What is Osteoporosis?
Bone is a living tissue made up of calcium, proteins and cells which continually absorb and build bone. Osteoporosis is a disease in which bones become fragile and susceptible to fractures. This can be caused due to deficiencies with the calcium and protein within the bone and reduction in cellular activity. As result, bones become brittle since there is a reduction in the total bone mass.
Any bone in the bone can be affected but of most concern are fractures of the hip and spine. Fractures due to Osteoporosis can lead to changes in posture, loss of height, muscle weakness, and bone deformity. Fractures can lead to chronic pain, disability, loss of independence and even premature death.
Men and women are affected by Osteoporosis. However, women are at greater risk of developing Osteoporosis than men, mainly due to the rapid decline in oestrogen levels after the menopause. Approximately 300,000 people in Ireland have Osteoporosis.
What is Osteopenia?
Osteopenia is the early stage of Osteoporosis and places a person at risk of developing Osteoporosis. A diagnosis of osteopenia will require preventative treatments to sustain bone health.
What are the symptoms of Osteoporosis?
Osteoporosis is often called the ‘silent disease’ because an individual with Osteoporosis may not develop any symptoms. Some people 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.
Unfortunately, many people present with a fracture as their first symptom of Osteoporosis. Any person who has had a fracture should consider being assessed for Osteoporosis. Diagnosis and treatment of any risk factor will help prevent any further fractures.
It is essential that you speak to your doctor if you experience any of the above signs or symptoms, particularly those who have the following risk factors for Osteoporosis.
What are the risk factors for developing Osteoporosis?
– Family history
– Use of corticosteroids
– Rheumatoid arthritis
– Overactive thyroid and parathyroid glands
– Coeliac disease and other gut conditions
– Chronic liver disease or kidney disease
– Genetic syndromes (Klinefelters/Turner’s Syndrome)
– Past or present eating disorders
– Impaired mobility
– Parkinson’s Disease
– Multiple Sclerosis
– Gastrectomy/bowel resection
– Bone marrow disorders
– In men, testosterone deficiency
– In women, early menopause
Back pain is very common and affects eight out of 10 people at some point during their lives. It is usually caused by muscular spasms or sprain injury. Normally, rest and over-the-counter painkillers (or hot and cold packs) are sufficient to relieve the pain. Less commonly, an individual may slip a disc and this may also cause pain in the legs. More seriously, it may cause leg weakness and this needs urgent medical treatment. Finally, acute back pain could be due to a spinal fracture. A doctor can often find the cause of your pain with a simple history and physical examination. If you are an older person with a thin build and/or a family history of Osteoporosis, a spinal fracture should be considered. This can be confirmed with a spinal X-ray. If a fracture is noted, your doctor may wish to refer you for a bone density test (DXA) to assess the strength of your bones.
Lifestyle choices can increase a person’s risk of developing Osteoporosis. These include:
– Excessive alcohol consumption
– Diet lacking in calcium
– Lack of sunlight exposure, which may cause vitamin D deficiency
– Sedentary lifestyle over many years
Patients who have had the following treatments are at increased risk of developing Osteoporosis:
– Post Organ Transplant Therapy
– Chronic Heparin
– Long-term Lithium Therapy
– Certain diuretics/water tablets
How does Vitamin D affect bone health?
Vitamin D deficiency is associated with:
– Reduced muscle strength and higher rate of falls
– Worsening of Osteoporosis
– Diabetes mellitus
– Cardiac conditions, including high blood pressure, diabetes mellitus and strokes
Ideally, vitamin D levels should be above 50 nmol/L. Most patients attending the Bone Health and Osteoporosis Unit have levels far below this, even those who are taking calcium supplements. We aim for patients to have a level above 80 nmol/L. A patient who is deficient may require 1000-2000 IU daily with a repeat vitamin D level at 3 months.