Osteoporosis: Symptoms, Causes, Tests & TreatmentHouston Endocrine Center2022-10-14T15:47:51+00:00
Osteoporosis is one of the most common diseases in women, affecting approximately 8 million people worldwide. Osteoporosis has several causes and symptoms, but it can be detected early with proper diagnosis and treatment.
Although there are several factors that contribute to the progression of bone loss, only one factor has been the most studied: age. Osteoporosis is more common with age, and although it can occur at any time in life, there seems to be a specific peak between 30 and 60 years of age.
Currently, there is no effective treatment for osteoporosis, and many people with this disease die from it. There are several treatments that can be used to help the body fight the effects of osteoporosis, but they are often not successful.
What Is Osteoporosis?
Osteoporosis is a disease in which the bones are not able to support the weight of the body. It results from an imbalance of calcium and phosphorus in the body. This can result in the bones becoming weak, making them more prone to fracture. These fractures may cause serious injuries.
Osteoporosis affects the bones, muscles, and cartilage of the body. It can result in fractures, dislocations, and even death. It appears as the bones become more brittle, and the skin becomes thin. You can treat osteoporosis by taking care of your diet, exercising regularly, and eating a balanced diet. There are also some supplements that may be helpful. Osteoporosis is caused by loss of bone mass due to a lack of calcium in the diet (calcium is the mineral that makes up the bones).
The main symptoms are pain, swelling, stiffness in the joints, and weakness in the muscles. Many people with osteoporosis describe feeling tired, weak, and having difficulty doing everyday activities. If you want to find out more about how your body works, your doctor can perform a physical examination. You may also ask to see one of our other doctors if you are concerned about something else related to your health.
What Are The Types Of Osteoporosis?
Osteoporosis is a condition in which the bones lose their ability to support the weight of the body. It is caused by a genetic predisposition to osteopenia (bone loss). There are several types of osteoporosis:
1. Primary Osteoporosis
Primary osteoporosis is the most common type. This condition can be caused by a faulty gene. It usually begins before age 40 and lasts for life. Symptoms include thinning of bones, reduced strength, and brittle fractures that can occur at any time, from minor accidents to surgery or fall from a height.
2. Secondary Osteoporosis
Secondary osteoporosis is caused by the gradual wear of bones as a result of disuse. Symptoms include thinning of the bones and loss of bone strength. This type can be seen in people who have not yet reached their 40s and 50s. Fractures can also cause secondary osteoporosis but are not as common when compared to primary types since fractures do not increase bone density.
3. Metabolic Osteoporosis
Metabolic osteoporosis is caused by the inability to manufacture or release enough bone. It can be caused by genetic predisposition and poor diet. Symptoms include loss of strength and brittle fractures that can occur at any time, from minor accidents to surgery or fall from a height.
4. Acquired Osteoporosis
The final type of osteoporosis is called Acquired Osteoporosis. It is caused by the weakening of bones due to an injury or disease. This type only occurs in people who have had previous bone loss, and it is more common in postmenopausal women. Acquired osteoporosis most commonly affects the hips and spine but can affect any bone within the body.
What Are The Symptoms Of Osteoporosis?
The most common symptom of osteoporosis is bone pain. The bones become thin and brittle, so they can break easily. The symptoms of osteoporosis vary depending on how severe the disease is and how quickly it progresses. Some people may not have any symptoms until they fracture a bone in an accident or fall, but there are some symptoms associated with the disease:
- Loss of height as a result of compression fracture (a broken bone) of the vertebrae (the bones in your spine). This occurs when one or more vertebrae collapse and cause you to lose height.
- Pain in the back, hips, or ribs due to osteoporotic compression fractures. These can happen suddenly (acute) or develop over time (chronic).
- Bent fingers or knuckles due to osteoarthritis in the joints caused by osteoporosis. This can make it hard to hold objects like a pen or pencil.
- Difficulty getting up from a chair because of weakened muscles and ligaments caused by osteoporosis in the legs and pelvis.
- Fractures that occur as a result of minor falls (for example, a broken wrist after falling down)
What Are The Main Causes Of Osteoporosis?
Osteoporosis can happen when you least expect it — while bending over, lifting something heavy, or even just getting out of bed in the morning.
There are many causes of osteoporosis, including:
- Age-related decrease in estrogen levels after menopause
- Genetic predisposition
- Low body weight or lack of exercise (especially if you’re overweight)
- Family history of osteoporosis
- Long-term use of certain medications such as corticosteroids (prednisone), anticonvulsants (phenytoin), and antacids.
- Medical conditions (such as other endocrine and hormonal diseases, rheumatoid arthritis, gastrointestinal diseases, specific types of cancer, anorexia nervosa, and HIV/AIDS.)
- Emotional stress
- Animal protein
- Soft drink
- No physical activity
A fracture is when a bone breaks or cracks. The most common type of fracture is from a fall or other trauma, such as being hit by a car or falling off a ladder. But some people have osteoporosis fractures without having any history of falls or injuries.
Source: The New York Times
When someone has an osteoporosis fracture, they may have pain in their hip or back or have trouble moving around because of the pain. They also might have broken fingers or toes (called “bruised bones”).
Osteoporosis fractures happen most often in the spine (spinal fractures), hips (hip fractures), and wrist/ankles/feet (foot/ankle fractures).
Types Of Osteoporosis Fractures
Osteoporosis fractures often occur in weight-bearing bones, such as hips and legs. The most common types of osteoporosis fractures are:
1. Hip Fractures
Hip fractures are common among older adults with osteoporosis and can result in significant disability and even death if not treated properly. Hip fractures often happen when an elderly person falls while walking or climbing stairs. Hip fractures are also more likely to result in death when they occur in people who have other medical conditions such as heart disease, lung disease, kidney failure, or dementia.
2. Vertebral Compression Fractures
A vertebral compression fracture is caused when the bones in the spine are weakened by osteoporosis. This can happen in any area of your spine, but it most commonly happens in the lower back (lumbar spine). When you have a vertebral compression fracture, the bone collapses and puts pressure on the nerves inside your spinal cord. This can cause pain, numbness, or weakness in your legs.
3. Femur Fractures
Femur (thigh bone) fractures are generally caused by a fall or a direct blow to the hipbone. A femur fracture occurs when the thighbone breaks in two or more places, causing severe pain and difficulty walking. A broken femur is a serious injury that requires immediate medical attention for proper treatment and recovery.
Symptoms Of Osteoporosis Fractures
Osteoporosis fractures occur most often in the spine, wrist, and hip. The following are some of the symptoms of osteoporosis fractures:
- Back pain. Back pain is a common symptom of osteoporosis fractures. The pain may be sudden or gradual and can range from mild to severe.
- Pain in your arms and legs. Pain in your arms and legs can be caused by compression fractures, which happen when compression forces cause the vertebrae to collapse.
- Changes in your walking pattern. You may notice that you have trouble climbing stairs or getting out of chairs because of changes to your walking pattern or balance.
- Severe back pain or frequent falls may indicate an emergency situation where immediate medical attention is needed — such as a spinal cord injury caused by a compression fracture that affects nerve function or causes paralysis.
- Unexplained bone pain, such as pain in the hips, ribs, or shoulders and unexplained numbness in hands or feet
Causes Of Osteoporosis Fractures
There are several known causes of osteoporosis fractures, including:
- Thin bones from childhood or adolescence.
- Low estrogen levels after menopause.
- Aging process as you get older.
How To Avoid Osteoporosis Fractures
The National Osteoporotic Foundation recommends these steps to prevent osteoporosis fractures:
- Take calcium and vitamin D supplements if you don’t get enough from your diet or sunlight — they’re especially important if you’re over 50 years old or have low body weight or slow metabolism.
- Exercise regularly — aerobic exercise helps boost bone density, while weight-bearing exercises help build strong muscles to support your bones.
- Don’t smoke because it lowers blood levels of vitamin D and increases your risk for fractures. Also, avoid excessive alcohol intake because it can increase your risk for falls and fractures by impairing balance and coordination.
- Avoid medications that cause increased calcium loss from the body, such as corticosteroids (often used to treat inflammatory diseases like asthma) or antiseizure medications (such as phenytoin).
Tests Used To Diagnose Osteoporosis
There are several tests that can be used to diagnose osteoporosis. The most common test is a DEXA scan.
1. DEXA Scan (Dual-Energy X-Ray Absorptiometry)
This is a special X-ray that measures bone density in the hip and spine. A DEXA scan may be recommended if you have risk factors for osteoporosis, such as being postmenopausal or having a family history of the disease.
Other tests include:
2. Blood Tests
These include tests to check your vitamin D levels and make sure you don’t have other diseases that could increase your risk of osteoporosis. Your doctor may also order blood tests to check your kidney function and thyroid gland function.
3. Bone Density Test
This test measures how much calcium is in your bones by using X-rays. You’ll lie still on a table while two X-ray machines shoot two beams at you from different angles. The machine then measures how much light is absorbed by your bones and sends the results to a computer program that calculates your bone density score based on this data.
Surgical And Non-Surgical Osteoporosis Treatments
There are two types of treatment for osteoporosis: non-surgical treatments and surgical treatments.
Surgical treatments include hip replacement surgery, spinal fusion surgery, vertebroplasty (a procedure that injects cement into fractured vertebrae), and more. Surgical treatment can be classified as minimally invasive procedures and traditional open surgeries.
a. Minimally Invasive Procedures
1. Minimally Invasive Spinal Fusion
A spinal fusion is used to fuse together two vertebrae in order to stop movement between them. This prevents stress on spinal discs and helps relieve pressure on nerves exiting through the spine. The procedure involves removing bone from one vertebra and placing it on another vertebra in order to bond them together permanently.
2. Minimally Invasive Hip Surgery
Minimally invasive hip surgery involves making smaller incisions than traditional open surgeries, so there are fewer scars and less post-operative pain associated with these procedures.
3. Lumbar Decompression With Instrumentation (LDI)
LDI is a minimally invasive procedure designed to decompress the lumbar spine by removing bone spurs from the vertebral bodies (the bone that makes up the spine). This procedure can relieve pressure on nerves exiting from your lower back and help prevent future nerve compression or damage due to arthritis or osteoporosis.
b. Traditional Open Surgeries
During a vertebroplasty, a needle is inserted into the vertebra where it meets the spinal cord. A fluid known as cement is then injected into the damaged bone. In this way, the damaged bone is strengthened and stabilized while giving you pain relief.
Kyphoplasty (pronounced: ky-foe’ plas-tee) is similar to vertebroplasty, but instead of injecting cement into the vertebra, a balloon-like device is placed inside the damaged part of the vertebra and inflated with compressed gas or liquid. The balloon expands within the cavity of the vertebra, creating more space for blood flow within the body and strengthening bones from the inside out.
3. Bone Grafting
Bone grafting involves taking bone from another part of your body (such as your hips) and inserting it into your vertebrae to strengthen them. Bone grafting may be done if one or more vertebrae have collapsed due to osteoporosis-related fractures or if an infection has infected your vertebrae and caused them to collapse.
4. Arthroplasty (Total Hip Replacement)
Arthroplasty is a surgical procedure in which the diseased joint surface is removed and replaced with an artificial joint. The goal of arthroplasty is to relieve pain, improve mobility, and return function to normal. There are several types of hip joint replacement surgery available. Your doctor will discuss the options that are best suited to your situation.
5. Knee Replacement Surgery
Knee replacement surgery may be appropriate for patients who have severe osteoarthritis of the knee joint. Knee replacement surgery involves removing all or part of the knee joint and replacing it with an artificial joint made of metal and plastic parts that fit together like puzzle pieces to form a smooth ball-and-socket joint. The new joint allows more movement than an arthritic knee does, which improves walking ability and reduces pain from arthritis.
6. Spinal Cord Stimulation (SCS)
This procedure involves placing an electrode into the epidural space around the spinal cord, which delivers electrical pulses through a battery pack implanted under the patient’s skin. The electrical pulses block pain signals from traveling up to the brain and can help reduce symptoms like leg pain and weakness associated with spinal stenosis.
Non-surgical treatments include medications such as bisphosphonates, hormone therapy, and corticosteroids, which help prevent further bone loss or increase bone density. Non-surgical treatments can be categorized as:
- Weight-bearing exercises
- Calcium and vitamin D supplements
- Hormonal therapy (I’m talking about estrogen)
Other non-surgical treatments include:
Braces will help prevent falls by providing support for weak bones in the spine and lower limbs. Your doctor will determine if bracing is right for you based on your specific needs and limitations.
Medications such as bisphosphonates and raloxifene (Evista) work by reducing bone loss and stimulating new bone formation by helping build strong, dense bones. Bisphosphonates include alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), and zoledronic acid (Reclast).
Preventing Osteoporosis Without Medication
The good news is that there are many ways to prevent osteoporosis without taking drugs:
- Eat a healthy diet
- Eat calcium-rich foods like milk products, tofu, and dark leafy greens.
- Exercise regularly and maintain a healthy weight.
- Get enough sleep
- Take breaks from sitting down (Standing up every hour or so can help reduce these problems).
- Don’t smoke cigarettes or use other tobacco products (including chewing tobacco).
- Avoid excessive alcohol consumption (more than two drinks per day).
Conclusion & Takeaway
Your bones are living tissue that needs fresh blood flow to stay healthy. As you age, your bone cells may not get enough nutrients or oxygen through the blood vessels that supply them. This can lead to weak, brittle bones.
Osteoporosis is a disease that makes bones weaker and more likely to break. Over time, it can make daily tasks like walking or climbing stairs difficult.
The good news is that osteoporosis can be prevented. And if you already have it, there are ways to manage your symptoms and keep active with less pain. Visit our website to book your appointment with us.