Dr Mathankumar Mohandoss
Often called the brittle bone disease, osteoporosis is a condition in which the density of the bone is reduced making it fragile and prone to easy fractures compared to normal bones. In osteoporosis, bones lose minerals, such as calcium, more quickly than the body can replace them, leading to a loss of bone thickness. As a result, bones become thinner and less dense.
High risk groups
Generally women have less bone stock than men. Bone density increases gradually with age and reaches a high peak value at 18 in women and 20 in men. Estrogen, a hormone in women that protects bones, decreases sharply when women reach menopause, which makes the problem even worse. Bone loss is approximately between 1 per cent and 5 per year after menopause. Though there is no clear data available, the International Osteoporosis Foundation (IOF), estimates that osteoporosis affects about 200 million women worldwide.
Don’t blame only the hormones
Though hormones are one of the major factors, they aren’t the only reason behind the ailment. Some of the other controllable and modifiable factors responsible are
- Sedentary lifestyle Inadequate
- calcium and Vitamin D intake Less exposure to sunlight.
- Smoking and excessive alcohol consumption
- Low body weight
What’s the diagnosis
Osteoporosis is a silent disease and it often progresses without any symptoms or pain. Noteable loss in height and presence of DowagerÄ€iÄ€¦s hump: a outward curvature noted in the spine, are most usual signs of it. Doing a bone density test is a must; dual-energy x-ray absorptiometry (DEXA) scanning is the most appropriate method to know about bone density. The calculated value of the test is called T-score and a value of -2.5 or lesser is considered to be osteoporotic. While value score of -1 or more is normal, the T-score between -1 and -2.5 is termed as osteopenic. Osteopenia is considered a borderline bone weakness which could progress into osteoporosis if no preventive measures are taken. Ultrasound scanning is also an option but can be used only as a screening tool.
Measures to be taken
- Adequate intake of calcium
- Adequate Vitamin D
- Cessation of smoking and reducing alcohol intake
- Regular exercise
- BMD (bone mineral density screening after 40 years
- Hormonal therapy after menopause, after surgical removal of ovaries and other problems in the liver and kidneys.
Getting it treated
Treatment helps to reduce risk of fractures and improve bone health, but doesn’t cure the problem completely. Once diagnosed with osteoporosis, drug therapy becomes important. There are several options available which include drugs with bisphosponates, calcitonin and hormonal therapy. Getting advice from the physician is important and the kind of therapy and dosage could be suggested only by a physician.
Surgical management like vertebroplasty, in which bone mass is injected into the vertebra involved, for back pain and joint replacement for hip fractures are other effective methods. Weight bearing exercises are the best conservative methods and whole body vibration therapy is a method which has been scientifically proven to be an option for conservative management. Prevention of fall and other injuries becomes important as fragile bones can fracture easily.