What is osteoporosis?
Osteoporosis is one of the most common bone diseases. One in three postmenopausal women and one in five men over the age of 50 suffer from osteoporosis.
Bones have the ability to adapt their shape and size, responding to the size and type of mechanical loads they receive.
However, in case of osteoporotic patients, reduced bone mass and disorders in the architecture and structure of the bones are observed, which increases the risk of fracture.
Fractures have a significant impact on the quality of life and reduce the life expectancy of osteoporotic patients.
Types of osteoporosis
Osteoporosis is divided into primary osteoporosis, associated with menopause or aging, and secondary osteoporosis.
The most common type is postmenopausal, which occurs in women during menopause and is interrelated with estrogen reduction.
Osteoporosis of the elderly appears after the age of 70 and can affect both sexes.
Secondary osteoporosis appears either in patients with specific conditions (e.g. rheumatoid arthritis) or in patients receiving medication that includes cortisone, antiepileptic pills, etc.
Risk factors for osteoporosis
Various factors can affect osteoporosis. These are divided into factors that can be modified through daily habits or into non-modifiable factors, such as:
- Genetic factors
- Previous fractures
- Female gender
- Age over 50 years
- Various diseases
- Continuous use of cortisone
Factors that can be adjusted:
Low intake of calcium and vitamin D through nutrition. These substances are essential for bone growth and healthy bone mass.
- Lack of physical exercise
- Low body weight
- Excessive alcohol consumption
Symptoms of Osteoporosis
Osteoporosis is an “insidious” disease. The absence of symptoms for a long time is a main characteristic of it. It can take years with continuous bone loss until a fracture occurs, which is the first symptom. Patients who have suffered an osteoporotic fracture have an increased risk of developing a subsequent fracture by 86%.
The vast majority of osteoporotic fractures involve the spine, radiocarpal joint and hip. Osteoporotic fractures can also occur in other bones.
A fracture may be accompanied with pain in the waist and without any previous injury.
Diagnosis of Osteoporosis
The diagnosis of osteoporosis is simple and is made by measuring bone density.
Bone mineral density (BMD, g/cm2), as measured by dual-energy X-ray absorptiometry (DEXA), is the standard method of diagnosing osteoporosis and monitoring osteoporotic patients.
Bone density is measured at the lumbar spine and at the proximal end of the femur.
However, your doctor may use more sophisticated assessment models regarding the fracture risk so as to perform a comprehensive assessment of the problem that take into account other risk factors besides bone density.
Example of calculating the ten-year-absolute-risk for an osteoporotic fracture in a 65-year-old woman with body mass index (BMI) = 25 kg/m2.
When should bone density be measured?
- In all women over 65, whether they have risk factors or not
- In women and men who receive long-time cortisone therapy.
- In patients with vertebral deformation
- In patients who have suffered a fracture
- To all those who are already under treatment for osteoporosis, in order to evaluate the results
Osteoporosis treatment and care
With contemporary osteoporosis treatment options, inhibition of extra bone loss, increase of bone mass and reduction of the risk of insufficiency fracture can be achieved.
Among the medications taken are calcium and vitamin D.
The treatment plan is defined by the doctor, for each patient individually, taking into account the particular characteristics of the patient.
Frequently asked questions
What does a bone density scan for osteoporosis show?
Bone density measurement will show the normal or abnormal values that may indicate osteoporosis. It is the only test that provides a safe diagnosis of the disease. The lower the value of bone density, the greater the risk of fracture.
The test shows how weak the bones are, assesses the risk of fracture in the near future, and evaluates whether the bone mass is improving or getting worse.
The bone density test should be repeated every two years in patients already on medication.
What happens when there is osteopenia and what are the differences between osteopenia and osteoporosis?
If your doctor tells you that you have osteopenia, it means that the bone density is low but not so low that you can be diagnosed with osteoporosis. Osteopenia does not necessarily mean that you are losing bone mass, you may simply be in the category of those whose bone mass has always been low. That is, for your body this value may be normal. This category includes people with reduced bone density due to genetic factors or people with a special body type or with specific diseases.
In case of osteopenia, a second measurement of bone mass should be performed. The doctor will compare the two results and assess whether there is indeed a loss of bone mass or whether this value found in the first measurement is stable. Sometimes a 2nd and a 3rd measurement may be needed for the doctor to decide whether or not you need medication.
What is the primary prevention of osteoporosis?
A careful diet depending on gender and age is crucial for preventing osteoporosis. Getting the right amount of calcium and vitamin D is very important, along with an exercise program.
The regulation of hormones in cases of premature menopause or amenorrhea for a long time is necessary.
Particular care must be taken in order to maintain a normal body weight and quit smoking.
Finally, in cases where cortisone is required, it should be done according to the instructions of the treating physician and in very carefully measured quantities.