What Is Osteoporosis?
Osteoporosis is a disease where the bone is porous, weak, and brittle. The osteoporosis meaning is “porous bone” normally a bone is very dense with a honeycomb-like structure, but in osteoporosis the holes get bigger. A simple osteoporosis definition is an increased vulnerability to breaking bones because of decreased bone strength and density. What is osteoporosis in real life? It is a silent disease. Bone tissue is living tissue which continuously breaks down and reforms, and after thirty years the loss begins to exceed the reforming of bones. People usually do not feel anything except the breakage, and therefore discover the disease after fractures. Early osteoporosis treatment can stop further bone loss, hence lowering the risk.
Osteoporosis Symptoms
It is referred to as a silent disease because osteoporosis symptoms do not manifest during the early stages. The signs and symptoms of osteoporosis usually begin to show up only when the bones have become weak or broken. They include sudden back pain which could be an indication of a broken spinal bone, height loss, bent spine, and a broken bone from a trivial fall, cough, or bump. The most common fractures are the spinal, hip, and wrist bones. If you notice any of these signs, especially if you are older than fifty years of age, you should ask your doctor to have a bone density test done for you.
Osteoporosis and the Spine
The spine is the area where osteoporosis is most frequently seen because the vertebral bone is primarily composed of trabecular bone which gets affected by osteoporosis first. It results in the vertebra being subjected to compression from normal stresses like bending, lifting, or even coughing, leading to a spinal compression fracture. Some fractures can cause pain on their occurrence, while others occur without any pain but are identified due to reduction in height. Spinal deformity develops due to repetitive collapse of vertebrae that result in stooping of the spine. These problems impair breathing and appetite. A single fracture increases the risk for further fractures, so the condition of osteoporosis requires treatment in addition to the broken bone.
What Causes Osteoporosis?
Primary osteoporosis causes aging and hormones. Among women, the rate of bone density reduction increases during menopause due to low oestrogen level while in old age men, it increases due to lower testosterone level. Other osteoporosis risk factors which increase the risk of osteoporosis are family history of the disease, being underweight, deficiency of calcium or vitamin D in diet, being physically inactive, smoking, excess drinking of alcohol and usage of steroids for long periods of time. In India, vitamin D deficiency is very common and is another major factor, especially among people who live in sunny areas.
Types of Osteoporosis
There are types of osteoporosis that are categorized as either primary osteoporosis or secondary osteoporosis. Knowing the type of osteoporosis will be helpful in treatment.
Primary Osteoporosis
Primary osteoporosis is due to aging and hormonal changes without any other disease. This includes post-menopausal osteoporosis in females and aging osteoporosis in old men and women.
Secondary Osteoporosis
Secondary osteoporosis arises due to some other factor or medication, for example, steroids, kidney diseases, thyroid disorders, or problems with nutrient uptake. It may happen at any age, even among young individuals.
How Osteoporosis Is Diagnosed: DEXA Scan and T Score
Bone Density Test is Used in Osteoporosis Diagnosis. A DEXA scan osteoporosis is a quick and painless low-dose x-ray examination of the spine and hip that determines the density of the bone and provides a T-score in comparison to the bone of a healthy young person. Although an ordinary osteoporosis Xray could diagnose a bone break or thin bones, it will take too much bone loss to notice, hence making a DEXA scan irreplaceable.
T score | What it means |
Higher than -1 | Normal bone density |
Between -1 and -2.5 | Osteopenia, low bone density |
-2.5 and lower | Osteoporosis |
-2.5 and lower with a fracture | Severe Osteoporosis |
The treatment you will receive is based on your T score osteoporosis results and your age as well as fracture history and risk factors. The physician can prescribe blood test to check the level of calcium, vitamin D, thyroid and kidney function.
Osteoporosis Treatment
Osteoporosis treatment involves strengthening the bones and preventing fractures through the adoption of lifestyle modifications, medication, and fracture treatment.
Lifestyle and Nutrition
Calcium, vitamin D, and protein intake; weight-bearing activities like walking; avoiding smoking; consuming moderate alcohol; and fall-proofing one’s home all contribute to healthy bones. Sunlight contributes to vitamin D production, but most require supplements.
Medication
Osteoporosis medications consist of calcium and vitamin D, bisphosphonates to decrease the rate of bone destruction, and bone formation and bone resorption inhibitors in the form of injections. It all depends on your T score, past experience with fractures, kidney condition, and age; hence, only a physician should prescribe you these medications.
Treatment of Osteoporotic Spine Fractures
Osteoporosis fracture patients usually make recovery through pain management, use of a brace, and physiotherapy. However, if the pain remains unbearable, vertebroplasty and kyphoplasty treatments help to stabilize the vertebrae using cement, and spinal stabilisation surgery helps in cases of instability and neurological compression. Dr. Zahir Abbas Merchant, who has more than 15 years of experience in orthopaedics, selects the most gentle solution.
When to See a Spine Doctor
Don’t delay consulting your doctor when your bone health starts deteriorating due to any kind of breakage. Schedule an appointment with the doctor if you’re above the age of 50, post-menopause, using steroids for more than one year, or if you have previously had any kind of breakages due to trivial injuries. Another indication for visiting the doctor includes sudden onset of back pain which does not resolve even after a few days. Additional symptoms are numbness of the back and legs, weakness of the legs, and urinary incontinence.
According to Dr. Zahir Abbas Merchant from The Spine eXpert Clinic, Mumbai, osteoporosis is a problem that occurs in the whole spine and not just a number extracted from the tests. He analyzes your DEXA scan, X-ray, and blood reports collectively, examines your posture and spine, and gives you an explanation regarding your T score and treatment plan in layman’s terms. Most people recover with the help of proper medications, modifications in their house, and physical activity under guidance. A surgery is considered if it will be helpful for you. Moreover, he also coordinates with your doctor for your bone health in the long run with follow-ups to reduce the risk of any more fractures.