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Osteoporosis – THE SILENT EPIDEMIC

Osteoporosis is a major health concern today affecting more than 44 million Americans, mostly women. Osteoporosis is progressive thinning (loss of calcium) of bones that result in them becoming porous and at high risk for fracture. Women who suffer from vertebral fractures suffer significant pain, disability and deformities of the spine (dowager’s hump). Approximately 20 percent of women with osteoporosis who suffer a hip fracture die within a year from consequences of the fracture.


Osteoporotic bone

Osteoporosis is costly when overlooked: Over the past decade the direct expenditures for osteoporotic fracture have increased from an estimated 5 billion to 14 billion dollars. The frequency of this condition is increasing as our society ages. Studies have shown that prevention of osteoporosis is critical in the treatment of the disease.

What happens to bones as the get older? As we age most adults experience some bone loss, but there is a difference between bone loss relating to natural aging and bone loss associated with osteoporosis. Depletion of hormones such as estrogen and progesterone, which comes with menopause, accelerates osteoporosis. Estrogens are important because they help to balance the destruction of old bone and the formation of new bone. When estrogen levels drop as we age bone loss speeds up and bones become more fragile. Women over the age of 30 lose bone at a rate of one-half to one percent per year, but after menopause women will lose bone as much as three to five percent a year. This means that women could lose more than 20 percent of their skeleton in just four to five years even if they are taking the right amounts of calcium.


Osteoporotic bone scan

Is osteoporosis painful? Osteoporosis is not the same as arthritis. Arthritis damages the joints while osteoporosis affects the bone tissue and the inside structure of the bone. However, there are many who have both osteoporosis and arthritis. Arthritis is generally painful with continued or excessive use of the joints. Osteoporosis is painless in the early stages, but after osteoporosis is well established, thin bones can result in painful bones. Compression fractures pf Osteoporitic spine can be extremely painful.

Men can get osteoporosis too. Osteoporosis is less frequent in men because men reach a higher peak bone mass and because hormones are less important in men than in women. But a man still has a 30 percent risk of having an osteoporosis-related fracture in his lifetime. One-third of men who suffer a broken hip die within a year. Men should be screened for osteoporosis also as they are often overlooked by practitioners who forget that osteoporosis is not just a disease that affects women. Other things that can influence the risk of osteoporosis in men are low physical activity, drinking alcohol, caffeine, smoking, and low levels of hormones such as testosterone, and genetics. Both men and women may have secondary osteoporosis, which results from another medical condition such as asthma or lung conditions, which require the use of steroids for treatment. Steroid use tends to place men and women at risk for early onset of osteoporosis.

Other risk factors for osteoporosis: Perhaps the strongest indication for osteoporosis in your body is contained in your family tree. Do mothers, sisters, grandmothers, great grandmothers carry the condition, or perhaps have suffered hip fractures or other conditions which were part of the osteoporosis complex? If the answer to these is yes, then you should be screened for osteoporosis early. If you are female, small boned, white or asian, have had menopause before the age of 45, or irregular menstrual cycles brought about by eating disorders or intense exercise, or use of medications such as Heparin, anticonvulsants, corticosteroids, and antacids containing aluminum or thyroid hormones, you are at increased risk.

How is osteoporosis diagnosed? The gold standard for diagnosis of loss of bone in the spinal column is the DEXA scan. This simple, non-invasive instrument measures bone density in select parts of the spine and provides a concise report which determines your bone density status and when and what king of treatment should begin.


DXA Scan Unit

How is Osteoporosis treated? Depending on the degree of osteoporosis, treatment usually involves a combination of calcium supplements, Vitamin D supplements, weight bearing exercise and elimination of factors, which aggravate osteoporosis or intensify osteoporosis such as excessive alcohol, smoking, and certain medications. Selected estrogen receptor modulators can reduce the loss of bone tissue significantly. Raloxifene/Evista is just one example of these products that can be useful in selected patients. Bisphosphonates are non-hormonal medications that may also help bone remodel. In addition, they may work to limit the activity of osteoclasts, the cells responsible for bone destruction. Among these Bisphosphonates are drugs sucj as alendronate. Fosamax and Risedronate/Actonel. Calcitonin is another medicine that has extract of the bones of salmon, a natural hormone that can be applied through a nasal spray. It is a great help in cases where osteoporosis is severe. Vitamin D is also important as well as parathyroid hormone, which may be utilized also in treatment of some patients. Aggressive treatment protocols have proved in our practice to reverse the effects of severe osteoporosis. As bone mineral density increases over the course of a year or two of treatment, bone pain decreases. Weight bearing exercise and diets high in Vitamin D and antioxidants are also very important factors.



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