Osteoporosis

Overview

Osteoporosis is defined by a loss of bone mass and density, which makes bones brittle, weak, and more prone to breaking. It happens when the amount of new bone growing isn't keeping up with the amount of old bone tissue being removed. This imbalance can cause the bones to gradually weaken over time, increasing their vulnerability to fractures, especially those that occur in the wrists, hips, and spine.

Types of Osteoporosis
Primary and secondary osteoporosis are the two fundamental categories into which osteoporosis is generally divided. There are unique risk factors and causes for each type:

Primary Osteoporosis: A bone disorder that develops naturally as people age is known as primary osteoporosis. The decrease of bone mass and density is what defines it. The most prevalent type of osteoporosis is called primary osteoporosis. Among the instances are:

Postmenopausal Osteoporosis: The most prevalent kind of osteoporosis, known as postmenopausal osteoporosis, strikes women after menopause as a result of lower oestrogen levels, which hasten the loss of bone.
Age-Related Osteoporosis (Senile Osteoporosis): Caused by a combination of deteriorating bone mass and the normal ageing process, this condition affects both men and women as they age, usually after the age of 70.
Secondary Osteoporosis: Secondary osteoporosis is failure of bone mass to develop in the growing skeleton, or loss of bone mass in the immature or adult skeleton, that occurs due to reduced mechanical loading arising as a consequence of several factors like:

- Endocrine diseases, including diabetes mellitus, Cushing's syndrome, hyperparathyroidism, and hyperthyroidism.
- Inflammatory bowel disease (IBD), malabsorption syndromes, and celiac disease are examples of gastrointestinal illnesses.
- Liver and renal diseases that are chronic.
- Rheumatologic conditions, including systemic lupus erythematosus and rheumatoid arthritis.
- A few drugs, such as long-term proton pump inhibitor usage, anticonvulsants, and glucocorticoids.

Symptoms of Osteoporosis

Osteoporosis is sometimes referred to as "the silent disease" since its symptoms may not be noticeable in its early stages until a fracture occurs. However, if the illness worsens, a number of symptoms could emerge:

Fractures: Even with little stress or trauma, osteoporosis weakens bones and increases their vulnerability to fractures. Common sites for fractures include the hip, spine (vertebrae), and wrists.

Back pain: Osteoporosis-related vertebral fractures can result in chronic back pain, which is frequently described as a dull ache or discomfort in the affected area. Serious spinal fractures can result in kyphosis, a hunched posture, and height reduction.

Loss of height: Compression fractures in the spine can result in a gradual loss of height over time, known as height reduction or shrinkage.

Stooped posture: Vertebral fractures can also contribute to a stooped or hunched posture, known as kyphosis, which is often referred to as a dowager's hump.

Decreased mobility: Fractures and pain associated with osteoporosis can lead to decreased mobility and limitations in daily activities.

Tooth loss: Severe osteoporosis can affect the jawbone, leading to tooth loss and dental problems.

Therefore, early detection through bone density testing and appropriate management are crucial in preventing complications associated with this condition.

Causes of Osteoporosis

Numerous variables, including genetic, hormonal, behavioural, and environmental ones, might contribute to osteoporosis. It is crucial to comprehend the several causes of osteoporosis in order to avoid it and treat it effectively:

One of the main risk factors for osteoporosis is getting older. Bone loss results from a decrease in bone mass and a disruption in the balance between bone growth and resorption as people age.

The development of osteoporosis is also significantly influenced by hormonal abnormalities. Bone loss is partly caused by decreased oestrogen levels in women during menopause and decreased testosterone levels in males as they age. Bone loss can also be accelerated by hormonal conditions such as hyperparathyroidism, hypogonadism, and hyperthyroidism.

Another significant factor influencing bone density and the risk of osteoporosis is genetics and family history. A person's likelihood of developing osteoporosis or fractures is increased if they have a family history of the ailment.

A deficiency in calcium and vitamin D, which are vital minerals for healthy bones, can deteriorate bones and raise the risk of osteoporosis. The metabolism of bones is also influenced by other minerals, such as phosphorus, magnesium, and vitamin K.

Osteoporosis can result from a number of lifestyle choices, such as smoking, drinking too much alcohol, being sedentary, and eating a diet low in minerals that are vital for healthy bones.

Bone health can be impacted by long-term medical diseases such rheumatoid arthritis, gastrointestinal issues, and endocrine abnormalities. Osteoporosis risk may also be raised by prolonged use of drugs including corticosteroids, anticonvulsants, and some cancer treatments.

Tests and Treatments of Osteoporosis

Osteoporosis diagnosis usually entails measuring bone density and analysing fracture risk using a variety of techniques:

Dual-Energy X-ray Absorptiometry (DEXA) Scan: DEXA scan is the gold standard for diagnosing osteoporosis. It measures bone mineral density (BMD) at the hip and spine, providing a T-score that compares an individual's BMD to that of a healthy young adult. A T-score of -2.5 or lower indicates osteoporosis, while a T-score between -1 and -2.5 indicates osteopenia (low bone mass).

Fracture Risk Assessment: Alongside bone density measurement, healthcare providers assess additional risk factors for fractures, such as age, sex, history of fractures, family history of osteoporosis, smoking, alcohol intake, and glucocorticoid use.

Clinical Evaluation: Healthcare providers conduct a thorough medical history and physical examination to identify potential underlying causes of bone loss, such as hormonal imbalances, nutritional deficiencies, or medical conditions.

Laboratory Tests: To check bone health and rule out secondary causes of osteoporosis, blood tests may be conducted to evaluate levels of calcium, vitamin D, thyroid hormones, and indicators of bone turnover.

Imaging Studies: Quantitative computed tomography (QCT) and vertebral fracture assessment (VFA) are two imaging studies that can be performed to estimate bone density at peripheral sites like the forearm or to assess vertebral fractures.

Prevention of Osteoporosis

Developing a holistic strategy that prioritises improving bone health and lowering risk factors related to bone loss is essential to preventing osteoporosis. The following are some methods for preventing osteoporosis:

Sufficient consumption of calcium: The health of bones depends on calcium. Make sure you eat foods high in calcium on a regular basis, like dairy, fortified foods, tofu, leafy greens, and almonds. If there is insufficient calcium in your diet, think about taking supplements.

Regular exercise: Engage in weight-bearing exercises such as walking, jogging, dancing, or strength training to promote bone strength and density. Incorporate balance and flexibility exercises to reduce the risk of falls and fractures.

Lead a healthy lifestyle: Refrain from smoking and drink in moderation as these behaviours can weaken bones and raise the chance of fractures. Sustain a healthy body weight because osteoporosis risk increases with underweight.

Avoid falls: Take steps to reduce the chance of falling, like clearing up trip hazards from your home, adding grab bars to your bathrooms, wearing appropriate footwear, and getting regular eye exams.

Bone density testing: Take into consideration having a bone density test (DEXA scan) as advised by your doctor, particularly if you are postmenopausal or have osteoporosis risk factors.