Osteoporosis

What is Osteoporosis?

Osteoporosis means “porous bone.” Viewed under a microscope, healthy bone looks like a honeycomb. When Osteoporosis occurs, the holes and spaces in the honeycomb are much larger than in healthy bone. Osteoporotic bones have lost density or mass and contain abnormal tissue structure. As a result, bones become weak over time and may break from a fall or, in severe cases, from coughing or minor bumps.

A gradual loss of bone mass generally begins around age 35 for everyone, and after growth is complete, women ultimately lose 30% to 50% of their bone density, while men lose 20% to 30%. Bone loss occurs mainly in the lower forearm above the wrist, spine, upper femur or thigh. However, the rate of progression and the effects can be modified with proper early diagnosis and treatment.

Symptoms & Causes

While the exact medical cause of the condition is still unknown, Osteoporosis causes more than 2 million fractures annually and is often the first sign of this “silent disease.” Patients may also notice that they are getting shorter or have a spine malformation such as a stooped or hunched posture (kyphosis).

Bones affected by Osteoporosis may become so fragile that fractures occur spontaneously or as the result of minor falls from standing height that would not usually cause a break in a healthy bone or everyday stresses such as bending, lifting or even coughing.

Patients who have certain types of autoimmune, hematological, gastrointestinal, endocrinal and neurological disorders, as well as various other diseases and conditions, are more susceptible to Osteoporosis. Certain medications, such as those that treat cancer as well as glucocorticoid steroids, may also increase the risk of developing Osteoporosis. Pregnancy, as well as a history of breast or prostate cancer, may also put a patient at higher risk.

Other factors contributing to Osteoporosis include demographic markers such as gender, age and race, as well as body size, family history, hormonal changes, diet and certain lifestyle choices like inactivity, smoking and heavy drinking.

If a patient is experiencing height loss or a curvature of their spine, they should immediately consult their doctor or healthcare professional. Additionally, patients 50 or older who have broken a bone should consult their physician about a bone density test

Affected Populations

Although Osteoporosis affects men and women across all races and ethnic groups as they age, the disease is most common in non-Hispanic white women and Asian women. For many women, the disease begins to develop a year or two before menopause.

While African American and Hispanic women have a lower risk of developing Osteoporosis, they are still at significant risk. Among men, Osteoporosis is more common in non-Hispanic whites. Some children and teens develop a rare form of idiopathic juvenile Osteoporosis. Doctors do not know the cause; however, most children recover without treatment.

Diagnosis

Osteoporosis is typically diagnosed during routine screening for the disease. These exams include a medical history review, noting any previous fractures, family history and lifestyle habits, including diet, exercise, alcohol use, and smoking history. Current or past medical conditions and medications that could contribute to low bone mass and increased fracture risk are also assessed, along with menstrual history for women.

Physicians may perform a physical exam to check for loss of height and weight, changes in posture, balance and gait evaluation (the way you walk) and muscle strength. In addition, a test measuring bone mineral density (BMD) in a specific area, usually your spine and hip, may be ordered.

The most common and reliable test for measuring bone mineral density is dual-energy x-ray absorptiometry (DXA). Quick, painless and non-invasive, a DXA scan uses low levels of X-rays as it passes a scanner over the patient’s body while lying on a cushioned table. In addition to diagnosing Osteoporosis, DXA is also used to proactively identify low bone density, help predict risk of future fractures and monitor the effectiveness of ongoing treatment for the disease.

Treatment

At North Florida Bone & Joint Specialists, our specialists take a comprehensive approach to each patient, evaluating for possible underlying or undiagnosed health conditions affecting bone health and prescribing a treatment regimen that fits each patient. Through the use of proper screenings, therapies and education, these individualized treatment plans are designed to: