Osteoporosis is a disease that weakens bones over time. The word “osteo” comes from the Greek osteon meaning “bone”, while “porosis” comes from the Greek poros meaning “hole, passage”. This disorder is characterized by low bone mass (bone density) and loss of bone tissue; it puts you at risk for breaking a bone. Bone mass is the amount of bone present in the skeletal structure. Generally, the higher the bone density, the stronger the bones. Peak bone density is reached at approximately 25 years of age. After age 35, both men and women will normally lose 0.3%-0.5% of their bone density per year as part of the aging process.
Bone loss accelerates after menopause due to decreased estrogen levels (estrogen is important in maintaining bone density in women). Osteoporosis is more prevalent in women; Caucasian and Asian racial groups are at a greater risk. Other risk factors include: thin and small body frames; family history of osteoporosis; cigarette smoking; excessive alcohol consumption; lack of exercise; immobility; diet low in calcium; vitamin D deficiency; poor nutrition; and long-term use of certain medications.
Osteoporosis is often called the “silent disease” because patients have no symptoms until bone fractures occur. Bones that are affected by osteoporosis can break with relatively minor injury that normally would not cause a bone to fracture. The hip, spine, feet, hands, wrist, and ribs are the most common locations for osteoporotic fractures; these fractures can cause considerable pain, higher health care costs, impaired quality of life, physical disability, and loss of independence.
A routine X-ray can suggest osteoporosis. However, X-rays are not accurate indicators of bone density. A DXA or bone density testing is recommended. To prevent and treat osteoporosis, a regular weight-bearing exercise such as walking three times a week is recommended. Although exercise is not known to increase bone density, it improves balance and/or increases muscle strength which can decrease the risk of falls along with improved household safety . Make sure that your exercise is prescribed by your doctor; it should not be extreme. Other treatments and lifestyle changes include: quitting smoking; avoiding excessive consumption of alcohol and caffeine; decreasing excess protein in the diet; and assuring adequate intake of calcium–by eating calcium-fortified foods and taking calcium supplements–and vitamin D which helps calcium absorption and stimulates bone formation. Talk to your doctor about the most effective medications for osteoporosis that are approved by the FDA. If you are considering menopausal hormone therapy, I suggest having an individualized discussion with your doctor (use of hormone replacement therapy is controversial and can have adverse effects).
