What Is Osteoporosis? Treatment, Symptoms, Medication
What Is Osteoporosis?

Osteoporosis is a disorder of the bones in which the bones become brittle, weak, and easily damaged or broken. A decrease in the mineralization and strength of the bones over time causes osteoporosis.
Does Osteoporosis Only Affect the Elderly?

While the effects of osteoporosis are often seen in the elderly, the disorder usually starts progressing from middle age on. Bones are their strongest in a person's mid-twenties, so it is important to have a good foundation early on to maintain healthy bones late in life.
Why Is Osteoporosis an Important Public Health Issue?

In the United States, 10 million people have osteoporosis (80% of those are women), and 44 million are at risk for developing the disease due to low bone density. Osteoporosis is a public health issue in the U.S. because the disease contributes to two million fractures (broken bones), including 300,000 hip fractures, annually. The costs of medical care for these injures is an estimated $19 billion annually. These injuries can also result in permanent disability or an inability to return to work or perform daily activities.
What Are the Symptoms of Osteoporosis?

Osteoporosis may not cause any apparent symptoms. People may not know they have osteoporosis until they break (fracture) a bone.
Osteoporosis Symptoms: Fractures of the Spine

Vertebral (spinal) compression fractures are broken bones in the back that are due to weak bones caused by osteoporosis. The vertebrae (spinal bones) collapse as a result of even minor injuries related to falling, bending, twisting, or sneezing. As the bones of the spine lose their mineralization and strength, they can collapse, causing a hunched-over appearance, often referred to as a "dowager hump."
Osteoporosis Symptoms: Stress Fracture

Stress fractures occur in bones due to repetitive injuries, usually with minimal trauma. People with osteoporosis are more prone to stress fractures because of the weakness of their bones.
Osteoporosis Symptoms: Hip Fracture

Those affected by osteoporosis are at greater risk for hip fractures. Even a simple fall can cause a hip fracture in a person with osteoporosis. Due to the weakness in the bones these injuries may take a long time or be difficult to fully heal.
What Are the Consequences of Osteoporosis?

Fractures related to osteoporosis can result in significant pain and disability. Hip fractures are common among people with osteoporosis. Approximately 24 percent of hip fracture patients over the age of 50 die within one year following their injury, and one-quarter will remain in a nursing home.
Those who have one vertebral (spinal) compression fracture are at high risk for developing other such fractures.
What Factors Determine Bone Strength?

Bone strength is related to bone mass (density), which refers to the amount of mineralization remaining in bones as people age. The denser the bones, the stronger they are.
Factors that determine bone strength include:
- Genetics
- Environment
- Medications
- Ethnicity (African-Americans have higher bone density than Caucasians or Asians)
- Gender (men have higher bone density than women)
- Aging (bone density reaches its peak around age 25, and decreases after age 35)
Menopause, Estrogen, and Osteoporosis

Women tend to be diagnosed with osteoporosis more often than men because once they reach menopause, estrogen levels decrease. Estrogen helps maintain bone density in women. Post-menopausal women can lose up to 20 percent of bone mass during the five to seven years following menopause.
What Are the Risk Factors for Developing Osteoporosis?

Risk factors for developing osteoporosis that cannot be controlled include:
- Female gender
- Ethnicity – Caucasian or Asian
- Family history
Risk factors for developing osteoporosis that can be controlled include:
- Smoking
- Lack of exercise
- Diets lacking calcium
- Poor nutrition
- Alcohol abuse
What Are the Risk Factors for Developing Osteoporosis? (continued)

Additional risk factors for developing osteoporosis include medical conditions such as:
- Chronically low estrogen levels
- Vitamin D deficiency
- Hyperthyroidism
- Inability to exercise
- Medications, such as chemotherapy, corticosteroids, or seizure medications
- Hyperparathyroidism
- Loss of menstrual periods (amenorrhea)
- Inability to absorb nutrients properly in the digestive tract
How Is Osteoporosis Diagnosed?

Osteoporosis is often diagnosed on an X-ray when the patient suffers a fracture. However, by the time osteoporosis is visible on X-ray there may be significant bone loss.
A dual energy X-ray absorptiometry (DEXA or DXA) scan can be used as a screening test for osteopenia (bone loss that precedes osteoporosis). This test measures bone density in the hip and spine and is more precise than an X-ray.
Who Should Have Bone Density Testing?

The National Osteoporosis Foundation recommends the following groups of people should have dual energy X-ray absorptiometry (DEXA or DXA) scans to screen for osteoporosis:
- All women age 65 and older
- All postmenopausal women under age 65 who have risk factors for osteoporosis
- Postmenopausal women with fractures
- • Women with a medical condition associated with osteoporosis, including rheumatoid arthritis, smoking, alcoholism, or body weight less than 127 pounds.