Osteoporosis occurs when the body fails to form enough new bone, when too much old bone is reabsorbed by the body, or both. Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, your body uses these minerals to produce bones. If you do not get enough calcium, or if your body does not absorb enough calcium from the diet, bone production and bone tissues may suffer. As you age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bone tissue weaker. This can result in brittle, fragile bones that are more prone to fractures, even without injury. Usually, the loss occurs gradually over years. Many times, a person will have a fracture before becoming aware that the disease is present. By the time a fracture occurs, the disease is in its advanced stages and damage is severe.
There are no symptoms in the early stages of the disease.
Symptoms occurring late in the disease include:
- Bone pain or tenderness.
- Fractures with little or no trauma.
- Loss of height (as much as 6 inches) over time.
- Low back pain due to fractures of the spinal bones.
- Neck pain due to fractures of the spinal bones.
- Stooped posture or kyphosis, also called a “dowager’s hump.”
The leading causes of osteoporosis are a drop in estrogen in women at the time of menopause and a drop in testosterone in men. Women over age 50 and men over age 70 have a higher risk for osteoporosis.
Bone mineral density testing (specifically a densitometry or DEXA scan) measures how much bone you have which can be used to predict your risk for bone fractures in the future.
A special type of spine CT that can show loss of bone mineral density, quantitative computed tomography (QCT), may be used in rare cases.
In severe cases, a spine or hip x-ray may show fracture or collapse of the spinal bones. However, simple x-rays of bones are not very accurate in predicting whether someone is likely to have osteoporosis.
You may need other blood and urine tests if your osteoporosis is thought to be due to a medical condition, rather than simply the usual bone loss seen with older age.
The goals of osteoporosis treatment are to:
- Control pain from the disease.
- Slow down or stop bone loss.
- Prevent bone fractures with medicines that strengthen bone.
- Minimize the risk of falls that might cause fractures.
Medications are used to strengthen bones when:
- Osteoporosis has been diagnosed by a bone density study.
- Osteopenia (thin bones, but not osteoporosis) has been diagnosed by a bone density study, if a bone fracture has occurred.
Regular exercise can reduce the likelihood of bone fractures in people with osteoporosis.
However, avoid any exercise that presents a risk of falling, or high-impact exercises that may cause fractures.
Some of the recommended exercises include:
- Weight-bearing exercises — walking, jogging, playing tennis, dancing.
- Resistance exercises — free weights, weight machines, stretch bands.
- Balance exercises — tai chi, yoga.
- Riding a stationary bicycle.
- Using rowing machines.
Get at least 1,200 milligrams per day of calcium and 800 – 1,000 international units of vitamin D3. Vitamin D helps your body absorb calcium.
Your doctor may recommend a supplement to give you the calcium and vitamin D you need.
Follow a diet that provides the proper amount of calcium, vitamin D, and protein. While this will not completely stop bone loss, it will guarantee that a supply of the materials the body uses to form and maintain bones is available.
High-calcium foods include:
- Ice cream
- Leafy green vegetables, such as spinach and collard greens
- Low-fat milk
- Sardines (with the bones)
It is critical to prevent falls.
Avoid sedating medications and remove household hazards to reduce the risk of fractures. Make sure your vision is good.
Other ways to prevent falling include:
- Avoiding walking alone on icy days
- Using bars in the bathtub, when needed
- Wearing well-fitting shoes