Osteoporosis

Description

Osteoporosis is a progressive skeletal disease that is characterized by decrease in bone mass and density. Bones undergo remodeling constantly. In osteoporosis, there is an imbalance between production and destruction. Bones become brittle, porous, and vulnerable to fracture. Fractures are most common in hip, backbone, and wrist.

Causes

Following are some of the causes of osteoporosis:

Family tendency of osteoporosis
Cystic fibrosis (lung infection)
Osteogenesis imperfecta (brittle bone disease)
Vitamin C and D deficiency
Malnutrition
Alcohol abuse and smoking
Medicines like anticonvulsants, anticoagulants, chemotherapy, or corticosteroids.
Abnormal thyroid levels
Diabetes type-I
Celiac disease

Risk factors

Several factors can increase risk of developing osteoporosis, some of them are:

Age: Risk of getting osteoporosis increases with increasing age.
Gender: Females have a predilection of getting osteoporosis.
Menopause: Bone density rapidly decreases in women after menopause because of estrogen deficiency.
Family history: Genetics has an important role in developing osteoporosis. There is an increased risk of developing osteoporosis if your parents or sibling have it.
Short stature: People with short height are more likely to develop osteoporosis.
Sedentary lifestyle: People who lack physical activity in their daily routine are more prone to developing this disease.
Smoking and alcohol abuse: Tobacco and alcohol negatively affect bone health.
Medicines: Certain medicines like anti-seizures and corticosteroids are associated with an increase in osteoporosis.
Malnourished: Nutrition is important for the health of bone. Malnourished is yet another identifiable risk of osteoporosis.

Symptoms

An increase in the tendency to fracture may be the only sign initially, and fractures of the wrist or hip bone after falling are very common. This may be followed by any of these symptoms:

Muscular aches and pains (particularly in the neck or back)
Muscle tenderness
Backache
Fractures
Leaned down posture
Loss of height.

Diagnosis

To reach a diagnosis, your doctor will ask for your complete medical history and perform a physical exam. If he/she suspects osteoporosis, your doctor may ask you to get the following test done:

Bone mineral density scan
DEXA scan
Ultrasound scan of heel.

Management

The goal of management is to relieve the symptoms, stabilize the remaining bone density, fracture prevention, and decrease osteoclast activity (destruction). Following are the medicines:

Lifestyle modification: Follow a strict diet rich in calcium, avoid smoking, alcohol, or caffeine intake, and exercise regularly.
Drug therapy: Medicines are prescribed by the doctor based on severity of osteoporosis, it includes:

Bisphosphonates are very useful for fracture prevention in patients who already had a fracture associated with osteoporosis.
Monoclonal antibodies
Hormone replacement therapy.

Surgery:

Vertebroplasty: To stabilize the weakened bone.
Kyphoplasty: To correct extreme curvature of spine.

When to consult a doctor?

Consult your doctor immediately if there is persistent back pain, fever, numbness in genitals, numbness in leg or feet, loss of control over bladder or bowel or if there is worsening of the condition.