What is Osteoporosis?
Osteoporosis is a condition characterised by the progressive weakening of bone. This is caused by the progressive loss of bone density and mineralisation which in turn can lead to an increased chance of fractures which is how osteoporosis is usually discovered. This condition is extremely common and affects more than 300,000 in the United Kingdom and by the age of 35 many people will have some form of osteoporosis. Very often elderly people present with a curved back caused by a series of small vertebral crush fractures as a result of this condition, to get an idea of how commonplace it is.
What are the causes for Osteoporosis?
Bone is often incorrectly thought to be an inert tissue but it is in fact highly active and throughout your life it undergoes a process of remodelling as a response to the pressures and stresses your lifestyle exerts on it. This is why people who undergo resistance training and lift weights have increased bone density and a decreased likelihood of suffering fractures.
However, this process of remodelling becomes increasingly ineffective and as you age you progressively lose bone density and mineralisation, thereby weakening them. This has a variety of causes and different factors and variables will affect different individuals.
A range of conditions including hyperthyroidism, kidney disease and all inflammatory conditions such as rheumatoid arthritis, inflammatory bowel disease and autoimmine disease can play a role. Smoking, alcohol consumption, malnutrition (particularly in childhood) and the use of common medications such as anticoagulants, glucocorticoids, antiepileptics and certain diabetes medications have also been implicated. A vitamin D or calcium deficiency (also the cause of rickets and osteomalacia in adults) can also cause osteoporosis due to the inability to adequately mineralise bone tissue.
Oestrogen is a hormone present in both men and women and it has important physiological functions, namely decreasingly bone reabsorption and increasing bone formation. In menopausal women present with hugely decreased levels of this hormone due to their menstrual periods stopping completely. As a result their risk of developing osteoporosis is increased and hormone replacement therapy is often prescribed. Oophorectomies (the surgical removal of an ovary) induce a similar effect.
Unfortunately there are a number of factors that an individual cannot influence. Age is the most influential factor due to hormonal changes (loss of testosterone and oestrogens) and decreasing activity. People of European or Asian heritage tend to have an increased risk as do those with a family history and smaller build.
What are the symptoms of Osteoporosis?
People rarely consult a healthcare practitioner for the first time specifically because of their osteoporosis. There are simply no overt symptoms. Most people suffer a fracture (most commonly wrist, hip or vertebral) and are consequently diagnosed with osteoporosis with the help of medical imaging once it is determined that their bone density is pathologically low.
Some people with osteoporosis fracture their ribs because of a sneeze or their wrist/hip due to a fall from standing height. Fractures due to these everyday occurrences that normally would have no medical consequence are termed fragility fractures, a subgroup of pathologic fractures that encompasses all breaks caused by an underlying condition.
How is Osteoporosis treated?
The nature of treatment for osteoporosis is largely based on how it was acquired, but irrespective of how an individual developed their osteoporosis measures are taken to minimise the risk of falls, which increasingly lead to fractures and chronic pain with age. This can include adjustments to the home and workplace, lifestyle advice and the treatment of any conditions that could lead to falls such as vertigo-inducing medication, and eyesight problems.
Alongside that further treatment is based on how the osteoporosis was acquired: A dietician can be consulted for lifestyle advice and calcium and vitamin D supplements can be prescribed if appropriate. Beyond that hormone replacement therapy can be used to alleviate low hormone levels and a group of drugs known as bisphosphonates that can be prescribed to reduce bone loss.