What is Osteoporosis?

Osteoporosis is a bone disorder that causes the bones to become weak and fragile. As we age, our bodies naturally break down bone faster than they build new bone. This process is accelerated in people with osteoporosis.

What is Osteoporosis? Signs, Risk Factors, Diagnosis, and Treatment
Osteoporosis is a bone disease that occurs when the body loses too much bone. Shutterstock Images

Commonly known as the ‘brittle bone’ disorder, it increases the chances of bone fractures.[1] It can also lead to complications in the joints and the spine. Women are more prone to osteoporosis because their bone density decreases drastically after the menopause. Osteoporosis and osteopenia are two related concepts – indicating a gradual bone loss.

The screening of mineral bone density diagnoses both the conditions. Bones are constantly changing and regenerating themselves. According to NCBI, when bones are not able to regenerate or renew themselves, it results in osteoporosis. Bones are made up of collagen, calcium, and some other vital minerals.[2]

When the struts in the mesh within the bone become weak, it causes the bone to become brittle. To be more precise, it means that the tissues within the bone are damaged, which makes the bone weak and fragile. Such bones can break under minimal pressure or minor falls.

What are the Types of Osteoporosis?

The major types of osteoporosis are:

Postmenopausal osteoporosis:

As mentioned, this is caused by dropping estrogen levels after menopause. Estrogen helps conserve bone mass. Without enough estrogen, bone resorption exceeds formation, leading to bone loss and increased risk of fractures. It usually develops several years after menopause and affects up to 25% of postmenopausal women.

Senile osteoporosis:

Also known as type 1 or age-related osteoporosis. It occurs due to general aging processes as well as decades of bone loss. Production of new bone cannot keep up with resorption. Both cortical and trabecular bones are affected. The risk increases significantly after age 70. It’s more common in women but also affects many men.

Idiopathic osteoporosis:

The cause is truly unknown in these cases. It tends to affect both sexes equally before age 50. Bone density and microarchitecture are significantly reduced. It may involve genetic factors and rapid bone loss. Fracture risk is high.

Secondary osteoporosis:

There are many potential underlying causes. Examples include excess corticosteroid use (often prescribed for conditions like arthritis), hyperthyroidism, rheumatoid arthritis, inflammatory bowel disease, cancer therapies, and some genetic disorders. These medical issues can impair bone formation or increase resorption.

Genetic osteoporosis:

Specific genetic disorders like osteogenesis imperfecta directly weaken bone structure and increase fragility from a young age. Family history also plays a role in the heritability of bone density and other genetic factors that influence peak bone mass.

What are the Signs and Symptoms of Osteoporosis?

Osteoporosis is a condition characterized by weakened bones, which increases the risk of fractures. The signs and symptoms of osteoporosis can be subtle and often go unnoticed until a bone fracture occurs. However, some common signs and symptoms include:

  • Fractures with Minimal Trauma: One of the most significant signs of osteoporosis is the occurrence of fractures from minor incidents or falls that wouldn’t normally cause a break. These are often referred to as fragility fractures and are particularly common in the spine, hip, and wrist.
  • Back Pain: This can be caused by a fractured or collapsed vertebra. The pain may be severe and sudden if it is due to a fracture.
  • Loss of Height Over Time: People with osteoporosis may lose height over time as the vertebrae (the bones of the spine) become compressed due to weakening.
  • Stooped Posture or Kyphosis: Sometimes referred to as a dowager’s hump,” this is a stooped posture that can occur when the bones of the spine (vertebrae) have fractured or collapsed.[3]
  • Bone Pain or Tenderness: Although less common, some individuals may experience a general feeling of pain or tenderness in the bones.

It’s important to note that osteoporosis can often develop without any symptoms at all until a bone is fractured. Therefore, risk factor assessment and bone density testing are important, especially for postmenopausal women and older adults, to diagnose and manage osteoporosis effectively. Regular exercise, a balanced diet rich in calcium and vitamin D, and, in some cases, medications are key in managing and preventing osteoporosis.

What are the Risk Factors of Osteoporosis?

Age and Gender

Osteoporosis often becomes more prevalent as individuals age, with a higher risk observed in older populations. Additionally, women, especially after menopause, are more susceptible to this condition.

Family History

Genetics can play a role in osteoporosis risk. If you have a family history of the condition, it’s important to be aware of the potential genetic predisposition.

Hormonal Changes

Hormonal fluctuations, such as a decline in estrogen levels in women during menopause, can influence bone health and increase the risk of osteoporosis.

Lifestyle Choices

Certain lifestyle factors can impact bone density, including:

  • Smoking: Tobacco use can weaken bones.
  • Excessive Alcohol Consumption: Heavy drinking can diminish bone strength.
  • Sedentary Lifestyle: Lack of physical activity may contribute to a higher risk of osteoporosis.

Dietary Habits

Insufficient intake of vital nutrients like calcium and vitamin D can weaken bones. A diet lacking these essential nutrients can elevate the risk of osteoporosis.

Medical Conditions

Some medical conditions and treatments are linked to bone loss, such as:

  • Rheumatoid Arthritis: An autoimmune disorder that can affect bone health.
  • Certain Medications: Prolonged use of medications like corticosteroids or anticonvulsants may contribute to osteoporosis risk.[4]

Body Weight

Being underweight can increase the risk of osteoporosis, as lower body mass may affect bone density.

Ethnicity

Ethnic background can influence susceptibility to osteoporosis, with some ethnic groups being at a higher risk than others.

The key is to be informed and take preventive measures, including a balanced diet, regular exercise, and bone health assessments, to minimize the risk of osteoporosis.

What are the Causes of Osteoporosis?

Osteoporosis is a typical bone disorder that affects the effectiveness of the skeletal framework of your body. Understanding the causes of this disease is essential to devising methods for the treatment and prevention of this disease.

Specific objectives of osteoporosis are beyond human control, like heredity, age, sex, and ethnicity. Women are more prone to osteoporosis as compared to men, and heredity plays a role in causing osteoporosis. Some of these causes are:

Lifestyle Choices:

  • Consumption of alcohol in excess
  • Smoking.
  • Eating disorders like anorexia nervosa.
  • Exposure to environmental pollutants like lead.
  • Inactivity, lethargy, and perceived fatigue.
  • A diet without essential nutrients and supplements like calcium, phosphate, vitamin D, and proteins.
  • Medical Treatments:

  • Corticosteroids/Glucosteroids which are used to treat arthritis, asthma, and other disorders, can cause osteoporosis.
  • Treatments for cancer, like chemotherapy or any other hormone replacement therapy that affects the level of sex hormones in the body, can cause this bone disorder.
  • Antiseizure or anticonvulsant medicines taken continuously for a very long time can result in osteoporosis.
  • How to Diagnose Osteoporosis Pain?

    Symptoms of Osteoporosis

    Symptoms of Osteoporosis. Shutterstock Image

    Symptoms of osteoporosis are not visible easily, not until the disease has taken a good hold of your body. You need to be conscious of your health and your increasing age. Any pain or discomfort in bones or joints should be brought to the notice of a doctor.

    Osteoporosis can be diagnosed in several ways. Most of them are non-invasive and do not cause any pain. A standard method of diagnosis is DXA, which measures the mass of bone in the spine, the hip, and other parts of the body as well.

    Another method is the bone mineral density test. These tests detect a loss in bone mass. You can also go for osteoporosis screening, in which your genetic and family disease history is considered while diagnosing your bone problem.

    How Osteoporosis is Treated?

    The treatment of osteoporosis involves five major elements. They are as follows:

  • Through Medication
    Medication protects bones from further degeneration. Doctors generally prescribe bisphosphonates (like Fosomax and Boniva) for preserving the bones and bringing them back to their normal mass.
  • Strength Exercise and Proper Diet
    Exercise builds up the strength of bones and increases bone density. A proper diet helps in overcoming the weakness and pain caused due to osteoporosis.
  • Vitamins
    Supplements provide the vital nutrients that are lacking in the body. Some common supplements provided are Vitamin D, calcium, and phosphate tablets.
  • Ensure your safety
    Safety and precaution ensures that you do not fall and fracture any of your bones. The whole idea is to prevent any kind of injury.
  • How to Prevent Osteoporosis?

    Osteoporosis can be prevented by following a healthy lifestyle, which would include:

  • Increase calcium intake.
  • Engaging in regular exercise like stretching and weight lifting.
  • Having a healthy diet with all the essential nutrients.
  • Maintaining a body that is neither obese nor fragile.
  • Avoiding alcohol, smoking, soda, or drugs and attending regular health checkups.
  • Expert’s Opinion

    According to National Osteoporosis Foundation, around 12 million people in the US have this bone disorder.[5] Learn more about osteoporosis, a condition that weakens the bones Although a medicine called Forteo is available on the market for this purpose, it is costly. This medicine is injected into the patient’s body. It is limited to only the most extreme cases.

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    Dr. Sarah Brewer, MSc, MA, RN

    Dr. Sarah Brewer is qualified from Cambridge University with degrees in Natural Sciences, Medicine, and Surgery. She is an award-winnin