Bone Pains? It Could Be Osteoporosis

About 50 million people in India have osteoporosis or low bone mass. 80% of urban Indian population is vitamin D deficient.

WHAT IS OSTEOPOROSIS?

Bone is composed of tissue and mineral. In osteoporosis, there is loss of both mineral and tissue. Osteoporosis weakens the bone and results in frequent fractures (breaks) in the bones.

Osteoporosis can strike at any age.

Osteoporosis affects both men and women.

Women and men equally begin to lose bone mass in their mid-30s, after menopause women have faster bone loss.

RISK FACTORS

Most important risk factor is Menopause.

Other risk factors:

Women are at higher risk than men

Family history

Small body frame

Hypothyroidism

Calcium and Vitamin D deficiency

Sedentary lifestyle

Excessive alcohol intake

Smoking,

Certain medications (heparin, anti-seizure medications and long-term use of oral steroids)

SYMPTOMS

There are no symptoms in early stages. Once bones are weakened, symptoms include:

Backache

Loss of height over time

Stooped posture

Bone fracture that occurs easily: Most common fracture sites are wrist, spine, shoulder and hips

DIAGNOSIS

Bone mineral density scan (X ray) called DEXA (Dual-energy X-ray absorptiometry) scan

Blood tests: serum Vitamin D, calcium, phosphorus, alkaline phosphatase and parathyroid hormone

SCREENING FOR OSTEOPOROSIS

Screening is recommended for:

Women > 65 years

Postmenopausal women < 65 years at risk for osteoporotic fractures

Screening is done using DEXA scan

Density is measured by T-score.

T-score < -2.5 indicates osteoporosis.

T-score -1 to-2.5 indicates milder form of disease and high risk for osteoporosis.

In patients with negative results, DEXA scan be repeated every 2 years.

PREVENTION

Building strong bones is the best defense against osteoporosis

Encourage children to drink milk and play in the sun to ensure adequate calcium, vitamin D synthesis and exercise.

Take diet rich in protein and calcium along with calcium supplements.

Spend 10-15 minutes in sun every day to help body produce Vitamin D.

Vitamin D is found in eggs, milk and oily fish.

Exercise daily (30 minutes) to strengthen bones. Even those with osteoporosis  can benefit by regular exercise.

Take stairs to strengthen bones and improve bone mass.

Quit smoking.

Limit alcohol intake.

Although bone loss is part of ageing, it can be stopped by medications that prevent further bone loss.

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TREATMENT

Medications that prevent further bone loss

Calcium, Vitamin D supplements

Hormone replacement therapy for postmenopausal osteoporosis

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