Osteoporosis

As people get older, their bones become thinner and lighter. By the age of 70, most people’s skeletons are about a third lighter than they were at the age of 40. This loss of bone density, known as osteoporosis, is the result of an imbalance between the natural breakdown and replaccement of bone. Eventually, all elderly people are affected by osteo-porosis, but the severity of the condition varies from person to person. People who are thin, who do little exercise, and whose relatives have condition to a greater degree than others.

Many people do not realize that they have osteoporosis until their fracture a wrist or hip as a result of a minor fall. In the UK, an estimated 60.000 fractures occur each year in people aged 65 or over. Osteoporosis is a major cause of these fractures, the hip being the most common site. In elderly people, hip fractures are offen life-threating or result in im-mobility.

Normal And Osteoporosis.

What are the cause?

Sex hormones are necessary for bone replacement. In both men and women, osteoporosis begins to develop as sex hormone producion declines with age. Any condition that causes this decline to accelerate can increase the severity of age-related osteoporosis. In women, production of the sex hormone oestrogen declines rapidly at the menopause. Early menopause, which tends to occur in women who smoke, increases the risk of osteoporosis. In men, untreated hypogonadism results in low levels of the sex hormone testosterone early in life and a low bone density.

Osteoporosis may occur as a result of long-term treatment with oral cortico-steroids. People with rheuma-toid arthiritis, an overactive thyroid gland, or chronic kidney failure are also at increased risk of osteoporosis.

Exercise is essential to maintain bone health. The density of bones declines rapidly in people who are confined to bed and in those whose daily activity is reduced by disorders such as arthritis or multiple sclerosis.

Osteoporosis sometimes runs in families. Women who have a close relative with oteoporosis are more likely to develop the disoder them-selves.

Can it be prevented?

Measures to prevent osteoporosis are most affective if started early in life. Teenagers and young adults should eat a balanced diet rich in calcium and vitamin D and maintain it throught life. Calcium is essential for bone strength, and vitamin D aids calcium absorption in the body. Extra calcium is needed during pregnancy, while breast-feeding, and during and after the menopause; it may be advisable to take a supplement at such times. Vitamin D is also produced in the skin in respone to sunlight. People exposed to little sun-light may need vitamin D supplements.
Walking and other weight-bearing exercise help to increase bone density. Not smoking and limiting alcohol intake also reduce the risk of osteoporosis.

Women may be encouraged to use hormone replacement therapy during and affer the menopause, which may help to protect against osteoporosis, but there is no medical consensus on how long it should be continued.

Anyone thought to be at increased risk of osteoporosis, such as having a family history of the disorder, can have his or her bone density measured. Bone density testing is offen used to assess a person’s likelihood of having bone loss and also to monitor people who are taking preventive treatment.

What are the symptoms?

Some physical changes associated with aging are in fact due to osteoporosis. These include:
- Gradual loss of height.
- Rounding of the back.
For many people, the first evidence of osteoporosis is a pain full fracture of a bone after minor stress or injury. An example is sudden, severe back pain due to a compression fracture of the body of a vertebra (bone of the spine). In severe osteoporosis, a fracture may occur spontaneously.

What might be done?

The diagnosis will be made from your medical history and an examination. Bone densitometry, X-rays, and blood tests may also be performed to exclude other causes of the symptoms, such as osteomalacia and Paget’s disease of the bone, and to look for various disorders that may cause osteoporosis, such as hyperthyroidism.



If you have back pain due to a fracture, your doctor may recommend that you take painkillers or use a heat pad. Underlying disorders will be treated if possible. For example, you may be prescribed drugs to treat an overactive thyroid gland.

To slow the progression of osteoporosis, it is important to follow the advice given above for taking preventive measures. Most drugs simply slow the rate of bone loss, although there is evidence that bisphosphonates reduce the risk of fractures. However, even if these measures are taken, some bone loss is inevitable in later life.

TEST BONE DENSITOMETRY:

This technique uses low-dose X-rays to measure the density of bone. The test is carried out to screen for and diagnose osteoporosis, a condition that is particularly common in post-menopausal women. The varying absorption of X-rays as they pass computer and displayed as an image. The computer calculates the average density of the bone and compares it with the normal range for the person’s age and sex. The procedure takes about 10-20 minutes and is painless.