Preventing osteoporosis fractures

We have all seen the multiple advertisements on TV regarding osteoporosis. There are foods high in calcium we should eat, medications we should take and exercises we should perform.

Yet still few people appreciate how prevalent osteoporosis is, even those people who are at high risk for the disease. After age 50, one in every two women and one in every four men will sustain some type of osteoporosis-related fracture. Osteoporosis is not an exotic disease that ‘happens to other people’; it is very prevalent in our society.

Osteoporosis is a condition marked by low bone mass which can lead to a weakening of the bone and increased likelihood of fracture. These fractures usually affect the hip, wrist or spine. In the spine, fractures can lead to chronic pain, decreased physical function and spinal deformity. An example of such a spinal deformity is the depressingly termed ‘dowager’s hump’.

Unlike many other common causes of back pain, osteoporosis and associated spinal fractures are largely preventable.

To prevent osteoporosis fracture there are four steps every adult needs to take:

– Understand their risk factors for osteoporosis.

– Get a bone density test to assess bone mass if they are at risk.

– Develop an individualized plan to fight osteoporosis.

– Make lifestyle and health changes designed to slow bone loss and build bone density.

Risk factors

The first step in preventing osteoporosis and associated spine fractures is to determine whether you are at risk or for developing the bone condition.

Advanced age. Those over 65 years of age are at particular risk.

Gender. Women are at much greater risk, losing bone more rapidly than men due to menopause. However, men still are at risk and constitute 20 per cent of osteoporosis suffers.

Family and personal history. This includes family history of osteoporosis, history of fracture on the mother’s side of the family and a personal history of any kind of bone fracture as an adult (after age 50).

Race. Caucasian and Asian women are at increased risk.

Body type. At greater risk are small-boned women who weigh less than 127 pounds.

Menstrual history and menopause. Normal menopause alone increases a woman’s risk of osteoporosis. Early menopause increases the risk even more.

Hypogonadism (small gonads) in males can lead to a testosterone deficiency.

Lifestyle

Lifestyle behaviours that increase osteoporosis risk include: calcium and/or vitamin D deficiency; little or no exercise, alcohol abuse; and cigarette smoking.

Certain types of medications can damage bone and lead to what is termed ‘secondary osteoporosis’. This type of osteoporosis is estimated to occur in almost 50 per cent of pre-menopausal women with osteoporosis and up to 60 per cent of men with osteoporosis.

The medications that can cause secondary osteoporosis are the ones used to treat endocrine disorders such as hyperthyroidism, marrow disorders, collagen disorders, gastrointestinal problems and seizure disorders.

Use of steroids (especially the oral form) to treat diseases such as asthma, rheumatoid arthritis and inflammatory bowel disease, can be particularly damaging to bone. Given the serious nature of the diseases these medications treat, it is not advisable to alter or stop taking these drugs unless under a physician’s advice.

People considered at especially high risk for developing osteoporosis include:

– All women over age 65.

– Women less than age 65 who are postmenopausal and have one or more of the above described risk factors for osteoporosis.

– Postmenopausal women who experience any type of bone fracture.

– Men who have a testosterone deficiency.

For those with any of the above risk factors for osteoporosis, it is advisable to get a bone density test to assess bone mass and the possible presence of osteoporosis.

Knowledge of one’s bone density is vital to developing an appropriate plan to prevent worsening of the condition and hopefully prevent a painful osteoporosis-related fracture.

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