Osteoporosis

Osteoporosis is a disease that
causes weak, thinning bones. This puts the bones at greater risk of breaking. The bones
most often affected are the hips, spine, and wrists.

Researchers don’t know the exact
cause for osteoporosis. But a number of factors contribute to the disease.

Women are 4 times more likely to
get osteoporosis than men. Here are other things that may put you at risk for osteoporosis:

  • Older age. Bones become less dense and weaker with
    age.
  • Race. White and Asian women are
    most at risk. But all races may get the disease.
  • Body weight. People who weigh less
    and have less muscle are more at risk for this condition.
  • Lifestyle factors. Lack
    of physical activity, caffeine, heavy alcohol use, smoking, dietary calcium, and
    vitamin D deficiency may all increase your risk.
  • Certain medicines. Some medicines
    may increase your risk.
  • Family history. Having a family
    history of bone disease may increase your risk.

Having low bone mass (osteopenia)
also puts you at a greater risk for osteoporosis.

Low estrogen is one of the main causes of bone loss in women during and after menopause. Women may lose up to 20% of their bone mass in the 5 to 7 years after menopause.

People with osteoporosis may not
have any symptoms. Some may have pain in their bones and muscles, particularly in their
back. Sometimes a collapsed vertebra may cause severe pain, decrease in height, or
spinal deformity.

The symptoms of osteoporosis may
look like other bone disorders or health problems. Always talk with your healthcare
provider for a diagnosis.

Your healthcare provider will
review your personal and family health history and do a physical exam. Other tests
include:

  • Bone density test (bone densitometry). This test measures
    the mass of bone and its volume to find the risk of getting osteoporosis.
  • Blood tests. These tests measure
    calcium and potassium levels.
  • FRAX score. This is a score given to
    estimate the risk of a fracture within 10 years. The score uses the results of a bone
    density test as well as other things.
  • X-rays. This test uses energy beams
    to make images of tissues, bones, and organs on film.

Women are encouraged to:

  • Review lifestyle practices with their
    healthcare provider regularly.
  • Have their personal risk for falls checked at least once a year after menopause.
  • Have their height and weight checked yearly.
  • Get checked for the development of a rounded humped in the spine and back pain (kyphosis).

Treatment will depend on your symptoms, age, and general health. It
will also depend on how severe the condition is.

The goals of managing osteoporosis
are to:

  • Decrease pain
  • Prevent fractures
  • Minimize further bone loss

Some of the ways to treat
osteoporosis are also ways to prevent it. They include:

  • Staying at a healthy body weight
  • Doing more walking and other
    weight-bearing exercises
  • Limiting caffeine and alcohol
  • Stopping smoking
  • Getting enough calcium and vitamin D
    through diet and supplements
  • Installing hand railings, or assistive
    devices in the bathroom or shower to prevent falls
  • Asking your healthcare provider about
    medicines that may help

These medicines help maintain bone
health in women with osteoporosis at menopause:

  • Estrogen replacement therapy (ERT) and
    hormone replacement therapy (HRT). 
    ERT reduces bone loss, increases bone
    density, and reduces the risk for hip and spinal fractures in postmenopausal women.
    But talk with your healthcare provider before taking them. Research found several
    important health risks linked to this therapy. For many women, the risks of ERT
    outweigh the benefits.
  • Biophosphonates. These medicines
    reduce bone loss, increase bone density, and reduce the risk for fractures.
  • Selective estrogen receptor modulators
    (SERMS). 
    These medicines help prevent bone loss.
  • Parathyroid hormone. This medicine is
    a form of parathyroid hormone. It helps form bone.
  • Monoclonal antibody. This medicine is
    given by shot (injection) under the skin. It’s approved for women with osteoporosis
    at high risk for fractures. It’s also used for women who are being treated with
    cancer medicines that can weaken bones. 

An osteoporosis rehab program can be vital to a full recovery. It can help you obtain the best possible bone health and quality of life. The focus of rehab is to decrease pain, help prevent fractures, and minimize further bone loss.

To help reach these goals, programs
may include:

  • Exercise programs and conditioning to increase weight-bearing and physical fitness
  • Methods to manage your pain
  • Nutritional counseling to improve how
    much calcium and vitamin D you get and to limit caffeine and alcohol
  • Assistive devices to make you safer at
    home
  • Education, especially on ways to
    prevent falls

These rehab programs can be done as
an outpatient or inpatient. Many skilled people are part of the team. They include:

  • Dietitian
  • Internist
  • Occupational therapist
  • Orthopedist/orthopedic surgeon
  • Physiatrist
  • Physical therapist
  • Psychologist/psychiatrist
  • Recreational therapist
  • Rehabilitation nurse
  • Social worker
  • Vocational therapist
  • Osteoporosis is a disease that causes weak, thinning bones. This leaves the bones at greater risk of breaking. The bones most often affected are the hips, spine, and wrists.
  • Women are 4 times more likely to get
    osteoporosis than men because of a decrease in estrogen after menopause.
  • Risk factors for osteoporosis include
    aging, race, body weight, and certain medicines.
  • The goals of managing osteoporosis are to decrease pain, prevent fractures, and minimize further bone loss.
  • For postmenopausal osteoporosis in
    women, medicines can maintain bone health.
  • Rehab programs can help regain bone health.

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your healthcare provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your healthcare provider if you have questions.