Osteoporosis is a common bone disease characterized by weakened bones that are more prone to fractures. It occurs when the body loses too much bone, makes too little bone, or both, leading to a decrease in bone density and strength. Osteoporosis often progresses silently without symptoms until a fracture occurs. Here are some key points about osteoporosis:
Risk Factors: Certain factors increase the risk of developing osteoporosis, including aging, female gender, family history of osteoporosis, low body weight or BMI, hormonal changes (e.g., menopause), inadequate calcium and vitamin D intake, sedentary lifestyle, smoking, excessive alcohol consumption, and certain medical conditions or medications that affect bone health.
Bone Density Testing: Osteoporosis is diagnosed through bone density testing, typically using dual-energy X-ray absorptiometry (DXA or DEXA) scans. These tests measure bone mineral density (BMD) at various sites, such as the hip and spine, and help assess fracture risk.
Fracture Risk Assessment: In addition to bone density testing, healthcare providers may use clinical risk assessment tools, such as the FRAX® tool, to estimate a person’s 10-year probability of major osteoporotic fracture or hip fracture based on various risk factors.
Prevention: Prevention of osteoporosis involves adopting lifestyle measures and behaviors that promote bone health, such as consuming a calcium-rich diet, ensuring adequate vitamin D intake, engaging in regular weight-bearing and muscle-strengthening exercises, avoiding smoking and excessive alcohol consumption, and taking steps to prevent falls and fractures.
Treatment: Treatment of osteoporosis aims to prevent fractures, preserve bone density, and reduce fracture risk. Medications commonly used to treat osteoporosis include bisphosphonates (e.g., alendronate, risedronate), selective estrogen receptor modulators (SERMs), hormone replacement therapy (HRT) for postmenopausal women, denosumab (a monoclonal antibody), teriparatide (a parathyroid hormone analog), and calcitonin.
Fall Prevention: Since falls are a major cause of fractures in people with osteoporosis, fall prevention strategies are crucial. This includes addressing factors that increase fall risk, such as poor balance, muscle weakness, vision problems, medications that affect balance, and hazards in the home environment.
Management of Fractures: If a fracture occurs, prompt evaluation and appropriate treatment are essential. This may include pain management, immobilization with casting or bracing, physical therapy, and measures to promote healing and prevent complications.
Monitoring and Follow-Up: Individuals with osteoporosis require regular monitoring of bone density, fracture risk, and treatment effectiveness. Periodic follow-up with healthcare providers is important to assess response to treatment, adjust medication regimens as needed, and address any new concerns or symptoms.