Osteoporosis or in literal terms, porous bone, is a condition in which the quality and the density of the bones get reduced.
As the bones are more fragile and porous, there are greater risks of getting a fracture.
The most dangerous part of this medical condition is that the loss of bone occurs silently and gradually, and to the utter shock, there are no symptoms before the first fracture happens.
The bones become brittle and weak due to osteoporosis. This may result in even very low impact trauma to cause fractures.
Yes, you heard it right!
Even mild stresses are enough to cause a fracture in the fragile bones when one suffers from osteoporosis. These kinds of fractures occur most commonly in the wrist, hip or spine.
Bones are living tissues, undergoing constant replacement and breaking down. When the process of creation of new bones is no longer able to cope up with the loss of old bone, osteoporosis affects the sufferers.
This is a very common condition affecting men and women belonging to all races, but white and Asian women, especially women who have attained menopause are at greater risks.
To prevent the occurrence of this condition, medications, weight-bearing exercises and a healthy diet are often the recommended course of the path.
The bones are getting renewed constantly. The new bones are made and the old bones get broken down. When we are young, our body can make the new bones faster than the rate of breaking down the old bones. Bone mass also increases faster. The peak bone mass is reached by the time we reach our thirties. Beyond this age the bone mass starts to reduce faster than it is created. The likelihood of osteoporosis to affect us depends on the amount of bone mass we have attained in our youth. We inherit the peak bone mass and it also varies depending on the ethnic group.
Some of the risk factors for osteoporosis to affect us are our sex, race, family history, age and body frame size.
Osteoporosis is also more common in people who have too little or too much of a certain kind of hormone.
Dietary factors like low intake of calcium, gastrointestinal surgery, long-term dependence on injected or oral corticosteroid medications like prednisone are also greater causes for osteoporosis to occur.
Whenever a doctor thinks of osteoporosis, as the condition the patient might be suffering from, he considers risk factors and family history. When they suspect osteoporosis, they will request for a bone mineral density scan or BMD. A type of X-ray known as dual-energy X-ray absorptiometry or DEXA is used in the scanning. DEXA is also used to monitor the person’s response to the treatments offered.
Treatment for osteoporosis basically aims at following:
The pharmacological treatment of osteoporosis aims at either reducing the rate of bone destruction in the body or increasing bone formation.
The 1st line treatment in the western world for Osteoporosis are a class of drugs called bisphosphonates (alendronic acid, Risedronic acid) which reduce the rate of bone destruction.
Calcitonin and Parathyroid hormone are used as treatment alternatives as they can increase bone formation. However there is some increased risk of forming bone tumour with these drugs.
Monoclonal antibodies are the newest group of drugs licensed for this condition and again acts by increasing bone formation. Serious adverse effects are so far not reported with this treatment although they are very new in the market.
Partial oestrogen agonists are possible alternatives. HRT is no longer considered a treatment option for bone protection only in post menopausal women due to various other risks associated with this treatment.
A healthy diet containing plenty of calcium and vitamin D is recommended to prevent osteoporosis.
A group of exercises called Strength and balance training exercises is recommended to build muscle strength around the joints and make them more stable; additionally then reducing the risk of falls and fracture.
Dr. Dwaipayan Sen is a Consultant Stroke Physician and Clinical Lead for Comprehensive Stroke Services (Salford Hope Hospital, UK)
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