Osteoporosis

Osteoporosis is a loss in bone mass and bone strength. Bones become less dense. This makes them weak and easier to break. Any bone can be affected. The hips, wrists, and spine are the most common sites. Peak bone mass is reached between the ages of 25 and 35. After age 35, bone mass starts to drop.

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Osteoporosis is a “silent disease.” It can progress without any noticeable signs or symptoms. Often, the first sign is a fracture of the hip, wrist, or spine. When signs and symptoms occur, they include:

• Gradual loss of height.

• Rounding of the shoulders.

• Sudden back pain.

• Stooped posture.

• “Dowager’s hump.”

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Causes & Risk Factors

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Osteoporosis occurs when new bone does not replace old bone fast enough.

Risk Factors Include:

• Being female. Women are 4 times more likely to develop osteoporosis than men. Why?

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– Their bones are thinner and lighter.

– They live longer on average than men.

– They have rapid bone loss at menopause due to a sharp decline of estrogen. The risk also increases for women who: Go through menopause before age 45. This could be natural menopause or one that results from surgery which removes both ovaries. Experience a lack of or irregular menstrual flow.

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• Having a thin, small framed body.

• Being Caucasian or Asian. African Americans and Hispanic Americans are at a risk, too.

• Lack of physical activity, especially walking, running, tennis, and other weight-bearing exercises.

• Long-term bed rest.

• Exercising too much to the point where menstrual periods cease.

• Low calcium and vitamin D intake or absorption.

• Family history of osteoporosis and/or bone fractures.

• Smoking cigarettes.

• Drinking too much alcohol, which may damage bones. Heavy drinkers often eat poorly, too. They are also more prone to fractures from falls.

• Taking certain medicines for a long time. Examples are: Corticosteroids; some antiseizure medicines; overuse of thyroid hormones; and antacids with aluminum.

• Having certain health problems, such as anorexia nervosa, an over-active thyroid gland, or rheumatoid arthritis.

• Persons with Crohn’s disease, ulcerative colitis, and celiac disease are at risk, too.

Treatment

There is no cure for osteoporosis. The focus of treatment is to prevent the disease, to prevent further bone loss, and build new bone. Special X-rays, such as one known as DEXA, can measure bone density in various sites of the body. These tests can help doctors decide if and what kind of treatment is needed. Treatment includes:

• Medications. There are different kinds. Your doctor will prescribe one(s) best suited for your needs.

• A balanced diet rich in calcium and vitamin D and taking supplements of these, as needed.

• Exercises, as advised by your doctor.

• Proper posture.

• Fall prevention measures:

– Wear flat, sturdy, non-skid shoes.

– Get regular vision exams. Wear corrective glasses, etc., as needed.

– Ask your doctor if any medications you take could increase the risk of falls. Ask how to deal with this. Let your doctor know if your medicine(s) affect your vision, balance, etc.

– Use grab bars and safety mats or nonskid tape in your tub and shower.

– Use handrails on stairways.

– Pick things up by bending your knees and keeping your back straight. Don’t stoop.

– Use a cane or walker if necessary.

– If you use throw rugs, use ones with nonskid backs.

– See that halls, stairways, and entrances are well lit. Use night lights in hallways, bathrooms, etc.

– Stay home if it is icy or slippery outside.

Questions to Ask

Question 1

After a fall, are you not able to get up or do you have wrist, hip, or back pain?

Get medical care without delay. If symptoms are life threatening go to the ER or call 9-1-1. Don’t call 9-1-1 or use the ER if symptoms do not threaten life. Ask your doctor ahead of time where you should go for a problem that needs prompt care, but not emergency care.

Question 2

Do you have signs and symptoms of osteoporosis listed on this page? Do you want to find out about medicines to prevent and/or treat osteoporosis?

You should be seen by your doctor for medical advice. Contact your doctor or health care provider to find out how soon you should be seen.

Question 3

Are you a female age 65 or older and have you not had a bone mineral density test?

Call your doctor or health care provider and state the problem. He or she can decide what you should do.

Question 4

Are you a female between ages 60 and 65, do you have risk factors for osteoporosis listed on previous page, and have you not had a bone mineral density test?

Call your doctor or health care provider and state the problem. He or she can decide what you should do.

Question 5

If you have osteoporosis and take medicine for it, are you having side effects from the medicine?

Call your doctor or health care provider and state the problem. He or she can decide what you should do.

Use Self-Care / Prevention:

You can probably take care of the problem yourself if you answered NO to all the questions. Use the “Self-Care” measures that are listed. Call your doctor if you don’t feel better soon, though. You may have some other problem.

Self-Care / Prevention

To Treat Osteoporosis

• Take medications, as prescribed.

• Do the daily exercises approved by your doctor.

• Practice good posture.

To Treat, Slow, and Prevent Osteoporosis

• Eat a balanced diet.

• Get your daily calcium need.

Choose High Calcium Foods Daily

• Skim and low-fat milks, yogurts, and cheeses. {Note: If you are lactose intolerant, you may need to use dairy products that are treated with the enzyme lactose or you can add this enzyme using over-the-counter drops or tablets.}

• Soy milks and yogurts with added calcium.

• Soft-boned fish and shellfish, such as cod, salmon, sardines, and shrimp.

• Vegetables, especially broccoli, kale, and collards.

• Beans and bean sprouts, as well as tofu (soy bean curd), if processed with calcium.

• Calcium-fortified foods, such as some orange juices, apple juices, and ready-to-eat cereals.

• Take calcium supplements, as advised by your doctor.

Get Your Recommended Daily Need for Vitamin D.

• Choose nonfat and low-fat dairy products that are fortified with vitamin D, saltwater fish, liver, and egg yolks. You also get vitamin D from direct exposure of sunlight on your skin. Fifteen minutes of midday sun exposure (without sunscreen) may meet the daily need.

• Take vitamin D supplements, as advised by your doctor. The best source of vitamin D for bone health is vitamin D3.

• Do regular, weight-bearing exercises at least 3 or 4 times a week. Examples are walking and low-impact or non-impact aerobics. (If you have osteoporosis, follow the exercise program outlined by your doctor.)

• Do not smoke.

• Limit alcohol.

• Use fall prevention measures.

This website is not meant to substitute for expert medical advice or treatment. Follow your doctor’s or health care provider’s advice if it differs from what is given in this guide.

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