« Back to Spinal Disorders

Osteoporosis Info: Definition Causes Risk Factors Symptoms Diagnosis Treatment Medications Safety Measures Prevention

Definition

Osteoporosis is a disease in which bones become weak and brittle. If left unchecked, osteoporosis can progress painlessly until a bone breaks (fracture). Any bone can be affected, but of special concern are fractures of the hip, spine, and wrist.

return to top

Causes

Throughout life, old bone is removed and new bone is added to the skeleton. During childhood and adolescence, new bone is added faster than old bone is removed. As a result, bones become heavier, larger and denser. Peak bone mass is reached around age 30. From that point on, more bone is lost than is replaced. If not treated, bone losses may lead to osteoporosis. Osteoporosis is more likely to occur if optimal bone mass was not achieved during the bone-building years.

Bone density also plays a role in bone health. Bone density is determined in part by the amount of calcium, phosphorus and other minerals contained within the framework of the bone. As the mineral content of a bone (especially calcium) decreases, the bone becomes weaker. Getting enough
calcium and vitamin D and exercising regularly can help ensure that bones stay strong throughout life.

return to top

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

	Sex: female
	Age: risk increases with age
	Body size: small, underweight women
	Race: Caucasian and Asian women
	Family members with osteoporosis
	Post-menopause
	Abnormal cessation of menstrual periods (amenorrhea) due to anorexia nervosa and rigorous exercise
	Low-calcium diet
	Medications:
	- Immunosuppressants, such as prednisone and other steroids, methotrexate, cyclosporine
	- Thyroid drugs
	- Anticonvulsants
	- Aluminum-containing antacids
	- Cholesterol-lowering drugs
	- Long-term heparin therapy
	Low estrogen levels in women
	Low testosterone levels in men
	Inactive lifestyle
	Too little sunlight
	Depression
	Early graying of hair
	Anorexia
	Cigarette smoking
	Excessive use of alcohol, coffee and tea
	Diseases including:
	- Liver disease, including cirrhosis
	- Hyperthyroidism
	- Scurvy
	- Alcoholism
	- Marfan's and Ehler-Danlos syndromes
	- Cushing's syndrome
	- Hyperparathyroidism
	- Cancer, including lymphoma
	- Gastrointestinal disorders

return to top

Symptoms

Symptoms include:

	Severe back pain
	Loss of height, with stooped posture
	Fracture of the vertebrae, wrists, hips, or other bones

return to top

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Early signs of osteoporosis can be detected with bone density testing. Bone density testing techniques include:

	Dual-energy X-ray absorptiometry — measures bone density in the entire body
	Single-energy X-ray absorptiometry — measures bone density in the arm or heel
	Dental X-rays of bone
	Ultrasound bone density measurement measures bone density in fingers, heels, leg bones

Other tests may include blood and urine tests to test for calcium levels or substances created when bone is broken down.

return to top

Nutrition
		Eat a balanced diet rich in calcium and vitamin D. Consider decreasing your intake of caffeinated beverages and alcohol. Calcium is abundant in:
		- Dairy products
		- Green leafy vegetables
		- Canned fish with bones
		- Calcium-fortified products
Smoking
		Do not smoke. If you smoke, quit
Exercise
		Exercise improves bone health and increases muscle strength, coordination, and balance. Maximum benefits are gained from doing weight-bearing exercises, including strength-training exercises. Balance training may help prevent falls and fractures.
Dietary Supplements
		People who cannot consume enough calcium from food might want to consider calcium supplements. Other vitamins and minerals may be recommended, including vitamin D, magnesium, vitamin K, and potassium. Talk to your doctor or dietitian before you begin taking dietary supplements.
Hormone Therapy
		Therapy may include:
		Estrogen replacement therapy (ERT) can:
		- Reduce bone loss
		- Increase bone density
		- Reduce the risk of hip and spinal fractures in postmenopausal women
		Hormone replacement therapy (HRT)
		- Estrogen combined with progestin (for women with an intact uterus because ERT slightly increases the risk of uterine cancer)
		Foods containing soy may improve bone mass because they contain plant estrogens.
		ERT/HRT reduces the risk of heart disease and may cut the risk of osteoporosis in half. It is approved for treatment and prevention of osteoporosis.

return to top 

Medications

These include medications to prevent bone loss, increase bone density, and reduce the risk of spine and hip fractures.

	Raloxifene (Evista) — one of a class of drugs known as selective estrogen receptor modulators (SERMS) that appears to prevent bone loss of the hip, spine, and total body. It is approved for both prevention and treatment of osteoporosis.
	Bisphosphonates (alendronate [Fosamax]; risedronate [Actonel]) — reduce bone loss, increase bone density, and reduce the risk of spine and hip fractures
	Calcitonin — slows bone loss, increases spinal bone density, and may relieve pain from bone fractures
	Fluoride — low doses of monofluorophosphate to decrease pain and fractures in the spine

return to top

Safety Measures

Because falls can increase the likelihood of fracture in someone with osteoporosis, the following measures are recommended:

	Use a cane or walker for added stability
	Wear rubber soled shoes for traction
	Use plastic or carpet runners when possible
	Keep rooms free of clutter

return to top

Prevention

Building strong bones throughout the early years is the best defense against osteoporosis. There are four steps to prevent osteoporosis, none of which is likely to be effective by itself:

	A balanced diet rich in calcium and vitamin D
	Weight-bearing exercise
	Healthful lifestyle (no smoking and moderate alcohol)
	Bone density testing and medications where appropriate:
	- Estrogen
	- Fosamax
	- Actonel
	- Evista

Copyright© 2000 HealthGate® Data Corp. All rights reserved.

return to top