Osteoporosis |
| Overview Osteoporosis is a potentially crippling disease characterized by low bone mass and deterioration of bone tissue. Eventually the bones lose their strength becoming so brittle they can easily break. Any bone can be affected but of special concern are fractures of the hip and spine as they can impair a person's ability to walk unassisted and may cause prolonged or permanent disability or even death. Bone loss happens gradually and can progress without any symptoms or warning signs until the disease is advanced. As a result osteoporosis is often referred to as the 'silent thief.' In Canada 1.4 million people suffer from osteoporosis. One in four women over the age of 50 and one in eight men over 50 has the disease. However osteoporosis can strike at any age. Knowing your risk factors can help improve your bone health and reduce your chances of developing this disease. Causes Just like our skin bone is a living tissue that undergoes a constant process of renewal. Certain cells wear away old bone creating small cavities in it. Still other cells fill the cavities with new bone. In younger people it's a team effort with both cells working together to build strong bones. But as we get older the process becomes less efficient and our bones gradually become thinner and weaker. Researchers don't know exactly why the process begins to breakdown in this way but they have identified certain factors they believe play a role. These include:
As you can see some risk factors are out of our control. However many others are entirely preventable. The more risk factors you have the more likely you will develop osteoporosis. If you have some of these risk factors you should speak to your doctor who may recommend a bone mineral density test. This is a safe painless procedure that measures the current strength or weakness of your bones. Symptoms A bone mineral density test is the only way to know for sure that you have osteoporosis before you actually break a bone. Osteoporosis is often called a "silent thief" because bone loss is similar to being burglarized in the night. By the time you discover something is missing there's little you can do about the loss. People may not know that they have osteoporosis until their bones become so weak that a sudden strain bump or fall causes a fracture or a vertebra to collapse. Collapsed vertebrae may initially be felt or seen in the form of severe back pain loss of height or stooped posture. Treatment Bisphosphonates are now the treatment of choice for most patients. They have been shown to slow bone loss increase bone density and reduce the risk of spine and non-spine fractures. Other treatments include selective estrogen receptor modulators (like Raloxifene) or nasal calcitonin (a naturally occurring hormone that helps with bone metabolism). They have been shown to increase bone mineral density and reduce the incidence of spine fractures with few or no side effects. Hormone Replacement Therapy (HRT) was once the preferred treatment mainly because of the supposed benefits in terms of cardiovascular disease. However this benefit was later disproved in a large Women's Health Initiative trial. The role of HRT now is mostly in terms of treating the symptoms of menopause such as hot flashes or mood swings. HRT also has some positive effect on the bones. The decision to take or not to take estrogen should be made with your doctor taking your individual circumstances into consideration. Pain management Osteoporosis itself does not cause pain however if you suffer a fracture the pain can be very sudden and intense. Rehabilitation can take time but the pain intensity will usually decrease gradually and eventually go away. Unfortunately some osteoporosis sufferers will experience chronic pain. As chronic pain can also be the result of compression fractures of the spine or muscle spasms it's important that you get an accurate diagnosis to ensure appropriate effective treatment. Pain is the body's first signal to urge you to attend to your health. You can do that by adjusting your activities and routines so that you're accommodating your pain without giving into it. Ice and heat Applications of ice and heat can help relieve pain. To apply ice try dampening a towel and freezing it. Soft cold packs (or a bag of frozen peas) also work well by adapting to your body curves. Heat can be applied using a hot water bottle hot towels or hot packs. Use caution when applying heat or ice since burns may occur in either case. Medication Pain relievers (acetaminophen and aspirin-like medications) are usually effective and well tolerated but they do have their limits. Your doctor will be able to tell you when and how medication can be useful. Prevention By about age 20 the average woman has acquired 98 percent of her skeletal mass. Building strong bones during childhood and adolescence can be the best defense against developing osteoporosis later. You can attain the highest peak bone mass possible and keep your bones strong throughout life by developing a lifestyle that includes proper nutrition and a reasonable amount of physical activity. Nutrition - o ur bones need calcium to stay strong. Adults over the age of 50 for example need 1500 mg of calcium daily to help preserve bone mass and reduce the risk of fracture. Are you getting enough calcium? To find out try our calcium calculator. Ensure that you are eating foods that are rich in calcium such as cheese yogurt salmon tofu (preserved with calcium citrate) and broccoli. Milk is a particularly good source of calcium. Two glasses of milk provide about 600 mg. If you cannot get enough calcium through diet you may need to take calcium supplements. Vitamin D is necessary for optimal calcium absorption. The easiest and most natural way to get the 400 I.U.s (800 I.U.s for people aged over 50) that adults require daily is through exposure to sunlight (typically 20 minutes a day). Milk and multivitamin pills are two other good sources of Vitamin D. Physical activity. Daily physical activity is an important part of a bone-healthy lifestyle. Brisk walking low impact aerobics and dancing are examples of "weight bearing" activities that help keep your bones strong. Also effective are "resistance" exercises such as weight training. With both types of activities your skeletal system responds to exercise by slowing bone loss and even increasing the bone mass in order to spread the load over a larger amount of bone. Avoid smoking. Smokers have faster rates of bone loss and a higher risk of fractures than non-smokers. Women smokers also tend to enter menopause at a slightly younger age than non-smokers. This causes the period of rapid bone loss to occur at an earlier age. Additional Resources |