Osteoporosis is a disease of bone characterized by low bone mass and weakness of bone. This, in turn, leads to brittle bones and painful fractures. It can occur in one in two women after the age of 45 or post-menopausal age. Men over 60 years of age can also be affected.
The bone is a living organ which is constantly built and taken down. Diet, exercises, hormones and age are the factors which favor for building bone. To maintain a healthy bone, a balance of bone building and bone take down is required. When this balance is broken, then osteoporosis or weakness of bone results.
The disease is a silent killer because there are no symptoms. A fracture may be the first symptom of this problem. Common fractures of the spinal bones after trivial falls, after traveling in a bus on a bumpy road or even coughing can cause this painful fracture.
Similarly, wrist bone fractures due to falling on an outstretched hand, hip fractures due to falls at home can also occur due to osteoporosis. This fractures are difficult to treat as they occur usually in elderly populations and healing potential of fractures are also poor. Also, the plates and screws used for fixing these fractures don’t hold well on a soft bone. Hence there will be a loss in fracture reduction and failure to unite.
PREVENTION OF OSTEOPOROSIS:
As with many diseases, prevention of osteoporosis is better than undergoing the pain of fracture and costly treatments after that. Osteoporosis fractures are preventable if osteoporosis is diagnosed early.
Diagnosing osteoporosis is by simple tests with x-rays, DEXA scans, ultrasound scan or MRI. Ultrasound scan of the heel is commonly done to screen the population for osteoporosis. The more sensitive test for osteoporosis is a DEXA (Dual Energy Xray Absorptiometry) scan, which is done for the whole body as well as places where fractures frequently occur, namely hips and spine.
World Health Organisation (WHO) has classified the risk of fracture occurring on a graph and according to the bone density compared to a normal person, the risk is given and treatment must be started accordingly.
TREATMENT:
Treatment is aimed at strengthening the bone by either reducing the bone turnover or by building up the bones. Many treatments have been tried and a group of drugs called bisphosphonates is effective in improving the quality of bone in osteoporosis.
Another new drug is synthetic parathyroid, which is given as an injection on a day to day basis for several months. This drug helps in building up the bone and hence improves the strength.
MYTHS ABOUT OSTEOPOROSIS:
1. Osteoarthritis (wear and tear of joints) is a result of osteoporosis. This is not true as they both are caused by different problems. Though they can coexist, they are not the reason for each other.
2. Vitamin D deficiency causes osteoporosis. Again, this is not true as explained earlier, the reason for osteoporosis is not vitamin D deficiency.
3. Calcium supplements can cause side effects. This is partially true as overdoses may lead to certain heart problems and kidney stones in those who already have a propensity for kidney stones disease. Consult your doctor for correct dosage of calcium supplements.
Its consequences are preventable, if you have an adequate diet, do regular exercises and perform a DEXA scan every year in post-menopausal age group. Treatment is indicated if there is a decrease in bone mineral density.
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