By John M. Neidecker, DO, ATC, and Barbara Harry, APN, C
Osteoporosis is the most common of all bone diseases, causing 1.5 million fractures in the United States each year. This disease is characterized by low bone mass (amount of bone) and disrupted bone architecture. The combination of these two factors results in reduced bone strength. Osteoporosis used to be called “brittle bones” and was considered a normal consequence of aging. Today, we know that it is a preventable and treatable condition.
Our bones are composed of living tissue that is constantly remodeling. In this process, old bone is removed and new bone is made. Osteoporosis occurs when this balance is altered and more bone is removed than replaced.
Osteoporosis is a silent disease. Unless there is a fracture, it does not cause pain. People do not feel their bones getting “thinner.” In some ways osteoporosis can be compared to high blood pressure, another “silent” disease. High blood pressure increases one’s risk for stroke just as osteoporosis increases one’s risk for fracture.
Risk factors can include menopause, inadequate dietary intake of calcium, smoking, alcoholism, and a sedentary lifestyle. Some medications, particularly glucocorticoids (prednisone) are known to contribute to osteoporosis. Additionally, certain medical conditions predispose a person to osteoporosis, including diabetes, kidney disease, hyperparathyroidism, rheumatoid arthritis, multiple sclerosis, and malabsorption syndromes (including weight loss surgery).
The DXA scan, also called “Dexa” scan, is the most accurate diagnostic test for those who may be at risk for osteoporosis. The DXA is a type of X-ray that measures bone density of the hip and lower spine. Results are expressed as “T-scores.” The National Osteoporosis Foundation recommends that all women age 65 and older and men age 70 and older have a DXA scan. Adults over the age of 50 who have risk factors for osteoporosis should receive DXA testing, particularly if they are considering pharmacologic therapy for osteoporosis.
A diet containing adequate calcium and Vitamin D is important for bone health. Weight-bearing exercise also helps maintain strong bones. Examples of weight-bearing exercise include walking, jogging, stair-climbing and golf—any activity performed while on your feet, working your bones and muscles against gravity. By comparison, swimming and bicycling are examples of non-weight-bearing exercise.
When low bone mass or osteoporosis is present, medications may be necessary to prevent further bone loss and facilitate optimal bone health. Today, several medications are available that are proven to be both safe and effective in treating osteoporosis.