Knowledge For Life: Osteoporosis 

More than 50 million Americans suffer from osteoporosis, according to the National Osteoporosis Foundation. This condition is the most common type of bone disease. It can strike both men and women, though women are at a greater risk. The name osteoporosis translates to “porous bone.” With this disease, the structure of the bone tissue has lost density, weakening the bone and making it more likely to break.

Although there is no cure for osteoporosis, the physicians, nurses, and staff in the Institute for Advanced Bone & Joint Surgery at St. Joseph’s/Candler are dedicated to helping patients prevent the disease’s emergence or to slow its progression. Their message of awareness is not designed only for the older generations—the modifiable risk factors for osteoporosis are linked to habits that should be established in childhood.
 
“Osteoporosis is the lack of normal mineralization in the bone,” explains orthopedist David N. Palmer, MD. “It is a disease process that occurs with aging, specifically in post-menopausal women. It is more prevalent in light-skinned women who are of a slender build.”
 
Bones in the hip, spine, and wrist are the most likely to break due to osteoporosis, but other bones are also vulnerable. Patients cannot feel their bones getting weaker, so they often don’t know they have the disease until they experience a fracture.

Risk Factors
 
With osteoporosis, there are some risk factors you can’t control and some that you can.
 
Uncontrollable Risk Factors:

• Being over the age of 50.
• Being female (especially of White or Asian ethnicity)
• Menopause
• Family history of osteoporosis
• Thin or small build
• Previous fracture

Controllable Risk Factors:

• Getting too little calcium and vitamin D
• Not eating enough fruits and vegetables.
• Inactive lifestyle.
• Smoking
• Drinking alcohol in excess

“It is important for younger women to try to build their bones with exercises such as weightlifting, walking, running, and more,” Palmer says. “Also, the more a pre-menopausal woman, specifically in her teens and 20s, builds up her bones by taking in enough calcium and vitamin D, the better off she will be later in life.”

Certain medications can also contribute to bone loss and increase your risk of osteoporosis. Consult with your physician to learn about the benefits and risks of medications that you take for other conditions.

Screenings

Along with a physical examination and medical history, the best screening for diagnosing osteoporosis is a bone mineral density test.
“Bone mineral density tests are recommended for women who are 65 and older, as well as women over 60 who have an increased risk for a fracture,” says Penny Swindell, RN, the Joint Academy Coordinator for the Institute for Advanced Bone & Joint Surgery at St. Joseph’s/Candler. “Men over the age of 70 should also consider being screened.”

These tests are simple, safe, noninvasive and painless. Low-dose x-rays measure the amount of minerals, including calcium, in an area of bone. Radiation exposure for the patient is usually less than in a standard chest X-ray. A bone mineral density test is not the same as a bone scan, which requires an injection of radioactive material and is used to identify bone infections and cancer.

Other laboratory screenings, such as blood and urine tests, can help identify other medical conditions that may be causing bone loss. This is known as secondary osteoporosis.

Goals

“Treatment for osteoporosis can be hormonal, which should be managed by a primary care physician or endocrinologist,” Palmer says. “This includes hormone replacement therapy, including estrogen replacement, which carries other risk factors. Other treatment options include certain bone-building medications as well as weight-bearing exercises, in addition to calcium and vitamin D supplementation.”

The exercise and nutrition Dr. Palmer notes as part of treatment mirrors the controllable risk factors listed above. Both Dr. Palmer and Swindell emphasize the importance of the effort that people can make—an active lifestyle with plenty of fruits, vegetables, calcium and vitamin D—to protect their bones before their 50^th birthday.

“Approximately one in two women and up to one in four men age 50 and over will break a bone due to osteoporosis,” Swindell says. “The goal of treating osteoporosis is the prevention of fractures, but the goal of every person should be to adopt good habits now for the health of his or her bones.”