Osteoporosis

You have osteoporosis if the density of your bones goes way down to the point they break easily. Fractures in osteoporotic bones do not mend easily. Therefore, these fractures can make the patient quite miserable.

Normal bone density changes

The density of one’s bone changes depending on diet and age.

Following illustrations give a broad idea of how bone density changes depending on age.

 

Density changes males

density changes in females

Bone density drops in males at around 65 years of age. It also drops in females after menopause (45-50 years).

Hence, reduction in bone density after a certain age is normal.

So much reduction in density that the bones break easily where they shouldn’t is Osteoporosis.

Pathophysiology- What goes wrong?

Normally, Bone density is maintained by two factors. Those are:

  1. Bone deposition- the making of bone, and
  2. Bone resorption– the breaking (absorption through blood) of bone.

Normally, these two things work in sync and balance each other.

As age advances or diet worsens, bone resorption increases. As a result, bone density falls down.

What makes it go wrong?

Many factors are responsible for taking a hit on bone density. They are:

  • Age
  • Low levels of Estrogen. For example, Menopause,  Removal of ovaries etc.
  • Alcoholism
  • Anorexia (Eating disorder leading to low weight)
  • Hyperthyroidism
  • Kidney diseases
  • Certain medications.

Clinical features

There are NO signs and symptoms of Osteoporosis itself. You get to know you have osteoporosis only if you break a bone or get a bone scan.

Hence, regular bone scans in people older than 60 are getting popular nowadays. Contact your doctor to know if that is a good idea for you.

Some type of fractures are commonly seen in osteoporotic bones. For example,

  • Hip fracture. (fracture of neck of femur)
  • Wedge fracture. (Fracture of the vertebral body)
  • Colle’s fracture. (a type of fracture at the wrist) etc.

Bone density scanning

This is a diagnostic method used to know the density of Bones. It is also known as a DEXA scan.

The procedure lasts for about 10-12 minutes. X-rays are passed through your body and their density is measured.

DEXA scan gives us T-score, which we can interpret as follows.

T-score < -2.5: Osteoporosis

T-score -2.5 to -1: Osteopenia

T-score > -1: Normal bone density.

Prevention

The best cure for osteoporosis is its prevention. We need to maintain good bone density throughout our lives to prevent bad fractures in our old age.

Bone density depends on the following things.

  1. Calcium
  2. Vitamin D
  3. Weight bearing exercise

By having adequate amounts of these three, we can maintain a good bone density.

Calcium.

Eat lots of dairy products to maintain good calcium levels. Food products rich in calcium are Seafood, Soya beans, Lentils etc.

Vitamin D

Vitamin D helps in taking Calcium to bones. without Vitamin D calcium just flows away from the body. Read more.

Weight bearing Exercise.

Bone develops density only if stresses are put on it. If there is no stress on bone Calcium and Vitamin D are not absorbed from the diet even if they are in surplus amount. This means that if you don’t exercise, Calcium and Vitamin D in your diet mean nothing. Your intestines will let them go, thinking that the body does not require them.

Stress, here, means weight the bone has to bear.

Weight bearing Exercises are: Walking, Running, push ups etc.

Osteoporosis and Yoga

Weight bearing exercise helps in osteoporosis. Hence, yoga poses and routines which involve weight bearing are helpful. For example.

Following pose (Padmasan) will NOT help as there is minimal weight bearing on bones.

meditating monk

 

One leg standing will help in osteoporosis. This is because there is weight bearing on the bones of one lower limb.

silhouette one leg stand

 

Following pose will help in improving bone density of upper limbs as the weight of the body rests on both the arms.

yoga pose

 

Osteoporosis, Osteopenia and Osteomalacia

All these conditions result in weaker bones which break easily.

Osteomalacia occurs due to deficiency of Vitamin D in adults. It is the adult form of rickets

Osteopenia is a milder form of osteoporosis. It occurs when T-score in DEXA scan is between -1 to -2.5. If you start treatment in this stage, worsening can be prevented.

Osteoporosis is a severe decrease in bone density.

Treatment

We cannot completely reverse osteoporosis once it has occurred. Goals of treatment are to prevent fractures and deterioration of the condition.

To prevent worsening of the condition, avoid the following things:

  • Alcohol
  • Smoking
  • Coffee

Basic treatment includes:

  • Calcium supplements
  • Vitamin supplements
  • Weight bearing Exercises (Mild)

In the case of Osteopenia.

Basic treatment along with Bisphosphonates.

In the case of Osteoporosis.

Basic treatment, Bisphosphonates and Teriperatide.

In addition to these, take very careful precautions to prevent fractures. That includes preventing falls, using supports while walking, padding of hard areas etc.

Conclusion

Osteoporosis is a silent disease quietly sneaking up on us. We cannot know if we have it or not unless we go for regular scanning. If untreated, Osteoporosis greatly increases the risk of fractures. These fractures then have a way of mending very late or not mending at all. Hence, Develop your bones while you are young and prevent fractures when you are old.

 

Featured Image Credit:

BruceBlaus Wikimedia Commons

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