Bone formation is a process in which there is a constant cycle of renewal where old and broken bones are being replaced by new and healthy bone tissue. Osteoporosis is a condition which interrupts this cycle as new bone formation is slower than the removal of old bone (bone mass is lost faster than it is created). As a result, the bones become very soft and weak – so brittle that a minor fall, cough or bend can cause bones to break especially in the hips, wrists or spine. It can affect both men and women – however, European and Asian women of post-menopausal age are at the highest risk of developing this condition.
Symptoms
- Major fractures as a result of minor falls, bends or coughs
- Spinal pain or back pain (caused by fractures or compressed vertebrae)
- Hyperkyphosis (hunchback)
- Loss of height due to collapsed vertebrae
Risk Factors
- Hormone levels – low levels of sex hormones can contribute to weak bones. At menopause, women experience a reduction in Estrogen levels which is one of the main contributing factors to the development of Osteoporosis at that age. Men are at a lesser risk of developing Osteoporosis as a side effect of age because men experience a gradual reduction in Testosterone.
- Age – the older a person, the greater the chance of developing this condition.
- Sex – women are more likely to develop Osteoporosis.
- Race – Eurpoean and Asian women are at a greater risk.
- Lifestyle choices – sedentary lifestyle such as prolonged sitting increases the risk of Osteoporosis. Lack of weight bearing exercises such as walking, running, jumping, dancing and weightlifting increase the chance of this condition as well.
- Low Calcium intake – Low Calcium diminishes bone density and leads to early bone loss and Osteoporosis.
- Hereditary – a familial history of Osteoporosis increases the risk especially if either of the parents experienced a hip fracture.
- Body size – people with a smaller body frame have less bone mass hence they have a greater chance of developing this condition as they age.
- Medical conditions and treatments – certain medications such as oral or injected corticosteroid medications can increase the likelihood of developing Osteoporosis with age.
- Treatments for cancer: Treatments for Prostate cancer reduce Testosterone and treatments for Breast cancer reduce Estrogen levels. These increase bone loss, and thus increase the chance of developing Osteoporosis.
- Thyroid – Increased Thyroid hormone can reduce bone formation and as a result can cause Osteoporosis.
- Alcohol – Excessive alcohol consumption on a regular basis of more than two alcoholic drinks a day can increase the risk of Osteoporosis.
- Smoking – It has been shown that regular use of tobacco can contribute to weak bones.
Falls and Fractures
Due to the softening of the bones, the risks of fractures are extremely high in people with Osteoporosis. As this condition is more common in the elderly, who may already be suffering from other conditions such as loss of balance, the risk of falls and fractures is of great concern in patients with Osteoporosis. Hip fractures are very common in people with Osteoporosis and can result in disability – it can also increase the risk of death within the first year after the fracture. Fractures from falls are more obvious, however it is important to realise that some fractures are silent in Osteoporosis. The spinal bones (vertebrae) can often soften to the point that they collapse, without any trauma, resulting in back pain. Therefore, it is imperative to get your spine checked if you suffer from Osteoporosis and experience back pain especially if you have lost height and have a hunched forward posture.
Treatment and Management
Bisphosphonates are the most common medications prescribed for Osteoporosis. Hormone replacement therapy, such as estrogen, is also used to treat the condition. However, it is not highly recommended as it increases the risk of heart conditions and some types of cancer. It is wise not to depend entirely on medication, other important practises include:
- Weight-bearing exercise – physical activity such as walking, jumping, running and weight lifting can strengthen the bone and improve balance and posture, further reducing the risk of falls.
- Good nutrition – ensure there is sufficient amount of Calcium and Vitmain D in your diet.
- Quit smoking – there is sufficient research that smoking tobacco can fasten bone loss.
- Limit alcohol intake – alcohol intake should be in moderation.
If you experience early menopause or have taken corticosteroids for a few months at one time, or either of your parents have had hip fractures then consult your doctor about Osteoporosis.
References
Jeremiah, M.P., Unwin, B. K., & Greenawald, M. H. (2015). Diagnosis and management of Osteoporosis. American Family Physician, 92(4), 261-268.
Dr Sarkaw Mohammad (Chiropractor)
Website: www.hillcrestspinal.co.nz
