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OSTEOPOROSIS

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FOREWORD

Osteoporosis, or "porous" bone, is common bone disease caused by low bone mass and the structural deterioration of bone tissue, leading to bone fragility and an increased risk of fractures of the hip, spine, and wrist. Both men and women are affected by osteoporosis. It is a disease that can be prevented and treated

Osteoporosis Facts

It is also called a "silent disease" because bone loss occurs without any symptoms.

1 in 2 women and 1 in 4 men will have an osteoporosis related fracture in their lifetime. *Moreover, women near or past menopause who has sustained a fracture in the past are twice as likely to experience another fracture.

As many as 20 percent of the people who break their hip because of osteoporosis die within a year.

It's never too late - or too early - to do something about osteoporosis. Everyone can take steps to keep their bones strong and healthy throughout their life.

Causes

The strength of your bones depends on their mass and density. To maintain bone density and strength, the body needs a sufficient supply of calcium and other minerals, proper production of certain hormones that help to regulate bone cell function, and an adequate supply of vitamin D, which is essential for calcium absorption and normal bone formation.

Bone is a changing, living tissue. Our bodies constantly build new bones and remove older bones. In childhood, more bones are built than removed, and so the bones grow in size. After the age of 30 or 40, however, the cells that build new bones do not keep up with those that remove bone. The total amount of bone then decreases, and osteoporosis may develop as a result.

The average rate of bone loss in men and women who have not yet reached menopause is small. But after menopause, bone loss in women increases to an average of one to two percent a year.

This is because after menopause, the level of estrogen (the female hormone) sharply decreases. Estrogen helps the bodys bone-forming cells to keep working, and thus protects the skeleton. After menopause, when the level of estrogen decreases, some of this protection is lost.

The risk of developing osteoporosis depends on how much bone mass you attained between ages 25 and 35 (peak bone mass), and how rapidly you lose it later. The higher your peak bone mass, the more and stronger bones you have, making you less prone to osteoporosis, as you lose bone during normal aging.

What are the risk factors for developing osteoporosis?

Factors that will increase the risk of developing osteoporosis are:

  • Female gender.
  • Caucasian or Asian race.
  • Thin and small body frames.
  • Family history of osteoporosis (for example, having a mother with an osteoporotic hip fracture doubles your risk of hip fracture).
  • Personal history of fractures as an adult.
  • Cigarette smoking.
  • Excessive alcohol consumption.
  • Lack of exercise.
  • Low calcium diet.
  • Poor nutrition and poor general health.
  • Malabsorption (nutrients are not properly absorbed from the gastrointestinal system).
  • Low estrogen levels (after menopause or with early surgical removal of both ovaries).
  • Chronic inflammation, due to diseases (such as rheumatoid arthritis and chronic liver diseases).
  • Immobility, such as after a stroke or from any condition that interferes with walking.
  • Hyperthyroidism: a condition caused by the thyroid gland Producing excessive thyroid hormone
  • Hyperparathyroidism: diseases wherein there is excessive parathyroid gland
  • Vitamin D deficiency.
  • Certain medications can also cause osteoporosis.

Signs and symptoms

There is usually no pain or symptom in the early stages of bone loss. But once the bones have been weakened by osteoporosis

You may have signs and symptoms that include:

  • Back pain, multiple joint pain and other vague symptoms
  • Loss of height over time, with an accompanying Stooped posture.
  • Fracture of the vertebrae, wrist, hips or other bones.

Fractures

If the bones become very weak due to osteoporosis, fractures may occur from a minor fall, after lifting something heavy, and even just while walking or coughing. The fracture usually heals with treatment. But if osteoporosis progresses, more fractures may occur.

When fractures occur in the spine, the bones in the spine may shorten. These are called compression fractures, and people with severe osteoporosis may sustain two, three, or even more. This is a common way older people lose height.

Spine fractures can also change the square shaped bones of the spine to wedge shaped. This can result in a stooped posture.

By the age of 80, nearly half of all women show a spinal fracture on an X-Ray. Yet many cannot recall any injury of incident that would have caused the fracture.

Unfortunately, the joint surface alignment in the spine may become distorted, and the joints may therefore wear down. This can cause arthritis in the spine and pain.

Surgery to deal with a fracture may be more difficult on osteoporotic bones, because thinner bones might be unable to hold devices such as rods and screws, which may be necessary to repair the fracture, firmly.

When to seek medical advice

Early detection is important in osteoporosis. You may be able to slow the disease if you find out you have it, or prevent it if you discover youre likely to develop it. Consider your risk factors, then discuss with your doctor and get the required treatment. For women, its best to do this before menopause as before menopause a womans body is more capable of undergoing functional rehabilitation.

Screening and Diagnosis

Osteoporosis may be diagnosed based upon patient and family history, physical examination, laboratory studies, and bone mineral density (BMD) testing. Doctors can detect early signs of osteoporosis using a variety of devices to measure bone density. At the present radiation free osteoporosis scan is preferred. This procedure is quick, simple, and gives accurate results. Although x-rays can also detect osteoporosis, it can do so only after >30% damage is already done.

If youre women, it is recommended that you have a bone density test if any of the following conditions apply to you, and you are not taking estrogen:

Some medications that you use that can cause osteoporosis.

You have type 1 diabetes (formerly called juvenile or Insulin- dependent diabetes), liver disease, kidney disease or a family history of osteoporosis.

You experienced early menopause.

Youre postmenopausal, older than 50, and have at least one risk factor for osteoporosis.

Youre postmenopausal, older than 65, and have never had a bone density test.

Management of osteoporosis

The goal of osteoporosis management is to prevent bone fractures, by decreasing bone loss and by increasing bone density and strength. Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fracture, none of the available treatments for osteoporosis are complete cures. In other words, it is difficult to completely rebuild bone that has been weakened by osteoporosis. Therefore, the prevention of osteoporosis is as important as its cure.

Diet

An optimal diet for the prevention or treatment of osteoporosis includes an adequate intake of calories, as well as calcium, vitamin D and protein, all of which are essential in helping to maintain proper bone formation and density.

Many published studies show that low calcium intake appears to be associated with low bone mass, rapid bone loss, and high fracture rates.

The main sources of calcium include milk and other dairy products, like cottage cheese, yogurt, hard cheese and green vegetables, such as spinach and broccoli.

Depending upon how much calcium you get each day from food, you may need to take a calcium supplement.

Vitamin D is needed for the body to absorb calcium. Without enough vitamin D, we cant form enough of the hormone calcitriol (known as the active vitamin D), causing insufficient calcium absorption from the diet. You can get vitamin D safely in two ways: through the skin and from the diet.

Vitamin D is formed naturally in the body after exposure to sunlight. Fifteen minutes in the sun is enough to manufacture and store all the vitamin D you need. Vitamin D-rich foods include egg yolks, saltwater.

Exercise

Exercise is an important component of an osteoporosis prevention and treatment program. Bone is a living tissue that responds to exercise by becoming stronger. Just as a muscle gets stronger and bigger the more you use it, a bone becomes stronger and denser when it is called upon to bear weight. For building and maintaining bone density, weight-bearing and resistance exercises are the two most important types of exercise.

Weight-bearing exercises are those in which your bones and muscles work against gravity, such as walking, climbing stairs, etc.

Resistance exercises are those that use muscular strength to improve muscle mass and strengthen the bones. The best example of resistance exercises is weight lifting, such as using free weights and weight machines at your local health club

  • Exercise helps in:
    • reducing the risk of fracture,
    • building and maintaining the bone density,
    • enhancing the body balance, flexibility and strength
    • reducing the chances of falling

Avoid Smoking

Women who smoke have lower levels of estrogen compared to non-smoking women. Smoking is bad for your bones, as well as your heart and lungs. And smokers often go through menopause earlier. They may also absorb less calcium from their diets.

Calcium and vitamin D supplementation

Calcium plays an important role in maintaining bone strength.

Calcium alone cannot prevent or cure osteoporosis, but it is an important part of the overall prevention or treatment program.

With age, calcium absorption decreases and vitamin D deficiency also occurs which plays an important role in the development of osteoporosis.

Many women consume less than half of the daily recommended amount of calcium.

If you are unable to get enough calcium through your diet, your doctor can recommend an appropriate calcium supplement, since there are several different types of calcium salts and a variety of supplements available.

Vitamin D plays a major role in calcium absorption and bone health.

The recommended daily intake of vitamin D is between 400 and 800 international units (IU).

Do not take more than 800 IU per day unless your doctor prescribes it, since massive doses of vitamin D may be harmful.

Drugs for treatment of osteoporosis

Specific drugs for prevention & treatment of osteoporosis are available.

This information is intended only to increase awareness and cannot substitute for a doctors advice.

For more information, Please contact your doctor.

Do's and Dont's for safe movement

Dos for safe movement

  • Always proper posture.
  • Keep your head erect and back straight.
  • Tighten you abdominal muscles and buttocks.
  • Whenever possible, walk or climb the stairs, always use the handrail.
  • Always bend from the hips and knees, not from the waist

Dont's for safe movement

  • Don't walk or exercise on slippery surface.
  • Don't wear shoes with slippery soles.
  • Don't move too quickly.
  • Don't engage in sports or activities that require twisting the spine or bending forward from the waist, such as conventional sit-ups or toe touches.
  • Don't force yourself to complete a task or exercise if you feel short of breath, are in pain or are fatigued.
  • Don't spend extended periods of time in your chair or bed remaining inactive is one of the worst things you can do.
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