Osteoporosis

BAsic information

description

Loss of normal bone density, bone mass, and bone strength. Osteoporosis (porous bones) is a progressive disease that leads to increased thinning of bones and risk of fractures (broken bones). It occurs in both sexes, but is most common in women after menopause due to a decrease in the hormone estrogen. Estrogen protects against bone loss.

frequent signs and symptoms

• Osteoporosis does not cause pain, and there are usually no obvious symptoms. It is called a "silent" disease.
• People don't realize they have osteoporosis until they fall and suffer a fracture, or a spontaneous fracture occurs in a backbone. Pain from fractures may be mild to severe. The pain may stop when the fracture heals or it may be chronic due to permanent bone damage.

causes

Loss of bone mass and density occurs due to a decrease of calcium (a mineral) and other substances that are needed for maintaining bone strength. A number of risk factors can contribute to the decrease.

risk increases with

• Females; advanced age; Asian or white persons.
• Early menopause (either naturally or due to surgery).
• Lack of exercise (sedentary lifestyle).
• A broad range of diseases and drugs.
• Poor nutrition. Lack of calcium, protein, and vitamins.
• Smaller-framed, thin women.
• Eating disorders (bulimia or anorexia).
• Family history of osteoporosis.
• Smoking.
• Excessive alcohol use.
• Men with low testosterone levels.

preventive measures

• Preventive measures need to start at a young age.
• Adequate calcium intake (1200 to 1500 mg a day) with milk and dairy products or calcium supplements.
• Regular exercise, such as walking (which is weight-bearing, and is better for preventing osteoporosis).
• Avoid risk factors such as alcohol and smoking.
• Preventive drugs may be prescribed in high-risk cases.

expected outcomes

There is no cure for osteoporosis. Treatment (no matter what age) can help halt and may reverse some bone loss. Pain symptoms can usually be helped with drugs.

POSsible complications

• Falls and bone fractures, such as hip, spine, and wrist.
• Severe, disabling pain.
• Deformed spinal column and bent back (sometimes called Dowager hump). Loss of height.

diagnosis & treatment

general measures

• Medical tests may include bone X-rays, ultrasound, and bone density studies. If bone density studies show bone loss is 10% or more, the diagnosis is osteoporosis.
• Treatment is aimed at stopping further bone loss, preventing fractures, relieving pain (if needed), and rebuilding bone. Treatment steps include drugs, lifestyle changes, and medical care for any underlying disorder. A treatment plan will be based on your individual case.
• Lifestyle changes may include diet changes, exercise, modifying behaviors, and home safety to prevent falls.
• Stop smoking. Find a way to quit that works for you.
• Stop excessive alcohol use.
• If a drug you take is a risk factor for osteoporosis, the medical advice may be to stop the drug, reduce the dosage, or use an alternative drug.

medications

• Different prescription drugs are used to prevent and treat bone loss. If one drug causes problems or is not effective, another drug can be prescribed.
• For minor pain, use nonprescription drugs such as acetaminophen or ibuprofen. Stronger pain drugs may be prescribed.
• Calcium and vitamin D supplements may be needed.

activity

Exercise strengthens muscles and bones and improves balance. Aerobic and resistance exercises should be part of a daily 30-minute program.

diet

Eat a healthy, well-balanced diet.

NOTIFY YOUR HEALTH CARE PROVIDER IF

• You or a family member has symptoms of osteoporosis.
• Pain develops, especially after an injury.

Content from: Moore, Griffith's Instructions for Patients. © 2005 Elsevier Inc. All rights reserved.