Osteoporosis

The World Health Organization defines osteoporosis as a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. In simpler terms, it is a disease in which bones become weak and may lead to fractures.

A loss of height, a stooped posture, back or neck pain, and bone fractures are often the most common symptoms of later-stage osteoporosis. Fractures of the spine, hip, and wrist are commonly associated with osteoporosis. Osteoporosis is a silent disease, usually, the patient has no symptoms until the first fracture.

Osteoporosis Risk Factors

The following are risk factors for osteoporosis:

Gender: Women are at higher risk than men
Age: Risk increases with age
Family history: Osteoporosis in first-degree relatives increases risk
Body size: Small, thin-framed people are more at risk
Calcium and vitamin D: A lifetime diet low in calcium and vitamin D is a risk factor for osteoporosis
Medications: anticonvulsants (anti-seizure medications)
Steroids
Lifestyle: An inactive lifestyle or extended bed rest/immobilization
Cigarette smoking: Increased risk with consumption
Alcohol Increased: risk with excessive intake

Diagnosis

The diagnosis of osteoporosis can be made in the presence of a fragility fracture (a fracture is a fracture resulting from a fall from standing height or less), particularly at the spine, hip, wrist, humerus, rib, or pelvis, or with measurement of bone mineral density using specialised DEXA scan in the presence of a T score of less than -2.5.

Treatment

All men and women who meet the criteria for the diagnosis of osteoporosis should be counseled about nonpharmacologic preventive measures including exercise, diet, smoking cessation, and reduction of fall risk.

All patients meeting the diagnostic criteria for osteoporosis should be offered drugs that increase bone mineral density. Many kinds of drugs ranging from daily oral tablets to daily/ 6 monthly injections are available for same. Patients should consult orthopaedic surgeons to know about individual drugs and pros and cons of each before starting therapy.