Osteoporosis literally means “porous bones”. Bones have a hard outer shell, with an inner space filled with bone marrow and blood vessles. The inside appearance is described as a honeycomb appearance with the holes allowing passage of blood vessels and bone marrow. Osteoporosis occurs when the holes within the bones become larger, making them more fragile and prone to fractures.
The first symptom of having osteoporosis is usually a fracture. When trauma occurs or other x-rays are taken your physician may detect that your bone structure has an appearance of osteopenia. Osteopenia is a term used to describe any “washed out” appearence of the bone on x-rays. Osteoporosis alone usually does not cause pain or other symptoms, and is sometimes considered a silent epidemic.
Causes for osteoporosis are varied, with various risk factors identified. Bone is constantly changing within your body as old damaged bone is discarded, new bone is formed. It’s estimated your entire adult skeleton completely changes every 7-10 years. Bone stops growing in length between the ages of 16-18 but continues growing in strength until your mid-twenties. The peak bone mass is usually reached around this age. After about age 35 the bone breakdown rate is faster than the bone generation as part of the aging process. The rate at which this occurs differs between individuals depending on risks and genetics. Women appear to have osteoporosis at a higher rate than men. Especially women with early menopause, hysterectomy, or missing there periods for six months or more as there is a lack of estrogen. Men are at risk if there is a lower level of the male hormone, testosterone. Both men and women are at risk with long term use of corticosteroids, those with inflammatory bowel disease and gastic surgery, heavy drinking, smoking, and low body weight. There also appears to have a higher risk if there mother had a hip fracture as genetics are an important factor. Diet has a strong effect on osteoporosis and there are ways to help prevent the disease even with the associated risk factors.
Testing may be required for an accurate diagnosis of osteoporosis. Normal x-rays be give a hint, but at least 30% of your bone density would have to be lost before it can be detected using this testing method. More specialized testing with a bone density scan can be performed. Usually your podiatrist, orthopedic physician, or family physician will have this test ordered if you are suspected to have osteoporosis. The scan, called a Dual Energy X-ray Absorptiometry Scan (DXA) is the most accurate and reliable means of assessing the strength of your bones. This scan is painless and fairly quick requiring you to lay on a table for about 10-15 minutes wile an x-ray arm goes over the body area. Sometimes a bone scan, different from a bone denisty scan, is also used to help determine areas of bone with high turnover rate.
Prevention is aimed at lifestyle modifications, as your genes inherited from your parents is uncontrollable. Peak bone mass should be maximized when you are growing and in your youth. Healthy bones need a well-balanced diet with proper minerals and vitamins. Calcium is the most abundant mineral found in our bones and helps give them strength and rigidity. Good sources of calcium are dairy products such as milk, cheese, and yogurt. Bread, green leafy vegetables, and baked beans are also a good source of calcium which are non-dairy. Too much animal protein, salt and caffeine can reduce your body’s ability to absorb or retain calcium. Bone strength can also be maintained with a regular exercise routine.
Treatment can be instituted by your physician once a diagnosis has been made to help prevent bone loss. Eight treatment medications are discussed here, discuss with your physician which treatment is the best for you.
- Hormone replacement therapy (HRT)
- Calcium and Vitamin D
- Anabolic Steroids
- SERMs (Selective Estrogen Receptor Modulators)