As time passes and age increases, bone strength naturally decreases, so more attention should be given to it. However, most people do not pay attention to this, because it is not noticeable from the outside and changes are not perceptible until osteoporosis and deterioration have progressed beyond treatment.
Osteoporosis is a condition caused by a decrease in the density of bone tissues and destruction to the internal structures of bones, leading to fragile bones and reduced bone strength. Thus, this leads to increased risk of breaking bones and injuries. Bone strength is determined by bone density and bone quality, but older age leads to age-related deterioration, and lack of exercise, alcohol consumption and low dietary intake of calcium, etc. are contributing factors.
The symptoms of osteoporosis are usually divided into 2 stages as follows:
- In the early stage, bone density gradually decreases. The patient will experience no symptoms at all, and the majority of cases occurs in menopausal women and people with risk factors. At this stage, diagnosis is possible only through a bone density measurement.
- In severe osteoporosis, this is when the bones have become very thin, possibly leading to vertebral compression fracture or a broken hip bone. The patient often experiences back pain and a hunched back, and it will be possible to notice a decrease in the patient’s height. In some cases, back pain is so severe that it spreads to the chest. The back may also be arched, and the patient will be able to eat less and experience bloating and congestion in the abdomen. This condition is frequently encountered in patients older than 65 years, and sometimes bones will break around the risk or other bones may easily break, accompanied by aches and pain throughout the body.
Risk Factors for Osteoporosis
- Being elderly, especially in females.
- Being in menopause or having undergone oophorectomy on both sides.
- Broken bones due to brittle bones.
- Being someone who does not exercise.
- Not having adequate dietary intake of calcium.
- Being a heavy smoker.
- Regular heavy consumption of alcohol and excessive amounts of caffeine.
- Being a patient who takes certain drugs that reduce calcium absorption in the body, for example, thyroid medications, steroid medications, diuretics, etc.
- Being a patient with an endocrine disorder, such as a thyroid disorder or diabetes.
- Having an adrenal gland disorder, being in a cast for a long time and paralysis or paresis.
Diagnosis
Today, doctors can diagnose brittle bones before symptoms occur by performing a bone mineral density test or BMD. This test exposes the intended site to a very small amount of x-ray and then using a computer to calculate bone density for comparison with standard values by comparing with the bone density of 25-year-old women. This is combined with blood tests to determine how bone tissues are being created and destroyed.
Mineral bone density testing helps delay loss of bone density.
The test procedure is simple and painless and requires no fasting beforehand. In the past, bone density testing required cutting out a piece of bone from the body to test it. Today, however, it is possible to test for bone density right away without fasting from water and food. After undergoing the test, the doctor will be able to identify the cause of bone density loss and plan treatment or ways to delay loss of bone density. As a result, there is a chance to significantly recover or experience improvements in symptoms from most cases of osteoporosis. If the condition is detected and treated early on, it is possible to increase bone density to reduce risk of broken bones and risk of falls.
Who should undergo bone mineral density testing?
- All post-menopausal women.
- People who are more than 65 years old.
- People with risk factors for osteoporosis such as prolonged smoking, drugs and steroid injections.
- People who are very thin.
- People with family history of osteoporosis.
- People who do not exercise.
Treatment
Medications. There are many medication approaches for treating thinning bones, especially in post-menopausal women. Drugs used to treat osteoporosis include the following:
- Estrogen hormone is usually prescribed to patients who have undergone oophorectomy in order to reduce symptoms of menopause.
- SWEMs (selective estrogen receptor modulators) is a synthetic drug similar to the estrogen hormone that was developed to reduce the incidence of breast cancer. It can be used to reduce loss of bone density and the incidence of brittle bones.
- Calcitonin is a natural hormone extracted from salmon that helps prevent loss of bone density and helps reduce the incidence of spinal fracture. It also has pain-relieving effects.
- Bisphosphonates are drugs that suppress bone loss and reduces risk of spinal fracture and hip fracture.
- Parathyroid hormone for patients with severe osteoporosis or patients that are unresponsive to other drugs.
Surgical treatment is aimed at correcting complications from broken bones. For example, this may include vertebroplasty in patients with vertebral compression fracture or hip replacement surgery in patients with hip fracture. It is possible to learn whether or not bones have degenerated by consulting a doctor for a review of the patient’s history, along with an x-ray and bone mineral density test. If abnormalities are discovered, it is important to urgently consult a doctor in order to receive proper care recommendations.
