What is osteoporosis?
Osteoporosis is a disease that affects your bones. It means you have bones that are thin and brittle, with lots of holes inside them like a sponge. This makes them easy to break. Osteoporosis can lead to broken bones (fractures) in the hip, spine, and wrist. These fractures can be disabling and may make it hard for you to live on your own.
Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace them, leading to a loss of bone thickness (bone mass or density). As a result, bones become thinner and less dense, so that even a minor bump or accident can cause serious fractures. These are known as fragility or minimal trauma fractures.
Any bone can be affected by osteoporosis, but the most common sites are bones in the hip, spine, wrist, ribs, pelvis and upper arm. Osteoporosis usually has no signs or symptoms until a fracture happens - this is why osteoporosis is often called the 'silent disease'.
Fractures due to osteoporosis (osteoporotic fractures) can lead to changes in posture (eg developing a stoop or Dowager's hump in your back), muscle weakness, loss of height and bone deformity of the spine. Fractures can lead to chronic pain, disability, loss of independence and even premature death.
Every 8 minutes, someone is admitted to an Australian hospital with an osteoporotic fracture. This is expected to rise to every 3 - 4 minutes by the year 2021, as the population ages and the number of osteoporotic fractures increase.
The Fracture Cascade
The 'cascade effect' means that women who have suffered a fracture in their spine are over 4 times more likely to have another fracture within the next year, compared to women who have never had an osteoporotic fracture.
People who have had two or more osteoporotic fractures are up to 9 times more likely to have another fracture, rising to an 11 times greater risk for people who have had three or more fractures, compared to someone who has not had one.
1 in 2 women and 1 in 3 men over 60 years will have an osteoporotic fracture in Australia.
Two thirds of fractures of the spine are not identified or treated, even though they nearly all cause pain and some disability. Often people believe that the symptoms of spine fracture back pain, height loss or rounding of the spine are just due to 'old age'. However, for many people, osteoporotic fractures can be prevented, or at least your risk of having further fractures greatly reduced.
To stop the fracture cascade, it is essential that osteoporotic fractures are identified and treated as quickly as possible.
Osteoporosis affects millions of older adults. It usually strikes after age 60. It’s most common in women, but men can get it too.
What causes osteoporosis?
Osteoporosis is caused by a lack of bone strength or bone density. As you age, your bones get thinner naturally. But some things can make you more likely to have the severe bone thinning of osteoporosis. These things are called risk factors. Some risk factors you can change. Others you can't change.
Risk factors you can't change include:
- Your age. Your risk for osteoporosis goes up as you get older.
- Being a woman who has gone through menopause. After menopause, the body makes less estrogen. Estrogen protects the body from bone loss.
- Your family background. Osteoporosis tends to run in families.
- Having a slender body frame.
- Your race. People of European and Asian background are most likely to get osteoporosis.
Risk factors you can change include:
- Smoking.
- Not getting enough exercise.
- Drinking too much alcohol.
- Not getting enough calcium, vitamin D, and phosphorus in the things you eat or from supplements.
What are the symptoms?
Osteoporosis can be very far along before you notice it. Sometimes the first sign is a broken bone in your hip, spine, or wrist after a bump or fall.
As the disease gets worse, you may have other signs, such as pain in your back. You might notice that you are not as tall as you used to be and that you have a curved backbone.
How is osteoporosis diagnosed?
Your doctor will ask about your symptoms and do a physical exam. You may also have a test that measures your bone thickness (bone density test) and your risk for a fracture.
If the test finds that your bone thickness is less than normal but is not osteoporosis, you may have osteopenia, a less severe type of bone thinning.
It’s important to find and treat osteoporosis early to prevent bone fractures. The United States Preventive Services Task Force advises routine bone density testing for women age 65 and older. If you have a higher risk for fractures, it’s best to start getting the test at age 60.
How is it treated?
Treatment for osteoporosis includes medicine to reduce bone loss and to build bone thickness. Medicine can also give you relief from pain caused by fractures or other changes to your bones.
It’s important to take both calcium and vitamin D supplements along with any medicine you take for the disease. You need both of these supplements to build strong, healthy bones.
You can slow osteoporosis with new, healthy habits. If you smoke, quit. Get plenty of exercise. Walking, jogging, dancing, and lifting weights can make your bones stronger. Eat a healthy mix of foods that include calcium and vitamin D. Try dark green vegetables, yogurt, and milk (for calcium). Eat eggs, fatty fish, and fortified cereal (for vitamin D).
Making even small changes in how you eat and exercise, along with taking medicine, can help prevent a broken bone.
When you have osteoporosis, it’s important to protect yourself from falling. Reduce your risk of breaking a bone by making your home safer. Make sure there’s enough light in your home. Remove throw rugs and clutter that you may trip over. Put sturdy handrails on stairs.
