All About Osteoporosis: What you Need to Know

What is osteoporosis? Who is vulnerable to this disease? What are the risks to women who have this debilitating bone disease? How can someone tell that she or he has the disease? Is this disease sexist and in what age group is it most likely to appear? What are the symptoms? Can osteoporosis be prevented and if not, how can it be treated and managed?

Osteoporosis is a debilitating disease which affects millions of Americans each year, both men and women are affected. By the end of this article one will know why this disease develops and how one can avoid it or at least minimize the painful affect of osteoporosis.

Osteoporosis is a disease of low bone mass and deterioration of living bone tissue. This low bone mass leads to fragile bones and increased fractures, "especially of the hip, spine, and wrist, although any bone can be affected." (www.nof.org, 2006). When someone develops this disease not only does her or his bone density decrease but a "variety of non-collagenous proteins in the bone is altered." (Wikipedia.com, 2006). Women are more susceptible to developing osteoporosis because their bones are already less dense than a man's.

What are the Risk Factors?

The factors of increased susceptibility for developing osteoporosis are: Current low bone mass, being a female, being slim and/or small boned, older aged, having anorexia, estrogen deficient resulting from menopause - even if it is surgically induced, low calcium, vitamin D deficient, certain medications and treatments like chemotherapy, low testosterone in males, sedentary or inactive living, cigarette smoking, using alcohol excessively, excessive use of soda's, and finally being Caucasian. (www.nof.org, 2006). Heredity is worth mentioning here as well. The chances of developing osteoporosis are more likely if a family member has or had it, especially if that family member is a parent (1^st degree family member).

Who can develop this disease?

Osteoporosis is more prevalent in women over 50 years of age but it is not a sexist disease as men who over 50 and older are susceptible as well. The estimated amount of women who have osteoporosis is approximately 8million as opposed to the 2million men in America. This figure calculates into 80% of American's who have osteoporosis are women. According to the National Osteoporosis Foundation, "One in two women and one in four men over age 50 will have an osteoporosis-related fracture in her/his remaining lifetime." (www.nof.org, 2006). An interesting fact about this painful disease is that it is mainly concentrated in Caucasians. There are cases in both Hispanic and African-Americans but not in such magnitudes. Because women suffer from extra amounts of bone density loss after menopause they are the most prone to the disease no matter their race.

What are the symptoms of Osteoporosis?

In the beginning stages of osteoporosis there are not visible symptoms. There are however, questionnaires one can take to assess level of risk. I took one of these assessments and found that it was not useful to me. I scored a five and the test does not indicate what that means and whether I should seek medical evaluation. One major indicator that suggests an evaluation is ceased menstrual cycle, especially if one is under the age of 50. I went through early menopause six years ago and thought it was a grand thing. Then things started happening and I brought it to my doctor's attention. Surprisingly, my physician acted aggressively in treatment, giving me straight estrogen. At the time I had no idea how precarious my situation was. I did not understand the implications of being postmenopausal (my estrogen level was nine - whatever that means) at the age of 28 but the further I get in the readings I get a bigger picture of the danger I was in. Luckily, my physician was able to force me out of menopause but I am left wondering what kind of damage was left behind to my bones.

After a time individuals suffering from lower-than-normal bone mass can develop osteopenia which can progress into osteoporosis. The symptoms of moderate to advanced osteoporosis are back pain, bone fractures associated with minor injuries like a bump against a table to the hip, loss of height, stooped height, and a dowager's hump or a curved upper back.

Fractures to the spine can happen while doing mundane activities such as opening a window or when twisting while picking up something. Advanced cases can lead to vertebral fractures - these can occur when performing an activity as minor as turning in one's sleep or sneezing. By the time fractures, especially spinal fractures occur an individual usually has advanced osteoporosis. Spinal fractures mostly occur in the thoracic spine or upper back. According to Spine-Health.com, spinal fractures that cause the disfiguring stooped posture are particularly painful and can turn into chronic pain and can cause crowding of internal organs. (www.Spine-health.com , 2006).

How can someone find out if she or he has osteoporosis?

If an individual suspects that she or he has a chance of developing osteoporosis he or she should schedule an appointment with a physician. Once there the physician can perform a bone mineral test or a BMD test, this test is called a DEXA scan which is a low energy x-ray. The x-ray passes "through the bone of the lower spine and hips" painlessly. (www.Spine-Health.com , 2006). The test measures the bone mass in individuals and is relatively quick. The DEXA scan is the only test used to diagnose osteoporosis before spinal or hip fractures occur. Once the T-score or bone density results are in a physician can prescribe a prevention or management plan. There are several medications that can be taken to prevent and/or manage osteoporosis, though I will only mention a few types:

Bisphosphonate is used to prevent and treat postmenopausal osteoporosis, which can help prevent fractures in the hip, spine and wrist. This medication can also help prevent bone loss in adults taking steroids. The side effects of taking Bisphosphonate are muscle and joint pain, heart burn or upset stomach.

Calcitonin is a hormone found in the body that helps with calcium regulation and bone metabolism. This can increase spinal bone density and can decrease bone loss in the spine, therefore; reducing the risks fractures to the spine. Calcitonin does not prevent fractures or bone loss in other bones in the body, this medication is strictly for the spine.

Hormone or Estrogen Replacement Therapy or HRT/ERT not only relieves menopausal symptoms but can be helpful to bones and the heart. ERT is primarily used in postmenopausal women to prevent osteoporosis and maintain bone density mass. This drug has been shown to slow or reduce bone loss and increase density in the spine and hip.

Another way to treat or prevent osteoporosis is to eat right. Changing one's diet to foods that are high in calcium helps increase bone density but is not a cure - this is only a prevention and management plan to help decrease chances of bone loss and fractures. Avoiding excessive use of vitamin A is suggested as it has been linked to low bone mass and can increase fractures in the hip. One should also consume vitamin C since this helps the immune system and can assist in keeping someone from becoming bedridden and thereby decreasing chances of developing osteopenia or osteoporosis from lack of movement and exercise.

Exercise has been proven to help fight bone loss as it builds the bone density, especially in men since they are more apt to have more bone mass than women. Repetitive exercises that are weight bearing and resistance are very good exercises to participate in. Using an elliptical machine is one option, since it provides a low impact resistance workout.

Finally, to help prevent the onset of osteoporosis, one should consider quitting smoking or excessive alcohol consumption since both have been shown to reduce bone density. There are a few options if one wants to quit smoking: smoking cessation classes can help by educating and unifying a group that can support one another, a nicotine patch has been used by millions of people to help break the cycle of hand to mouth motion and wean a smoker from nicotine, and finally a person can go "cold-turkey" by quitting spontaneously at once never to return to the harmful habit; this method takes sheer will and can be very difficult, especially if other smokers are around. There are fewer options where quitting alcohol is concerned. Again, one would have to rely on his or her will and support from others. One might have to change the environs that he or she frequents as this is usually a social disease. Making a life change is never easy but it is possible, especially when the over all health is in question.

There are resources available for people who want to learn more about osteoporosis and the management and prevention of the disease. One can go on-line and visit several sites like: www.fore.org or the National Osteoporosis Foundation. Asking their health care provider for information is also a way to learn about osteoporosis. Another option would be talking to someone who has this disease and getting first-hand information. Someone who is living through it may not only be able to provide hard copy resources, but verbal support as well and they may be able to guide someone who is new to the disease to a support group.

In closing I would like to reiterate that osteoporosis is a disease of the bone which is a decrease in bone density mass. This disease can cause fractures to the spine, hip, and wrist and can be quite painful. Osteoporosis is treatable and manageable with medications, exercise, and a calcium rich diet. Women are mostly susceptible to the disease, but men can develop it as well. Age, heredity, life-style, gender, race, body size, hormone and vitamin D deficiency are the prime risk factors of osteoporosis. The best way to prevent or manage the disease is early detection, if someone has any of the above mentioned risk factors, she or he should visit their health-care provider to receive a bone mineral density test and make a plan that is right for their situation.

Resources:

A-Z Health Guide from WebMD: Health Topics. (2006). Osteoporosis Symptoms. Retrieved November 1, 2006, from www.webmd.com/hw/osteoporosis/hw131453.asp

Osteoporosis (2006). Retrieved October 31, 2006, from http://en.wikipedia.org/wiki/Osteoporosis

Osteoporosis (2006). What is it? Retrieved October 30, 2006, from www.nof.org/osteoporosis/index.htm

Osteoporosis & Osteopenia (2006). Just the Facts. Retrieved October 29, 2006, from www.fore.org/patients/treatment.html

When is back pain a fracture? (2006). Compression fractures of the spine. Retrieved November 1, 2006, from

www.spine-health.com/topics/cd/fracture/fracture01.html