Osteoporosis: Definition, Symptoms, Diagnosis, and Prevention

Osteoporosis is a condition that weakens bones and makes them break easily. It’s often referred to as the “silent disease” because it doesn’t typically cause any symptoms until a bone has already been broken. This means it can be difficult to diagnose and treat, but with the right knowledge, you can be better prepared for the prevention or management of this condition. Let’s take a closer look at what osteoporosis is and how it can be prevented or managed. 

Definition of Osteoporosis 

The word ‘osteoporosis’ means ‘porous bone’. Those who have it will not notice it until they break a bone. You are more prone to unexpected and sudden bone fractures. The person suffering from osteoporosis has less bone mass and strength with abnormal tissue structure. The microscopic view of a healthy bone appears like a honeycomb whereas an osteoporotic bone appears with holes and spaces in the honeycomb that are much larger than the ones in a healthy bone. Osteoporotic bones have lost their density, are very fragile, and are more likely to break. 

Is it common?

More than 12 million Americans above the age of 50 have osteoporosis and over 50 million more have a low bone density which puts them at risk for osteoporosis. According to studies, approximately one in two women and one in four men aged 50 and above, will break a bone because of osteoporosis. 

Symptoms of Osteoporosis

Osteoporosis does not cause any symptoms in its early stages, so it can often go unnoticed until a fracture occurs. The most common symptom is a pain in the affected area after an unexpected fracture has occurred. 

  1. Vertebral compression fracture: The spinal bones, called the vertebrae, are more prone to fracture due to osteoporosis and it usually occurs in the middle to lower back. The drum-shaped body of one or more vertebrae collapses into itself and becomes compressed into a wedge shape. This is called vertebral compression fractures and it may occur in people who have any type of osteoporosis. The weak vertebrae may collapse voluntarily or after a minor injury. Most vertebral compression fracture does not cause pain.  But, the pain can start suddenly and can worsen.
  2. Fragility fracture: It results from minor strain or fall such as a fall from a standing height or less, which includes falling out of bed, which usually doesn’t fracture a healthy bone. This occurs in the hip, wrist, spine, upper arm bone, and pelvis.
  3. Hip fracture: This is one of the most serious fractures. The hip fracture causes disability and older people lose their independence because of this.
  4. Wrist fracture: This occurs often in people with postmenopausal osteoporosis.

Fractures of the nose, ribs, collarbone, and bones in the feet are not osteoporosis-related fractures. Some of the other signs of possible fractures include a hunched posture and/or difficulty standing up straight due to back pain, loss in height over time, bone tenderness, or bone deformities. If you experience these symptoms, it’s important to seek medical attention immediately as they may indicate signs of osteoporosis. 

How is osteoporosis diagnosed?

It can be difficult to diagnose osteoporosis without having any obvious symptoms or pain associated with it. However, there are certain tests available to diagnose the condition such as 

  1. Dual-energy X-ray absorptiometry (DEXA) scan

Osteoporosis can be diagnosed only when bone loss leads to fracture. So, bone density screening is the only way to know if you have osteoporosis.  Dual-energy X-ray absorptiometry (DEXA) scan measures the bone density in the spine, wrists, and hips. The DEXA test calculates a score called T-score and the lower your score, the greater you are at risk of bone fracture. 

  1. Bone mineral test

Dr. Dimar suggests a bone mineral test for all women aged 50 and above so that they do not lose years of treatment with calcium, vitamin D3, and osteoporosis medications when they diagnose osteoporosis later.

  1. CT Scans

Spine surgeons can screen for osteoporosis using CT scans which are generally taken before spine surgery. 

  1. Tests that include measurement of
    • Calcium blood levels
    • Vitamin D3 levels
    • Certain hormone levels such as thyroid hormones and parathyroid hormones.

How can I prevent osteoporosis?

Generally, prevention of osteoporosis is better than treatment because it’s easier to prevent loss of bone density than trying to restore the density that’s been lost. The health of your bones depends on lifestyle factors such as diet and exercise. Here are some of the ways to prevent osteoporosis.

  1. Calcium intake: It is highly recommended by experts to take 1,200 mg of calcium for women aged 50 and above and for men it’s recommended to intake 1,000 mg from age 50 years to 69 years and then increase the intake to 1,200 mg from age 70 years and above. Calcium-rich food are:
    • Dairy products such as milk, cheese, and yogurt
    • Alternative milk products such as fortified almond, soy, oats, and coconut milk
    • Leafy green vegetables like collard greens, spinach, broccoli
    • Tofu
    • Dried fruits
    • Canned sardines or salmons
    • Orange juice and calcium-fortified cereals.
  2. Vitamin D3 intake: Ask your doctor to check your vitamin D3 levels as many people in the US have vitamin D3 deficiency which is very risky for bones. Adults aged 50 years and above are highly recommended to take 600 IU and 800 IU for adults aged 70 years and above. People diagnosed with osteoporosis may need even higher doses than those mentioned above. Calcium helps build strong bones while vitamin D assists with calcium absorption into your body which helps maintain healthy bones throughout life.
  3. Exercising: Weight-bearing exercises such as walking, running, stair climbing, jumping rope, and strength training with weights or resistance bands help to strengthen bones and prevent osteoporosis. It helps to keep your bones strong by putting pressure on them which stimulates the growth and maintenance of bone tissue over time. If you have osteoporosis and a compression fracture, you should go for low-impact exercises such as water aerobics, walking, and biking. Yoga and tai chi can prevent falls by improving your balance.
  4. Avoid smoking and alcohol consumption: According to Dr. Dimar, the single best thing that one can do for their bones is to stop smoking. It interferes with bone metabolism and healing. Avoid drinking alcohol or restrict yourself to one drink per night. Alcohol interferes with vitamin D3 metabolism in the liver and also prevents the liver from producing factors that you need to produce new bone.
  5. Avoiding falls: Take measures to prevent falls so that you can decrease the risk of fractures. Make sure you install and make use of safety grab bars in the washroom, have anti-slip flooring in bathtubs and showers, and remove throw rugs and other household hazards to reduce the risk of falls.

Osteoporosis is a silent disease that weakens bones, making them prone to fractures without any warning signs or symptoms until after the fact. While there is no cure for this condition yet, there are ways to decrease your risk of developing it by eating foods high in calcium and vitamin D while also engaging in regular weight-bearing exercise routines that stimulate growth in bone tissue over time. If you are concerned about developing osteoporosis or think you may already have it based on sudden fractures or other symptoms described here today, make sure to see a doctor right away so they can provide further guidance on how best to manage your individual case going forward!

For expert advice, check out the video on how to maintain strong bones and prevent osteoporosis from Dr. Douglas E Lucas, a DO board-certified orthopedic surgeon.

Jayashri Jambu
Wellneste Editorial Team

Referred Sources:
https://www.bonehealthandosteoporosis.org/patients/what-is-osteoporosis/
https://www.nhs.uk/conditions/osteoporosis/prevention/
https://www.merckmanuals.com/en-ca/home/bone,-joint,-and-muscle-disorders/osteoporosis/osteoporosis
https://www.spineuniverse.com/conditions/osteoporosis
https://www.uptodate.com/contents/osteoporosis-prevention-and-treatment-beyond-the-basics#disclaimerContent
https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/osteoporosis

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