Osteoporosis

Osteoporosis defines progressive, systemic skeletal disease characterized by decreased bone mass and micro-architectural deterioration of bone tissue, resulting in increased bone fragility and fracture susceptibility. Bone strength, which reflects both bone density and bone quality, is compromised, increasing fracture risk. Fractures are most common in the hip, spine, and wrist, with hip fractures having the highest morbidity. This condition can be primary or secondary. Primary osteoporosis is the bone loss that occurs after menopause and with aging, whereas secondary osteoporosis is bone loss caused by diseases or medications such as glucocorticoids. Prednisolone or its equivalent at 5 mg daily for at least 3 months has been linked to osteoporosis, known as glucocorticoid-induced osteoporosis. A similar risk is demonstrated when a higher glucocorticoid dose is administered for a shorter period of time. Strong glucocorticoids inhaled over a 7-year period are linked to significant bone loss.

Epidemiology

Though osteoporosis is underdiagnosed and undertreated in Asia, it is predicted that by 2050, Asia will account for more than half of all osteoporotic hip fractures. Almost all Asian countries’ calcium intake is less than the FAO/WHO recommendation of 1-1.3 g/day. In different Southeast Asian countries, studies on both sexes and all age groups revealed a widespread incidence of vitamin D deficiency or insufficiency.

Sign and Symptoms

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Osteoporosis is known as a “silent” disease because there are usually no symptoms until a bone fracture or one or more vertebrae collapses (fracture). Severe back pain, loss of height, or spine malformations such as a stooped or hunched posture in increased kyphosis are all symptoms of vertebral fracture.

Possible Complications

Osteoporosis-affected bones may become so fragile that fractures occur spontaneously or as a result of:

  • Minor falls, such as a fall from standing height, are unlikely to result in a break in a healthy bone.
  • Bending, lifting, and even coughing are examples of normal stresses.

What To Do Next?

Dual-energy x-ray absorptiometry is the most commonly used test for determining bone mineral density (DXA). It is a simple, non-invasive test that takes only a few minutes. DXA employs low-level x-rays as a scanner is passed over your body while you lie on a cushioned table. The test determines the BMD of your skeleton and at various fracture-prone sites, such as the hip and spine. DXA bone density measurements at the hip and spine are widely regarded as the most reliable method of diagnosing osteoporosis and predicting fracture risk.

Your doctor will compare the results of your BMD test to the average bone density of young, healthy people as well as the average bone density of other people your age, gender, and race. Doctors report the test results as a DEXA T score or a Z score. The T score compares an individual’s bone mass to a younger person’s peak bone mass. -1.0 or higher indicates good bone strength, while -1.1 to -2.4 indicates mild bone loss (osteopenia). A score of -2.5 or lower indicates osteoporosis and a score more than less than -2.5 indicates severe osteoporosis with a risk of fractures. The Z score compares bone mass to that of people of similar build and age. A doctor will usually repeat the test every two years so that they can compare the results.

What Treatment To Expect

The goals of osteoporosis treatment are to slow or stop bone loss and to prevent fractures. Your doctor may advise you to do the following:

  • Nutrition is essential.

Calcium and vitamin D are essential nutrients for preventing osteoporosis and promoting bone mass. If you don’t get enough calcium, your body will take it from your bones, which can lead to bone loss. This can cause bones to become weak and brittle, leading to osteoporosis.

Calcium-rich foods include dairy products with low fat, vegetables with dark green leaves (bok choy, collards, turnip greens), boned sardines and salmon; soymilk, tofu, orange juice, cereals, and bread are examples of calcium-fortified foods.

Vitamin D is required for calcium absorption from the intestine. It is produced in the skin as a result of exposure to sunlight. Natural sources of vitamin D include fatty fish, fish oils, egg yolks, and liver. Other vitamin D-fortified foods, such as milk and cereals, are also a good source.

  • Changes in lifestyle.
  • Exercise

According to research, the best physical activities for bone health are strength training or resistance training. Because bone is living tissue, exercise can strengthen bones during childhood and adulthood. Exercise, on the other hand, no longer increases bone mass in older adults. Instead, regular exercise can benefit older adults in the ways of increasing muscle mass and strength while improving coordination and balance to prevent falls. Exercise also helps to enhance daily function and postpone loss of independence. Although exercise is beneficial for people with osteoporosis, it should not be done in a way that puts undue strain on your bones. High-impact exercise should be avoided if you have osteoporosis. A physical therapist or rehabilitation medicine specialist can do the following to help prevent injury and fractures. For instance, specific exercises to strengthen and support your back, safe ways to carry out daily routines, or exercise programs that are tailor-made to meet your needs.

  • Fall prevention can aid in the prevention of fractures.
  • Medications

Can be grouped into two categories: Antiresorptive drugs to slow the breakdown rate of bone (bisphosphonates, denosumab, estrogens, calcitonin) and anabolic drugs to increase bone formation (romosozumab and teriparatide).

Any Lifestyle Modification

You can help prevent the disease and fractures by doing the following:

  • Maintaining physical activity by engaging in weight-bearing exercises such as walking.
  • Moderate alcohol consumption.
  • Quitting smoking, or refraining from starting if you do not smoke.
  • Take your prescribed medications, which can help prevent fractures in people with osteoporosis.
  • Eating a calcium- and vitamin-D-rich diet can help you maintain good bone health.

Never hesitate to Ask a Doctor for your health concerns.