What is Osteoporosis?

What is osteoporosis?

Osteoporosis, or porous bone, is a disease in which there is a loss of bone mass and destruction of bone tissue. This process causes weakening of the bones and makes them more likely to break. The bones most often affected are the hips, spine, and wrists.

Who is affected by osteoporosis?

Osteoporosis affects over 10 million Americans over the age of 50, with women four times more likely to develop osteoporosis than men.

Another 34 million  Americans over the age of 50 have low bone mass (osteopenia) and therefore have an increased risk for osteoporosis. Estrogen deficiency is one of the main causes of bone loss in women during and after menopause. Women may lose up to 20 percent of their bone mass in the five to seven years following menopause.

Other risk factors for osteoporosis

Although the exact medical cause for osteoporosis is unknown, a number of factors contribute to osteoporosis, including the following:

• Aging
  
  Bones become less dense and weaker with age.

• Race
  
  Caucasian and Asian women are most at risk, although all races may develop the disease.

• Body weight
  
  Obesity is associated with a higher bone mass, therefore people who weigh less and have less muscle are more at risk for developing osteoporosis.

• Lifestyle factors
  
  The following lifestyle factors may increase a person's risk of osteoporosis:

  • Physical inactivity

  • Caffeine

  • Excessive alcohol use

  • Smoking

  • Dietary calcium and vitamin D deficiency

• Certain medications

• Family history of bone disease

In 2006, the North American Menopause Society (NAMS) reviewed and updated its guidelines on the diagnosis, prevention, and treatment of postmenopausal osteoporosis. Among its updated recommendations, NAMS suggests that women's lifestyle practices should be reviewed regularly by their physicians, and that practices that help to reduce the risk for osteoporosis should be encouraged. Also, NAMS recommends that a woman's risk for falls should be evaluated at least once a year after menopause has occurred. An additional recommendation is that a woman's height and weight should be measured annually, and she should be assessed for kyphoses - development of a rounded humped spines - and back pain.

What are the symptoms of osteoporosis?

Osteoporosis is often called the "silent disease" because persons with osteoporosis may not develop any symptoms. Some may have pain in their bones and muscles, particularly in their back. Occasionally, a collapsed vertebra may cause severe pain, decrease in height, or deformity in the spine.

The symptoms of osteoporosis may resemble other bone disorders or medical problems. Always consult your physician for a diagnosis.

How osteoporosis is diagnosed

In addition to a complete personal and family medical history and physical examination, diagnostic procedures for osteoporosis may include the following:

• X-rays (skeletal) - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

• Bone density test (also called bone densitometry) - measurement of the mass of bone in relation to its volume to determine the risk of developing osteoporosis.

• Blood tests (to measure serum calcium and potassium levels)

• FRAX score® - a score given to estimate the risk of a fracture within 10 years. The score uses the results of a bone densitometry test as well as other individual factors.

The effects of this disease can best be managed with early diagnosis and treatment.

More about bone densitometry

Bone densitometry testing is primarily performed to identify persons with osteoporosis and osteopenia (decreased bone mass that has not yet reached the level of osteoporosis) so that the appropriate medical therapy and treatment can be implemented. Early treatment helps to prevent future bone fractures. It may also be recommended for persons who have already fractured a bone and are considered at risk for osteoporosis.

The bone densitometry test determines the bone mineral density (BMD). Your BMD is compared to two norms - healthy young adults (your T-score) and age-matched (your Z-score).