Many people never learn they have osteoporosis until they suffer a bone fracture, usually in the spine. Fractures can cause pain and a stooped posture, known as a Dowager’s Hump.
Women and men with small body frames are at higher risk, as are those with a family history of osteoporosis. The risk increases with age, particularly after menopause when levels of bone-bolstering estrogen drop. Contact Osteoporosis Care in Boca now!
Osteoporosis is a disease that causes bones to become thin and weak, increasing the risk of broken bones. This condition can affect any bone in the body, but is most common in the hip, spine and wrist. Symptoms of osteoporosis are often not noticed until it is too late and a bone breaks.
The cause of osteoporosis is not fully understood, but it is known that old bone tissue breaks down faster than new bone can be made. This can lead to a cycle where the bones get thinner and break more easily over time. The disease is more common in women than men, but both can get it. The risk of osteoporosis increases with age, and white and Asian people are more likely to get it than other races. People with certain health conditions are also at greater risk, including rheumatoid arthritis, inflammatory bowel diseases like Crohn’s and ulcerative colitis, and chronic obstructive pulmonary disease (COPD). Genetic disorders such as Ehlers-Danlos syndrome, Marfan syndrome, and glycogen storage diseases can contribute to the disease.
Osteoporosis can develop without any symptoms in the early stages, so some people do not know they have the disease until a bone fractures. This can happen in any bone, but is most common in the hip, back or wrist. Often the first symptom of severe osteoporosis is a back pain, which may be worse in the morning or after standing for long periods of time. Some people with advanced osteoporosis can get a curved back, called a stooped posture, or a hump in the upper spine, which is caused by spinal compression fractures.
People who are at a higher risk of osteoporosis should talk to their doctor about screening and treatment options. A doctor can perform a simple test, called a bone density scan, to measure the strength of your bones. This test uses X-rays to create images of your bones and shows the amount of calcium and other minerals in them. The test is also known as a DEXA scan, DXA or bone density scan. The results of this test can help your doctor diagnose the disease.
Diagnosis
Osteoporosis is a condition that makes bones thinner and weaker, making them more likely to break. It usually doesn’t cause any symptoms and is often spotted only when a bone breaks, which happens most frequently in the hip, spine or wrist. These broken bones are called fragility fractures because they are caused by a minor event, such as a fall, that wouldn’t have caused a break in someone with healthy bones.
People with osteoporosis may also experience a loss of height, mainly due to compression fractures of the spine, which can make the spine curve and become shorter as each vertebrae break. Some people develop back pain as a result of these changes, while others may have difficulty breathing due to the reduced space under their ribs.
The earliest sign of osteoporosis is usually a broken bone, which can be triggered by simple actions such as sneezing or coughing. This can lead to a hip, spine or wrist fracture and is most commonly seen in women.
Doctors diagnose osteoporosis using a test to measure bone density, known as central dual-energy X-ray absorptiometry (DXA). A health professional scans your hip or spine with this machine to see how dense your bones are and compare them to other people of your gender and age.
A DXA scan takes anywhere from 10 to 15 minutes and is painless. People with certain medical conditions or on medications that increase their risk of osteoporosis may require special tests to identify the condition. These include those with a history of rheumatoid arthritis or some inherited diseases, such as osteogenesis imperfecta, multicentric carpotarsal osteolysis syndrome, spondylolisthesis and some metabolic disorders, including glycogen storage disease, homocystinuria, Menkes’ disease and epidermolysis bullosa.
Your healthcare provider can help you to manage your symptoms and prevent further bone loss by recommending treatments such as medication, weight-bearing exercise, diet, lifestyle changes and physical therapy. Some healthcare providers may suggest that you take calcium and vitamin D supplements. They may also recommend that you talk to other people with osteoporosis and/or join a support group.
Treatment
Medications that help prevent or treat osteoporosis work by helping the body balance bone loss with new bone formation. They can slow down the breakdown of bones and reduce the risk of fractures. Some examples of medicines used to treat osteoporosis include alendronate (Fosamax), bisphosphonates (Aredia, Boniva), denosumab (Prolia) and romosozumab (ReoPro).
The best time to begin treatment is before you have a break or serious fracture. However, most people don’t have symptoms until they break a bone, which often happens during a minor fall or in the back. The most common broken bones are in the spine, wrist or hip. People who have a break in their back may develop a vertebral crush fracture, which can cause a stooping posture and shorten the height. In some cases, the break in the spine can cause the collapse of a part of the rib cage, which can make breathing difficult.
A healthy diet and regular exercise are important for building and maintaining strong bones. Eat plenty of calcium-rich foods such as milk, yogurt, cheese and dark green vegetables. Also get enough vitamin D, which is found in some foods and supplements. Exercise regularly, especially weight-bearing exercises that put some pressure on the bones, such as walking, stair climbing or dancing.
Your healthcare team will create a care plan that includes a mix of treatments, depending on your risk for breaking a bone. They will consider your age, sex, results of your bone density scan and other factors.
These treatments may include medicines and physical therapy. The team will also talk to you about safe and healthy ways to manage your condition, such as removing tripping hazards from the home. They can also show you how to use assistive devices like walkers.
If you have insurance, most plans cover the cost of osteoporosis treatments. Your share, or co-pay, will vary depending on your insurance company and the type of medication you take. If you need to have a medication given in the doctor’s office or hospital (such as a drug that is administered by intravenous injection), ask your insurance company about costs.
Prevention
Osteoporosis makes bones thinner and weaker, causing breaks (fractures) that can lead to pain, disability, or death. Osteoporosis is called a “silent disease” because many people do not know they have it until they break a bone. Prevention includes diet, exercise, and medications to prevent fractures and slow bone loss.
Bones are living tissue that need to be constantly broken down and rebuilt, just like muscle. In the early years of life, more bone is built than broken down, leading to peak bone mass around age 25. After that, the balance shifts and bone loss begins to outpace new bone growth. It is important to protect bone health through proper diet and lifestyle choices, especially for men and women over 50.
For example, drinking too much alcohol and smoking can increase bone loss. People who are at greater risk for osteoporosis include those with rheumatic diseases such as rheumatoid arthritis, ankylosing spondylitis, or systemic lupus erythematosus. Other medical conditions linked to osteoporosis include sarcoidosis, polyarticular juvenile idiopathic arthritis, and hematologic disorders such as leukemia or lymphoma, multiple myeloma, thalassemia, and sickle-cell disease.
Other risk factors for osteoporosis include family history, race, and sex. Women have a higher risk for osteoporosis than men because they lose bone mass at a faster rate, especially after the onset of menopause. Bone loss is also accelerated in those with low estrogen levels, such as women taking hormone replacement therapy for breast cancer or men using hormone-reducing therapies for prostate cancer.
Your doctor can help you predict your risk of osteoporosis by analyzing your symptoms and medical history, performing a physical exam, and ordering a DEXA scan. The test measures your bone density and gives a number, known as your Z-score, that compares your bone strength to the strength of healthy people of the same age and sex. Your doctor can use this information to develop a treatment plan for you. In addition to medications, this may include lifestyle changes and, in some cases, surgery. For example, a hip fracture from osteoporosis can lead to severe disability, so your doctor may recommend surgery to improve stability and prevent future falls.