Boning Up On Osteoporosis



Dr. Seth Greenky



Necessary evils of all surgical subspecialties are important medical conditions that don't require surgery but require other intervention.  One such condition is osteoporosis, a problem responsible for contributing to more than 1.5 million fractures each year.  Orthopedists are in the front line in this battle so we unfortunately must deal with it.

A broken bone may be more than meets the eye.  It might be an early warning sign that you have osteoporosis.  Although osteoporosis is a fairly commonly used medical term in 2009, most people aren’t really aware of the far-reaching impact of this major health problem and the risk that it poses.

Osteoporosis (also call porous bone) is a condition that causes a loss of bone mineral density (BMD) resulting in the body’s bone becoming sponge-like and porous (filled with holes).  It gradually weakens the bones and makes them vulnerable to injury over time.  Persons with low bone density have a higher risk for an initial fracture and then a later re-fracture of the bones that are impacted by this disease.

Osteoporosis is a silent disease and people are often completely unaware that they are inflicted with this condition until experiencing a fall that normally would have had minor impact, results in a fractured wrist, hip, or compression fracture of the spine.

A Compelling Argument for Action

Consider the impact to society.  Osteoporosis contributes to more than 1.5 million fractures each year, including:

·         300,000 hip fractures

·         700,000 spine (vertebral) fractures

·         250,000 wrist fractures

·         300,000 fractures at other areas of the body

Often, the fracture dramatically impacts a person’s well-being and ability to live and function independently:

·         The risk of a serious repeat fracture can more than double after experiencing the first fracture

·         One out of four people who experience an osteoporotic hip fracture will need long-term nursing home care

·         More than half the people experiencing osteoporotic hip fractures will be unable to walk without the use of an assistive device

·         People experiencing an osteoporotic hip fracture have a 24% increased risk of dying within one year following the fracture

Hip fractures heal slowly, cause significant physical pain, and result in long-lasting disability.  Their impact is far reaching and extends to others beyond the person experiencing the fracture.  A broken bone does not always mean an individual has osteoporosis.  It does mean, however, that bone density testing should be considered to determine if it is a possible contributing cause.  Discuss this with your doctor.

According to the National Osteoporosis Foundation, more than 10 million Americans have osteoporosis and over 30 million have a bone density mass low enough that they are at risk for the disease.

The Many Faces of Osteoporosis

It may surprise you who should be concerned about developing osteoporosis.  Although aging Caucasian women are well-recognized to be affected by the disease, more than 2 million American men have osteoporosis as well.  The loss of bone knows no age boundaries and can also begin as young as the mid twenties.

Factors that put you at risk for developing osteoporosis include:

·         Aging

·         Caucasian race

·         Family history of osteoporosis

·         Small bone structure or being thinner than normal

·         Lack of weight-bearing exercise

·         Smoking cigarettes

·         Excessive alcohol intake

·         Reduced levels of estrogen after menopause

·         Long term use of certain drugs such as steroids

·         Low dietary intake of calcium or the reduced ability to absorb calcium and vitamin D

Diagnosis

Osteoporosis is usually diagnosed by your doctor by conducting a complete medical history and physical, x-rays, laboratory tests, and bone density testing.  Bone density testing is an x-ray technique that compares your own bone density to the peak bone density of a person usually in the mid twenties of your same sex and ethnicity.

Prevention

Osteoporosis is preventable and treatable.  Preventative measures should actually begin in childhood. Eating a well-balanced, calcium-rich diet and regular physical exercise are critical to ensuring healthy bones.  Bone mass reaches its peak in the mid twenties and then levels off.  After people reach their mid thirties, bone mass begins to decline.  Adopting a life-long diet rich in calcium and vitamin D (milk, cheese, yogurt, soy, almonds, leafy green vegetables), engaging in regular weight-bearing exercise such as walking, hiking, jogging, and tennis, and avoiding habits that lead to calcium loss such as excessive alcohol consumption and cigarette smoking, can reduce bone density loss. Vitamin D in sufficient quantities supports the effective absorption of calcium.  Calcium supplements may also be an effective way to ensure an adequate daily intake of this important nutrient.  Ask your doctor for the calcium supplement that is right for you.

Treatment

It is impossible to replace bone that has been lost so treatment focuses on reducing the further loss of bone and preventing injuries.  Although there is no cure for osteoporosis, there are many medications that are effective in slowing the loss of bone and increasing bone density.  Discuss medication options with your doctor if you have a family history of osteoporosis or have been diagnosed with it by bone density testing.

Conclusion

Osteoporosis is a major health problem affecting millions of Americans.  Your doctor and you can effectively develop and implement a combination of measures to prevent the further loss of bone, establish effective exercise and nutritional therapies, explore medication treatment options, and adopt practices to minimize your risk of injury.  Be sure to discuss these options with your doctor at your next visit.

References:

American Academy of Orthopedic Surgeons

Centers for Disease Control and Prevention

National Osteoporosis Foundation