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What is osteoporosis?
Also known as “brittle bones” osteoporosis is
the gradual loss of bone density and strength. Through this
thinning of the bones, they become weak and may break easily.
Throughout our lives, bone tissues are constantly building
up and breaking down. In order for bone regeneration to happen,
a range of minerals (including calcium and magnesium) and
exercise is needed by the body. The reproductive hormones
play a part in maintaining the balance, but as we age, hormone
production decreases and breakdown exceeds the build-up process.
This can be the beginning of osteoporosis. Menopausal women
are most susceptible because of the drastic reduction of oestrogen
and progesterone in their body.
Osteoporosis can, however, strike people in their mid-twenties.
It can be caused by anorexia nervosa, or the overuse of steroids
and diuretic drugs, which increase calcium excretion.
The condition usually begins in the spine. The body’s
weight compresses the weak bones, resulting in a rounded back
and loss of height. The patient often suffers chronic back
pain, loss of mobility and sometimes severe, debilitating
pain.
While the weakened bones are neither tender nor painful,
the real problem is the susceptiblity to fractures and the
complications these can cause. Common sites of fracture are
the wrist, hip and upper arm.
The most feared and serious complication is hip fracture,
which requires requires surgery to replace the affected hip,
and prolonged hospitalization. Subsequent mobilization is
arduous and most patients never return to their previous levels
of activity.
Colle’s fracture, or fracture of the wrist, often resulting
from a fall onto an outstretched hand, may leave permanent
deformity, loss of grip, strength and pain.
Who gets osteoporosis?
People most at risk include:
- Caucasian (white) and Asiatic women
- Family history of osteoporosis of hip fracture
- Women who elected not to, or could not take hormone replacement
after the menopause
- Early menopause
- Smoking, low dietary calcium intake, sedentary lifestyle
- Cortisone treatment
- Thyroid disease, Rheumatoid arthritis.
How is osteoporosis diagnosed?
The density (thickness) of your bones can be accurately measured
by means of a simple office scan called a DEXA. This test
takes less than 1/2 an hour to perform is very safe, reliable
and is not associated with any discomfort to the patient.
Can osteoporosis be treated?
In short - YES!
The aim of treating osteoporosis is to prevent the devastating
fractures that may result if appropriate attention is not
given to the problem.
The treatment of osteoporosis involves:
Fracture risk assessment
The risk of developing osteoporosis and breaking a bone depends
on a number of important factors that need to be comprehensively
assessed prior to advising treatment. These include:
- Measuring the bone density with a DEXA
- Assessing fall risk. It goes without saying that most
fractures are caused by falls and the reducing the risk
of a fall is an essential part of fracture prevention
- Medical examination by a Specialist and a limited number
of Pathology tests
Preventative treatment.
Prevention is obviously the first priority. Strategies for preventing
osteoporosis need to be individualized according to the patients'
specific needs and preferences. They include:
- Calcium supplementation
- Exercises to strengthen bones, improve muscle strength
and tone in the elderly, and exercises to help prevent falls
- Hormone treatment where appropriate
Specific medical treatment
Various medications are now available for the treatment of
proven osteoporosis. These have been shown to be both safe
and effective in reducing the risk of osteoporotic fractures.
They may need to be considered in selected patients.
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