Osteoporosis is sometimes referred to as brittle bones. It is the loss of bone density, which leaves bones vulnerable to painful breaks and fractures. The best way to avoid pain from osteoporosis is to take preventative steps before developing brittle bones, but there are also lots of ways to live well with osteoporosis and manage osteoporosis pain.
The word “osteoporosis” means “porous bone.”
The body is constantly breaking down bone and replacing it with new bone. As the body ages, the rate at which the body breaks down bone begins to outstrip the rate at which new bone is made. This leads to weakened, brittle bones. The National Osteoporosis Foundation explains this, stating:
“If you look at healthy bone under a microscope, you will see that parts of it look like a honeycomb. If you have osteoporosis, the holes and spaces in the honeycomb are much bigger than they are in healthy bone.”
The larger holes and spaces signal a lower bone density. If bone density levels become too low, even simple actions such as sneezing or lifting something heavy can cause a fracture.
Roughly 54 million people in the United States have osteoporosis or low bone density. Osteoporosis is typically associated with aging, with people aged 65 and older at the highest risk.
Risk factors and causes of osteoporosis
Several additional risk factors and causes for osteoporosis have been identified, as well.
Women are generally much more likely to develop osteoporosis than men. After age 30, both men and women begin to experience bone loss. However, when women go through menopause, the rate of bone loss speeds up fir them. After menopause, though, the rate of bone loss in women slows again, so that both men and women experience bone loss at the same rate by age 65 to 70.
Additionally, a family history of osteoporosis can increase the risk of developing the condition. Some medical conditions, like hypothyroidism, can increase these risks, as well. Deficiencies of calcium or vitamin D, both of which are involved in production of new bone, raise the risk of osteoporosis, too.
Certain substances can also lead to increased osteoporosis risk. The use of steroid medications has been associated with increased risk. In addition, regular or high-volume alcohol consumption or tobacco use increase the risk of osteoporosis.
Symptoms of osteoporosis
Osteoporosis is often called a silent disease, because there are no symptoms in the early stages.
It’s impossible to feel bones losing mass, so people often don’t know they have osteoporosis until breaks or fractures occur. For instance, some people may notice back pain. There may also be a noticeable increase in the curvature of the spine, like a hunch, or a loss of height. These are due to vertebral compression fractures, or fractures in the spine that cause the vertebrae to collapse inward on themselves. Impaired mobility or neurological symptoms are also possible with vertebral compression fractures.
Interestingly, one group of researchers has found that people with osteoporosis also have a 1.76-fold higher risk of developing sudden sensorineural hearing loss (SSHL), or sudden hearing loss in one ear. SSHL can occur in a single day or over the course of several days, although most people who experience SSHL will regain at least some of their hearing with treatment. This, according to researchers, suggests that osteoporosis may affect other systems in the body, in addition to the bones, which makes it even more important to pursue screening and treatment.
The most common way to test or screen for osteoporosis is with dual X-ray absorptiometry (DXA or DEXA), which is a simple, pain-free, low-radiation test. DXA is, as its name suggests, an X-ray with two different X-ray beams, each with different energy levels. The amount of X-rays that pass through the bone is measured for each beam, and the difference between the two beams is used to determine bone density.
It’s recommended that people aged 65 and older undergo regular testing for osteoporosis, although high-risk individuals may be encouraged to undergo testing sooner. As people age, it becomes increasingly important to undergo testing.
One study found that the wrong populations tend to undergo the most testing. Specifically, relatively low-risk women (between ages 50 to 64, without risk factors) tend to get screened for osteoporosis much more regularly than higher-risk women (age 65 and above).
Additionally, because of the strong association between women and osteoporosis, the screening rate for at-risk men is much lower than it should be. Even older, at-risk men who have experienced a broken or fractured bone may be treated for the injury without being screened for osteoporosis.
The bottom line is that anyone who is at risk should be screened. Discuss risk factors with a physician, and carry through with any suggested screenings, supplements, or medications.
Reducing your risk for osteoporosis
A healthy lifestyle can lower your risk of osteoporosis.
The best way to avoid pain from osteoporosis is to avoid getting it in the first place. Getting enough calcium, vitamin D, and lean protein, along with plenty of exercise, will help decrease the risk of osteoporosis. However, these changes must occur before peak bone density is reached, typically around age 30. It’s best if these changes happen during childhood, but a healthy lifestyle will be beneficial no matter what age.
During adulthood, the same healthy lifestyle is suggested. Additionally, extreme diets or crash diets can lead to malnutrition and deficiencies of calcium, vitamin D, and protein; for this reason, extreme diets should be avoided. Use of tobacco or alcohol should be limited. Regular weight-bearing exercises can help build strong bones.
To live well with osteoporosis, a healthy lifestyle should be complemented by physician-recommended medications, supplements, and activity.
Two types of medications are commonly prescribed to people with osteoporosis. One type, called anti-resorptive medications, prevents the body from absorbing existing bone. The other type, called anabolic medications, stimulates the body to form new bone mass. Physicians may also prescribe calcium and vitamin D supplements.
Additionally, scientists are examining the effects of a protein called PPARy. This protein impacts stem cells, which are capable of developing into one of many different cell types in the body. These scientists have found that in mice with a lowered PPARy level, more stem cells develop into osteoblasts, which encourage bone formation. This research is still in its early phases, but it does provide a potential future treatment for the bone loss of osteoporosis.
To manage pain from osteoporosis, non-steroidal anti-inflammatory drugs (NSAIDs) or opioids might be suggested. Alternative treatments, such as acupuncture, might also be effective.
When osteoporosis has led to vertebral compression fractures that interfere with day-to-day life, surgery can be effective. Vertebroplasty is the injection of medical cement into collapsed vertebrae to replace lost bone. Kyphoplasty is the same as vertebroplasty, with the addition of small inflatable balloons into the vertebrae before injection of the medical cement. Kyphoplasty is associated with reduced cement leakage and shorter procedure duration, while vertebroplasty is associated with increased long-term healing and reversal of osteoporosis effects.
A healthy diet and regular activity are still vitally important after a diagnosis of osteoporosis, as emphasized by the International Osteoporosis Foundation:
“Doctors and patients should also be aware that attention to lifestyle factors must go hand in hand with any drug treatment prescribed.”
Have you been screened for osteoporosis?
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