What is Osteoporosis?

Osteoporosis is a disease that causes the bones to lose density and mass, becoming weak and brittle. This can cause bones to break more easily from falls or as a result of mild stresses such as a bump, bending over or coughing. In some cases the fracture occurs without any known trauma or stresses to the bone, causing the person to fall. 

Baptist Health is known for advanced, superior care for patients with orthopedic conditions and the diagnosis, treatment and management of osteoporosis. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Early stage osteoporosis typically causes no symptoms. In many cases, osteoporosis is not diagnosed until a broken bone occurs. Symptoms of osteoporosis can include:

• Back pain caused by a fractured or collapsed vertebra
• Loss of height over time
• Slouching, slumping or stooped posture
• Easily fractured bones

Diagnosis

If osteoporosis is suspected, a physical examination is performed that assesses for risk factors and includes questions about symptoms. Advanced diagnostic procedures and technology are used to effectively diagnose, determine treatment and carefully monitor the condition. 

Osteoporosis is usually diagnosed using a bone scan, also known as a bone density scan or bone mineral density test. This test uses special imaging technology that can show the density of a bone or active bone formation, and is typically conducted on one or several sites on the body, most commonly the hip, spine and wrist.

If a fracture or other condition resulting from osteoporosis is suspected, additional diagnostic procedures may be ordered, and can include:

CT Scan: X-rays and computers are used to create images of the affected area. This provides a more detailed picture than an ultrasound. 

Quantitative Computed Tomography (QCT): Similar to a CT scan, this test provides 3-D images of the hip and spine and can help determined bone density.

Magnetic Resonance Imaging (MRI): A large magnet, radio waves and a computer are used to produce pictures of the heart and blood vessels.

X-ray: A common imaging test of bones or joints, an X-ray can also include dual-energy X-ray absorptiometry (DEXA), which can help measure bone density. 

Causes

Many causes of osteoporosis cannot be controlled. Causes of osteoporosis that can be controlled include: 

• Being underweight (such as with eating disorders or runners)
• Excessive alcohol use
• Lack of weight-bearing exercise
• Long-term use of certain medications, including corticosteroids and some medications used for gastric reflux, seizures, thyroid disorders, cancer and transplant rejection
• Low calcium and vitamin D intake
• Tobacco use
• Caffeine Use

Risk Factors

Risk factors for osteoporosis include: 

Age: The risk of osteoporosis accelerates with age. Post-menopausal women and men over the age of 70 are at the greatest risk. 

Gender: Due to a smaller frame size and hormonal factors, women are much more likely to develop osteoporosis than are men.

Race: Asians and Caucasians are at the greatest risk of osteoporosis.

Family history: Having a parent or sibling with osteoporosis increases risk, especially if your mother or father experienced a hip fracture.

Body frame size: A small body frame increases risk because it means you are starting with less bone mass.

Hormone levels: Low levels of estrogen in women and testosterone in men, and overactive thyroid, parathyroid and adrenal glands are linked to osteoporosis.

Chronic diseases: Chronic diseases that affect the kidneys, lungs, stomach, and intestines or alter hormone levels increase the risk for osteoporosis. These include type 1 diabetes, rheumatoid arthritis, lupus, cancer, multiple myeloma and inflammatory bowel disease.

Gastrointestinal surgery: A reduction in the amount of nutrients your body absorbs resulting from gastrointestinal surgery can put you at higher risk for osteoporosis. 

Prevention

While some risk factors cannot be controlled, there are ways you can help to prevent osteoporosis:

Maintain a healthy lifestyle: Make sure your diet includes recommended levels of calcium and vitamin D, stay active and exercise regularly, stop smoking and limit alcohol and caffeine.

Mind your medications: Understand why you must take prescribed medications and discuss the use of medications known to cause bone loss with your doctor.

Prognosis

The prognosis for people with osteoporosis depends upon how advanced the disease is. While people who have osteoporosis are at greater risk of breaking bones, most can manage their condition with lifestyle changes to help prevent further bone loss and reduce the risk of injury. 

Treatment and Recovery

Lifestyle Changes: In many cases, your doctor may simply recommend maintaining a healthy diet with recommended levels of calcium and vitamin D, exercising regularly, avoiding tobacco and excessive alcohol.

Minimize fall risks: Avoid wet, icy or slippery surfaces. Wear shoes with a closed back that are well-fitting and equipped with a non-slip sole. Maintain open, well-lit uncluttered pathways in the home especially between the bed and the bathroom. Teach small children and pets to not run between your legs or grab your legs to prevent loss of balance and subsequent falls. Secure loose flooring and extension cords to prevent tripping. 

Medications: If your bone mass is low or falling quickly, your doctor may recommend a medication that prevents bone loss and stimulates bone growth. The most common class of these medications are known as bisphosphonates. For the most advanced cases, enosumab injections help prevent bone loss and teriparatide injections are effective at promoting bone growth. 

Hormone Replacement Therapy: Estrogen replacement in post-menopausal women and testosterone replacement in older men can help slow or prevent osteoporosis.

Complications

People with osteoporosis have an increased risk of bone fractures. Fractures caused by osteoporosis can be extremely painful and debilitating, and can lead to limited mobility, weight gain and depression. Immobility increases the risks of pressure wounds (bed sores), blood clots, pneumonia and constipation. Preventative measures and early evaluation and treatment of osteoporosis are key in preventing further complications related to this bone disease.