Osteoporosis treatment

Osteoporosis is a disease characterized by low bone mass and loss of bone tissue that may lead to weak and fragile bones. If you have osteoporosis, you have an increased risk for fractured bones (broken bones), particularly in the hip, spine, and wrist.
Osteoporosis is often considered to be a condition that frail elderly women develop. However, the damage from osteoporosis begins much earlier in life. Because peak bone density is reached at approximately 25 years of age, it is important to build strong bones by that age, so that the bones will remain strong later in life. Adequate calcium intake is an essential part of building strong bones.
In the United States, nearly 10 million people already have osteoporosis. Another 18 million people have low bone mass that places them at an increased risk for developing osteoporosis. As our population ages, these numbers will increase. About 80% of those with osteoporosis are women. Of people older than 50 years of age, one in two women and one in eight men are predicted to have an osteoporosis-related fracture in their lifetime.
According to the World Health Organization, the prevalence of osteoporosis among U.S. white women past menopause is estimated to be 14% in those 50-59 years of age, 22% in those 60-69 years of age, 39% in those 70-79 years of age, and 70% in those 80 years of age and older. Significant risk has been reported in people of all ethnic backgrounds. White and Asian racial groups, however, are at greatest risk.

Osteoporosis Causes
Osteoporosis occurs when there is an imbalance between new bone formation and old bone resorption. The body may fail to form enough new bone, or too much old bone may be reabsorbed, or both. Two essential minerals for normal bone formation are calcium and phosphate. Throughout youth, the body uses these minerals to produce bones. Calcium is essential for proper functioning of the heart, brain, and other organs. To keep those critical organs functioning, the body reabsorbs calcium that is stored in the bones to maintain blood calcium levels. If calcium intake is not sufficient or if the body does not absorb enough calcium from the diet, bone production and bone tissue may suffer. Thus, the bones may become weaker, resulting in brittle and fragile bones that can break easily.
Usually, the loss of bone occurs over an extended period of years. Often, a person will sustain a fracture before becoming aware that the disease is present. By then, the disease may be in its advanced stages and damage may be serious.
The leading cause of osteoporosis is a lack of certain hormones, particularly estrogen in women and androgen in men. Women, especially those older than 60 years of age, are frequently diagnosed with the disease. Menopause is accompanied by lower estrogen levels and increases a woman's risk for osteoporosis. Other factors that may contribute to bone loss in this age group include inadequate intake of calcium and vitamin D, lack of weight-bearing exercise, and other age-related changes in endocrine functions (in addition to lack of estrogen).
Other conditions that may lead to osteoporosis include overuse of corticosteroids (Cushing syndrome), thyroid problems, lack of muscle use, bone cancer, certain genetic disorders, use of certain medications, and problems such as low calcium in the diet.

  • The following are risk factors for osteoporosis:
    • Women are at a greater risk than men, especially women who are thin or have a small frame, as are those of advanced age.
    • Women who are white or Asian, especially those with a family member with osteoporosis, have a greater risk of developing osteoporosis than other women.
    • Women who are postmenopausal, including those who have had early or surgically induced menopause, or abnormal or absence of menstrual periods are at greater risk.
    • Cigarette smoking, eating disorders such as anorexia nervosa or bulimia, low amounts of calcium in the diet, heavy alcohol consumption, inactive lifestyle, and use of certain medications, such as corticosteroids and anticonvulsants, are also risk factors.
    • Rheumatoid arthritis itself is a risk factor for osteoporosis.
    • Having a parent that has/had osteoporosis is a risk factor for the offspring.

Osteoporosis Symptoms
Early in the course of the disease, osteoporosis may cause no symptoms. Later, it may cause dull pain in the bones or muscles, particularly low back pain or neck pain.
Later in the course of the disease, sharp pains may come on suddenly. The pain may not radiate (spread to other areas); it may be made worse by activity that puts weight on the area, may be accompanied by tenderness, and generally begins to subside in one week. Pain may linger more than three months.
People with osteoporosis may not even recall a fall or other trauma that might cause a broken bone, such as in the spine or foot. Spinal compression fractures may result in loss of height with a stooped posture (called a dowager's hump).
Fractures at other sites, commonly the hip or bones of the wrist, usually result from a fall.

When to Seek Medical Care
If you are past menopause and have constant pain in areas such as the neck or lower back, consult us for further evaluation. If you are at risk for developing osteoporosis (see risk factors above), also consult your doctor for a medical assessment and bone density screening.
Go to the hospital if you feel severe pain in your muscles or bones that limits your ability to function. Go to the hospital's emergency department if you have sustained trauma or suspect fractures of your spine, hip, or wrist.

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