Osteoporosis: Causes, Symptoms, Diagnosis, and Treatment

Osteoporosis is a bone disease characterized by low bone mass and deterioration of the bone tissue. This results in fragile, brittle bones prone to fracture. While often initially asymptomatic, osteoporosis can lead to chronic back pain, loss of height, and frequent bone breaks later on. This article provides an overview of osteoporosis - what it is, what causes it, how it's diagnosed, and current treatment options.

Introduction

Osteoporosis affects over 10 million adults in the United States. Women are at especially high risk as they age due to declining estrogen levels after menopause. The disease develops slowly over many years. Maximum bone density is built by age 30, after which bone breakdown naturally exceeds formation. In osteoporosis, this bone loss is accelerated. The resulting thin, porous bones fracture easily from minor stresses like bending over or coughing. Hip and spine fractures are most common and can impair mobility and independence. While not curable, early diagnosis and treatment can help maintain bone strength and prevent fractures.

Causes and Risk Factors

Osteoporosis results from an imbalance between bone formation and resorption. The body constantly remodels bone by removing old tissue and replacing it with new. Osteoporosis occurs when this remodeling process fails and bone breakdown overtakes building. Exact causes are unclear, but involve complex interactions between genetic, hormonal, nutritional, and lifestyle factors.

Major risk factors include:

• Female gender, especially post-menopause
• Older age
• Family history of osteoporosis
• Low body weight or small frame
• Certain medications like steroids
• Inadequate calcium and vitamin D intake
• Excessive alcohol consumption
• Smoking and tobacco use
• Inactive lifestyle with minimal weight-bearing exercise

Underlying medical conditions like hyperthyroidism, Cushing's disease, and anorexia nervosa also raise osteoporosis susceptibility by affecting hormone levels and nutrition.

Symptoms of Osteoporosis

Osteoporosis doesn't cause symptoms until severe bone loss has already occurred. Many people remain undiagnosed until a fracture happens. Typical osteoporosis symptoms include:

• Fractures from minor stresses, like sneezing or lifting light objects
• Loss of height and stooped posture as vertebrae collapse
• Back pain from fractured or collapsing vertebrae
• Tooth loss associated with jaw bone loss

Painful fractures of the hip, wrist, and spine are hallmarks of progressed osteoporosis. They can severely impact quality of life by limiting mobility and independence.

Diagnosing Osteoporosis

Diagnosing osteoporosis involves:

• Medical history review
• Physical exam assessing risk factors
• Bone mineral density test using dual-energy x-ray absorptiometry (DXA)
• Lab tests to check for underlying conditions

The DXA scan measures hip and spine bone mineral density. Results are reported as T-scores. Scores above -1 are normal. Scores between -1 and -2.5 indicate low bone mass, while scores below -2.5 confirm an osteoporosis diagnosis. The test is painless - the radiation exposure is very low.

Other tests like CT scans or blood marker analysis may also be performed. Bone density screening is recommended for all women age 65+ and men age 70+, as well as younger adults with fracture risk factors.

Treating Osteoporosis

Treatment aims to prevent further bone loss, build bone density, and lower fracture risk. Options include:

Medications like bisphosphonates (alendronate, ibandronate, risedronate, zoledronic acid), denosumab, raloxifene, calcitonin, and teriparatidework by different mechanisms to strengthen bones.

Nutritional supplements like calcium and vitamin D are essential for bone remodeling. Getting enough through diet and sunlight is ideal. Supplements may be prescribed if intake is inadequate.

Lifestyle changes like regular weight-bearing and muscle-strengthening exercise, smoking cessation, limited alcohol intake, and fall prevention boost bone health.

For serious osteoporosis, vertebroplasty or kyphoplasty may be used to treat collapsed vertebrae by injecting bone cement. Occasionally a joint replacement or rod implantation surgery is needed after bone fractures.

Early diagnosis and adhering to prescribed treatment is key to managing osteoporosis. A coordinated approach combining medications, nutrition, exercise, and lifestyle changes can significantly improve bone strength.

Conclusion

While incurable, osteoporosis does not have to result in disability and loss of independence if Caught early. Maintaining a bone-healthy lifestyle with good nutrition, exercise, and avoiding smoking pays dividends. Women should have routine screening after menopause. Being vigilant about falls and protective of fragile bones is essential. Emerging research brings hope for more effective osteoporosis therapies in the future. With proper prevention and management, osteoporosis patients can enjoy full, vibrant lives.

References

National Osteoporosis Foundation. What is Osteoporosis and What Causes It?

National Institute on Aging. Osteoporosis: What You Need to Know.

MedlinePlus. Osteoporosis.

Mayo Clinic. Osteoporosis.

Johns Hopkins Medicine. Osteoporosis.