Osteoporosis is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These broken bones, also known as fractures, occur typically in the hip, spine, and wrist.

What are the symptoms of osteoporosis?

The osteoporosis condition can be present without any symptoms for decades, because osteoporosis doesn't cause symptoms unless bone fractures. Some osteoporosis fractures may escape detection until years later. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. Then the symptoms are related to the location of the fractures.

Vertebral crush fractures (fractures of spinal vertebrae) may occur in people who have any type of osteoporosis. These fractures are called osteoporotic fractures. The weakened vertebrae may collapse spontaneously or after a slight injury. Chronic back pain may occur because of these fractures. Usually, pain starts suddenly, stays in a particular area of the back, and worsens when a person stands or walks.

Causes of Osteoporosis

Getting older

Being small and thin

Having a family history of osteoporosis

Taking certain medicines

The process of bone remodeling

Scientists have yet to learn all the reasons why this occurs, but the process involves how bone is made. Bone is continuously changing — new bone is made and old bone is broken down — a process called remodeling, or bone turnover.

Estrogen plays an important part in maintaining bone strength because it helps keep bone remodeling (which is now taking away more bone than is added) rates low. There are two lines of cells for bone remodeling, the bone-eating cells (osteoclasts) and the bone-forming cells (osteoblasts). Without estrogen, the osteoclasts are favored and more bone is resorped (removed) than laid down, resulting in thinning of the bone.

Who gets osteoporosis

Osteoporosis is more common in older individuals and non-Hispanic white women, but can occur at any age, in men as well as in women, and in all ethnic groups.

In the U.S., about 8 million women and 2 million men have osteoporosis. Those over the age of 50 are at greatest risk of developing osteoporosis and suffering related fractures.

Diagnosis of Osteoporosis

The diagnosis of osteoporosis is made on measuring the bone mineral density (BMD). The most popular method is dual energy X-ray absorptiometry (DXA or DEXA). In addition to the detection of abnormal BMD, the diagnosis of osteoporosis requires investigations into potentially modifiable underlying causes; this may be done with blood tests and X-rays. Depending on the likelihood of an underlying problem, investigations for cancer with metastasis to the bone, multiple myeloma, Cushing's disease and other above mentioned causes may be performed.

Treatment Of Osteoporosis

Physicians must pay attention to basic prevention before writing a prescription. Medications do not work as well (if at all) in patients who have poor nutrition, vitamin D deficiency, or lack of exercise. In frail women and men, hip protection should be part of the plan. Patients with secondary osteoporosis may require different treatments from those that are useful for primary osteoporosis.

How can I prevent it?

It's better to prevent any condition than simply to manage it when it happens. Osteoporosis assessment and management is an important factor in maintaining the health of your bone structure as you enter middle age.