This disorder of the skeleton weakens the bone leading to an increase in the
risk of breaking bones (bone fracture). Normal bone is composed of protein,
collagen, and calcium.
Bones that are affected by osteoporosis can fracture with only a minor fall or
injury that normally would not cause a bone fracture.
The fracture can be either in the form of cracking (as in a hip fracture), or
collapsing (as in a compression fracture of the vertebrae of the spine). The
spine, hips, and wrists are common areas of osteoporosis-related bone fractures,
although osteoporosis-related fractures can also occur in almost any skeletal
The osteoporosis condition can operate silently for decades, because
osteoporosis doesn't cause symptoms unless bone fractures.
Some osteoporosis fractures may escape detection until years later. Therefore,
patients may not be aware of their osteoporosis until they suffer a painful
Then the symptoms are related to the location of the fractures:
Fractures of the spine (vertebra):
Can cause severe "band-like" pain that
radiates around from the back to the side of the body. Over the years, repeated
spine fractures can cause chronic lower back pain as well as loss of height or
curving of the spine, which gives the individual a hunched-back appearance often
called a "dowager hump."
A fracture that occurs during the course of normal activity is called a minimal
trauma fracture. For example, some patients with osteoporosis develop stress
fractures of the feet while walking or stepping off a curb.
typically occur as a result of a fall. With osteoporosis, hip fractures can
occur as a result of trivial accidents. Hip fractures may also be difficult to
heal after surgical repair because of poor bone quality.
How to prevent the problems of osteoporosis?
Goals should include prevention of both the underlying disorder (the
disease) and its effects (osteoporotic fractures).
Secondary osteoporoses are managed by eliminating the underlying
disorder. To prevent primary osteoporosis, good health-related behavior
during childhood and young adulthood has been suggested as the most
Such behavior includes:
► Avoiding cigarette smoking
► Excess alcohol intake
► Maintaining a normal body weight
► Maintaining optimal dietary intake of calcium: It has been suggested
that the recommended daily allowance (RDA) for
calcium in the
postmenopausal period and the recommended intake of
vitamin D in the
aged should be increased.
At menopause, the possibility of estrogen replacement therapy should be
considered for women who are at high risk for osteoporosis. Fracture
prevention should be a lifelong effort. During childhood and the
premenopausal years, a maximal peak bone mass should be developed
through weight-bearing exercise. Exercise to improve coordination and
flexibility and to maintain good posture is also useful.
What are the consequences of osteoporosis?
Osteoporosis bone fractures are responsible for considerable pain,
decreased quality of life, lost workdays, and disability. Up to 30% of
patients suffering a hip fracture will require long term nursing home
care. Elderly patients can further develop pneumonia and blood clots in
the leg veins that can travel to the lungs (pulmonary embolism) due to
prolonged bed rest after a hip fracture. Some 20% of women with a hip
fracture will die in the subsequent year as an indirect result of the
fracture. In addition, once a person has experienced a spine fracture
due to osteoporosis, he or she is at very high risk of suffering another
such fracture in the near future (next few years). About 20% of
postmenopausal women who experience a vertebral fracture will suffer a
new vertebral fracture of bone in the following year.
Risk factors for developing osteoporosis:
► Female gender
► Caucasian or Asian race
► Thin and small body frames
► Family history of osteoporosis (for example, having a mother with an
osteoporotic hip fracture doubles your risk of hip fracture)
► Personal history of fracture as an adult
► Cigarette smoking
► Excessive alcohol consumption
► Lack of exercise Diet low in
► Poor nutrition and poor general health
► Malabsorption (nutrients are not properly absorbed from the
gastrointestinal system) from conditions such as celiac sprue
► Low estrogen levels (such as occur in menopause or with early surgical
removal of both ovaries)
► Chemotherapy can cause early menopause due to its toxic effects on the
► Amenorrhea (loss of the menstrual period) in young women also causes
low estrogen and osteoporosis; Amenorrhea can occur in women who undergo
extremely vigorous training and in women with very low body fat
► Chronic inflammation: due to diseases (such as rheumatoid arthritis and
chronic liver diseases)
► Immobility: such as after a stroke, or from any condition that
interferes with walking
,excessive parathyroid hormone causes too much
calcium to be removed from the bone, which can lead to osteoporosis
► Vitamin D deficiency:
vitamin D helps the body absorb calcium. When
vitamin D is lacking, the body cannot absorb adequate amounts of calcium
to prevent osteoporosis. vitamin D deficiency can result from lack of
intestinal absorption of the vitamin such as occurs in celiac sprue and
primary biliary cirrhosis
► Certain medications can cause osteoporosis. These include long-term use
of heparin (a blood thinner), anti-seizure medications phenytoin and Phenobarbital, and long term use of oral corticosteroids.