracture.
The most common drugs used to treat osteoporosis are called bisphosphonates such as Fosamax, Boniva, and Reclast. Bisphosphonates are used to prevent the loss of bone mass. They may be taken orally or by injection.
According to the Mayo Clinic, the following treatments are also available:
- In men, testosterone therapy may help increase bone density.
- For women, estrogen used during and after menopause can help stop bone density loss. Estrogen therapy has also, unfortunately, been associated with increased risk of blood clots, heart disease and certain types of cancer.
- One alternative medication, raloxifene (Evista), has been found to provide the benefits of estrogen without many of the risks, although there is still an increased risk of blood clots.
Other medications sometimes used in the treatment of osteoporosis include:
- denosumab, which is taken by injection, may prove even more promising than bisphosphonates at reducing bone loss
- teriparatide, which is also taken by injection and stimulates bone growth
- calcitonin, which is taken as a nasal spray and reduces bone reabsorption (Mayo Clinic, 2011)
The chief complications of osteoporosis are fractures and the pain and disability that accompany them. Medication and lifestyle changes such as fall prevention measures can help avoid fractures, however. Pain management and an appropriate plan for rehabilitation can ease their impact.
There are many risk factors for osteoporosis that you cannot control. These include gender, being older, and having a family history of osteoporosis. There are some factors, however, that do fall within your control.
According to the University of Maryland Medical Center (UMMC), some of the best ways to prevent osteoporosis include
- getting plenty of calcium and vitamin D
- engaging in weight-bearing exercises such as walking or lifting weights
- stopping cigarette use
- limiting caffeine to three cups of coffee per day or the equivalent
- for women, weighing the pros and cons of hormone therapy (UMMC, 2010)
Written by: Debra Stang
Medically reviewed on May 10, 2013 by George Krucik, MD, MBA