Osteoporosis Treatment

Despite being one of the most common metabolic bone diseases, osteoporosis can pose a danger to the patient during the occurrence of fractures. Until then this ailment lies as a subclinical condition which is why it is called as "silent disease," until investigations during fracture reveals it

In this disorder, the propensity for fractures lies high due to the reduction in bone density thus increasing bone fragility. Fractures are both a medical and personal burden especially in adults aged 50 years or older as it poses significant and imminent risk for subsequent fractures. The common sites of fracture injury are the hip, spine, or wrist. The vertebral fractures, especially, are associated with a 5-fold increased risk for additional vertebral fractures. Untreated osteoporosis can lead to a vicious cycle of recurrent fractures, often resulting in disability and premature death

Types of Osteoporosis

The two main types of osteoporosis are:

Primary Osteoporosis: Also called as the postmenopausal osteoporosis, this type of osteoporosis is more common among menopausal women which occurs about 10-15 years after menopause. Estrogen deficiency in this state causes loss of bone structure resulting from excessive bone resorption. This type is also seen in men with low testosterone levels.
Secondary Osteoporosis: In secondary osteoporosis, certain medical conditions and medications trigger the development of this disease through increased bone remodeling leading to disrupted bone reformation. The common diseases causing secondary osteoporosis include thalassemia, multiple myeloma, etc. The common medications causing secondary osteoporosis include antacids containing aluminium, anticonvulsants, etc.

Osteoporosis Symptoms

Signs of osteoporosis often are not noticeable symptoms until a fracture occurs. Common symptoms include:

Fractures: Often seen in the hip, spine, or wrist, which may occur with minimal or no trauma.
Back Pain: Patients with osteoporosis can sometimes report low back pain, despite no fracture. The osteoporotic low back pain is strongly related to pain at rest rather than that in motion.
Loss of Height: Height loss is a frequent manifestation of vertebral osteoporosis. Various research studies suggested that loss of height could be an important factor for the detection of osteoporosis of the hip, implying that evaluation of height loss should be routine in the outpatient setting.
Posture Changes: Osteoporotic patients often break bones in the upper (thoracic) spine causing pain, height loss and stooped or hunched posture, called kyphosis.

Osteoporosis Causes

Hormonal Changes: Commonly seen in menopausal women. The rapid bone loss is related to estrogen deficiency which arises from the imbalance between bone resorption and bone formation. Osteoporosis can also result from excessive glucocorticoid usage, which induces bone demineralization, indicating potential risk of fracture.
Dietary Factors: Dietary factors which increase the risk of osteoporosis include a deficiency of calcium, 1,25-dihydroxyvitamin D and protein.
Sedentary Lifestyle: When the relationship of sedentary activity (SA) is compared with bone mineral density (BMD) and body fat percentage, it was found that sedentary lifestyle is negatively associated between sedentary activity and bone mineral density but positively associated with body fat percentage.
Chronic Conditions: Diseases like hyperthyroidism, diabetes, thalassemia, multiple myeloma, intestinal malabsorption, leukemia, liver diseases, metastatic bone diseases etc can impact bone density.
Medications: Long-term use of corticosteroids, certain anticonvulsants antacids containing aluminium, heparin, methotrexate, thyroid hormone supplements, Steroids can lead to decreased bone density.

When to See a Doctor?

If the patients are experiencing miscellaneous presentations and symptoms such as back pain, or alterations in height, posture etc, it is necessary that the patients are to Consult Dr. Prudwiraj Sanamandra for expert guidance and comprehensive care. This becomes much more imperative if the patents are elderly as they are at an increased risk of developing fractures. Early diagnosis can greatly help in the preparation of osteoporosis treatment strategies.

Osteoporosis Risk Factors

There are both modifiable and nonmodifiable risk factors that help in the development of osteoporosis:

There are higher chances of developing osteoporosis in woman as they possess lesser bone tissue compared to men. Also they lose bone faster especially during menopause.
The elderly the person, the higher the risk of osteoporosis. Also, the bones become thinner and weaker with age.
Family history: People whose parents have a history of fractures also seem to have reduced bone mass and may be at risk for fractures.
Sex hormones: Abnormal absence of menstrual periods (amenorrhea), low estrogen level (menopause), and low testosterone level in men can cause osteoporosis.
Anorexia nervosa: Characterized by an irrational fear of weight gain, this eating disorder can significantly increase the risk for osteoporosis.
Calcium and vitamin D intake: . A low calcium and vitamin D diet displays increased propensity to bone loss.
Cigarette smoking: Smoking is bad for bones as well as the heart and lungs.
Alcohol intake: Excessive consumption of alcohol increases the risk of bone loss and fractures

Osteoporosis Complications & Prevention

Complications from untreated osteoporosis can be severe, leading to fractures, chronic pain, disability, and reduced quality of life. Preventive measures include:

Nutrition: Ensure a diet rich in calcium and vitamin D.
Exercise: Engage in regular weight-bearing and strength-training exercises to strengthen bones.
Lifestyle Modifications: Avoid smoking and limit alcohol intake to enhance bone health.
Regular Screenings: Bone density tests can help identify osteoporosis early, enabling timely intervention.

Osteoporosis Diagnosis & Tests

Diagnosis of osteoporosis typically involves:

Bone Density Testing: Dual-energy X-ray absorptiometry (DEXA) scans measure bone mineral density to assess osteoporosis risk.
Blood Tests: These may be conducted to check for calcium, vitamin D, and other metabolic conditions affecting bone health.
Fracture Risk Assessment: Tools like FRAX (Fracture Risk Assessment Tool) help evaluate the likelihood of fractures based on clinical risk factors.

Osteoporosis Treatment

Osteoporosis management focuses on preventing fractures and improving bone density. Osteoporosis treatment options include:

Medications: Bisphosphonates, hormone replacement therapy, and selective estrogen receptor modulators (SERMs) can help maintain or increase bone density.
Calcium and Vitamin D Supplements: Essential for bone health, these supplements can be beneficial, especially in individuals with dietary deficiencies.
Lifestyle Modifications: Weight-bearing exercises and fall prevention strategies are crucial in managing osteoporosis.

Do's and Don'ts for Managing Osteoporosis

Do's:

Engage in regular weight-bearing exercises to promote bone strength.
Consume a balanced diet rich in calcium and vitamin D to support bone health.
Maintain regular check-ups and follow-up appointments for monitoring bone density.
Educate yourself about osteoporosis and its management.

Don'ts:

Don’t smoke, as it negatively impacts bone health.
Avoid excessive alcohol consumption, which can interfere with calcium absorption.
Don’t ignore symptoms; early intervention is crucial for effective management.
Avoid high-impact activities that could increase the risk of fractures without proper guidance.

Care at Dr. Prudwiraj Sanamandra Endocrinology Clinic

At the Dr. Prudwiraj Sanamandra Endocrinology Clinic, we specialize in the comprehensive diagnosis and management of osteoporosis. Dr. Prudwiraj Sanamandra provides tailored treatment plans, ensuring the best care for patients to enhance bone health and prevent fractures effectively.