Osteoporosis, commonly known as bone thinning or porous bones, is a prevalent condition characterised by a decrease in bone density and quality, making bones more porous, fragile, weak, and susceptible to fractures due to the loss of essential elements and minerals necessary for bone health, such as calcium.
Risk Factors
Several factors directly influence bone formation and lead to decreased mineral density. Additionally, other factors indirectly increase the risk of fractures. These risk factors include:
Gender: Women are more susceptible to osteoporosis than men.
Age: While osteoporosis can affect individuals of all ages, it is more common in people over 50 years old.
Family history: Having a family history of osteoporosis increases the risk of developing the condition.
Hormonal imbalances: Deficiencies in hormones such as oestrogen in women due to menopause, hysterectomy, or breast cancer treatments, and testosterone in men due to ageing or prostate cancer treatments, can contribute to osteoporosis.
Nutritional deficiencies and eating disorders: Inadequate intake of vitamin D and calcium increases the likelihood of developing osteoporosis.
Digestive system surgeries: Procedures such as weight loss surgeries, which reduce stomach size or remove part of the intestines, can increase the risk of nutrient deficiencies essential for bone health.
Weight loss and low body mass index (BMI): Regardless of age or gender, significant weight loss and a BMI below 20 are associated with bone loss and increased fracture risk.
Thyroid disorders: Hyperthyroidism can lead to bone loss and increased fracture risk.
Other medical conditions: Conditions such as asthma, rheumatoid arthritis, gastrointestinal diseases, kidney or liver diseases, and cancer can directly or indirectly affect bone health.
Medications: Certain medications, including anticonvulsants, antipsychotics, immune suppressants, and corticosteroids, can impact bone health.
Unhealthy lifestyle habits: Some bad habits can increase the likelihood of osteoporosis, such as:
Alcohol consumption: which hinders calcium absorption and bone formation.
Smoking: smokers are more prone to osteoporosis compared to non-smokers.
A sedentary lifestyle: increases the risk of fractures, especially hip fractures.
Symptoms
Osteoporosis often remains asymptomatic in its early stages, earning it the nickname “silent disease.” However, as the condition progresses, symptoms may include:
– Severe back pain due to vertebral fractures, erosion, or slippage.
– Loss of height and stooped posture.
– Joint stiffness and rigidity.
– Increased susceptibility to bone fractures.
Complications
Bone fractures are the most prevalent and serious complications of osteoporosis, particularly in the spine or hip, as these are major weight-bearing bones. Fractures can occur due to minor trauma or falls and may lead to disabilities and an increased mortality risk within the first year post-fracture, especially among the elderly.
In some cases, vertebral fractures may occur without a significant fall, as spinal vertebrae weaken and deteriorate, causing back pain, height loss, and spinal curvature.
Diagnosis:
External Signs: Curvature of the back and height loss may indicate bone thinning, potentially accompanied by spinal fractures.
Bone Mineral Density Measurement: Utilizing a Dual-Energy X-ray Absorptiometry (DEXA) scanner, which employs low levels of X-rays to assess bone mineral density.
Diagnosis:
Given the lack of clear symptoms of osteoporosis, several indicators can aid in diagnosis:
External Signs: Visible signs such as back curvature and height loss may indicate bone thinning, potentially accompanied by spinal fractures.
Bone Mineral Density Measurement: Diagnosis often involves the use of a Dual-Energy X-ray Absorptiometry (DEXA) scanner, which employs low levels of X-rays to assess bone mineral density.
Treatment:
Addressing osteoporosis typically involves a multifaceted approach. Medications are available to slow down bone mass loss and alleviate symptoms. Additionally, calcium and vitamin D supplements play crucial roles as supportive therapies.
Physical therapy sessions may also be recommended to strengthen muscles around affected joints, increase flexibility, and alleviate pain.
Prevention:
Taking proactive steps to prevent osteoporosis is crucial, starting from childhood and continuing throughout life to promote healthy bone development and strength.
Key preventive measures include:
Early Detection: Screening for osteoporosis typically begins for women at age 65 or older, and earlier if menopause occurs earlier or if there are any risk factors present.
Balanced Nutrition: Ensuring adequate intake of essential elements and minerals crucial for bone health, such as calcium, which can be obtained from dietary sources such as low-fat dairy products, dark green leafy vegetables, salmon or sardines, breakfast cereals and orange juice fortified with calcium.
Moreover, if you are unable to get a sufficient amount of calcium from your diet, it is possible to take calcium supplements under a doctor’s supervision.
Additionally, Vitamin D enhances the body’s ability to absorb calcium, thereby improving bone health. It can be obtained through exposure to sunlight for at least 15-20 minutes daily. Dietary sources rich in vitamin D include cod liver oil, salmon, milk, and fortified breakfast cereals.
Regular Exercise: Engaging in physical activities that contribute to bone strength and slow down bone loss.
Fall Prevention: Mitigating the risk of falls, which increases the chances of fractures, by ensuring a safe environment at home, avoiding slippery surfaces, and ensuring the removal of electrical wires or rugs from the floor, which may lead to tripping and falling.
Furthermore, Adequate lighting should be provided in all areas inside and outside the house, including staircases.
Healthy Lifestyle Habits: Including avoiding smoking and excessive alcohol consumption, reducing caffeine intake, evaluating the risk of osteoporosis, and adhering to prescribed medications and supplements to maintain bone mass and reduce fracture risk.
By: Dr Badreyya Al-Harmi, Consultant Public Health, Emirates Public Health Association
