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Osteoporosis

Osteoporosis is a disease when there is a decrease in bone density that results in decreased bone strength. This condition results in increased risk and propensity for fractures.

The majority of women who develop osteoporosis do so after Menopause. But it can occur at any age and in both men and women. And it is the leading underlying cause of a broken bone in older men and women. It is considered preventable with medication, lifestyle changes, and increase exercises in some cases.

All women over 65 should be screened for osteoporosis.

Below 65 should be screened when they have associated risk factors or an unexpected fracture.

Between 65 and 80 are when men are often screened.

Symptoms

–  No specific symptoms are seen
–  Often fractures are first findings
  –  Fractures can occur in vertebral column, ribs, hips, and wrist
  –  Compression fractures suddenly occur causing pain
  –  Unexpected falls

Risk factors:

–  Vitamin D deficiency
–  Smoking
–  Excess
–  Alcohol
–  Physical inactivity
–  Underweight
–  Soft drinks

Causes:

–  Endocrine disorders
–  Malnutrition
–  Immobilization
–  Space Flight
–  Rheumatoid Arthritis
–  Medications
–  and many others

DEXA or DXA scan to evaluate bone density

Diagnostic criteria by “World Health Organization”

–  T-score of greater then – 1.0 – Normal
–  T-score of between – 1.0 and – 2.5 – Low bone mass = osteopenia
–  T-score of less then – 2.5 or below –  Osteoporosis

Treatment

Medications

Bisphosphonates

.    Sodium Alendronate [Fosamax]
.    Risedronate  [Actonel]
.    Ibandronate  [Boniva]
.    Zoledronic Acid  [Zoledronate, Zometa]

.    Teriparatide  [Forteo] –

.    Strontium Ranelate – Dual action bone agents

.    Estrogen replacement therapy

–  Not always recommended for each person

.  Testosterone treatment in men

2.)  Calcium supplement

3.)  Vitamin D

Exercise

–  Aerobics
–  Resistance
–  Weight bearing
–  Walking
–  others