Twenty-five million Americans have osteoporosis. Fifty thousand people die each year because of complications related to osteoporosis. Yet, most of us know little about protecting ourselves from this disease.
What is Osteoporosis?
Osteoporosis is a disorder of the bones characterized by decreased bone mass (generalized thinning of the bones), which also decreases bone strength. Because weakened bones are more fragile and more likely to break, people with osteoporosis are at increased risk of fractures, especially fragility fractures (broken bones that happen with little or no trauma). It is not a form of arthritis, although it may cause fractures that, in turn, lead to arthritis.
In the United States, osteoporosis causes more than 1.3 million fractures annually and is much more common in women than in men. The most common first fracture is a wrist fracture, which typically occurs at age 50 to 70 in women. Hip fractures and fractures of the spine (compression fractures) may also occur and are most common in patients who are in their 70s. Particularly when it leads to hip fracture, osteoporosis can cause a great deal of suffering, including an increased risk of institutionalization or death.
Most people with osteoporosis have no symptoms and are totally unaware that they have the problem. One early sign can be a loss of height caused by curvature of the spine (Dowager's hump), which is caused by weakened vertebrae (spine bones). The weakened vertebrae undergo compression fractures — tiny breaks that cause the spine bones to collapse vertically. When this happens, the height of the vertebrae is decreased, and the shape of each single vertebra goes from a normal rectangle to a more triangular form. Although the loss of height caused by compression fractures can sometimes be associated with back pain or aching, more typically it is asymptomatic (causes no symptoms).
When taking your history, your doctor will look for factors that increase your risk of osteoporosis.
Osteoporosis Risk Factors
- Being female
- Being age 40 or older
- Being a postmenopausal woman who does not take estrogen replacement medication
- Having a diet low in calcium or an intestinal problem that impairs absorption
- Having an overactive thyroid
- Leading a sedentary lifestyle, with little or no routine exercise
- Being thin
- Taking certain medications, such as prednisone
- Having a certain ethnic background (white people and those of Asian descent are more at risk of osteoporosis than are African-Americans)
- Using alcohol to excess
- Having a family history of osteoporosis
- Having a history of at least one fragility fracture
The diagnosis of osteoporosis should be strongly suspected in any person who has a fragility fracture. It can also be established by a bone density test, or bone densitometry. There are several techniques available to measure bone density. The most complete and accurate method is DEXA (dual- energy X-ray absorptiometry), which is the best for both diagnosing osteoporosis and assessing response to treatment. DEXA is a quick (10 to 15 minutes) and painless test that uses minute amounts of radiation (less than dental X-rays) and is generally done on the spine and hip. DEXA is available at MedStar Orthopaedic Institute.
Bone densitometry can diagnose osteoporosis when the condition is asymptomatic and mild and can help lead to treatment that will prevent the condition from getting worse. In people with loss of height or suspicious fractures, bone density tests not only confirm the diagnosis of osteoporosis, they also serve as a baseline for treatment and can be used to follow the response to therapy.
Ask your physician or therapist atMedStar Orthopaedic Institute if you are at risk for osteoporosis and if bone densitometry may be indicated.