SPINE DISORDERS

OSTEOPOROSIS

What is osteoporosis?
Osteoporosis is a bone disease in which bones become thinner and more porous. It is usually a painless disease until a bone breaks or fractures. Fractures are the most common result of osteoporosis. More than 1.5 million osteoporosis-related fractures occur each year in the United States, mostly in older women. These fractures are usually in the spine, hip and wrist.

What causes osteoporosis?
Although not all causes of osteoporosis are known, loss of estrogen due to menopause is a known factor for women.

Osteoporosis is most common in older women. About 25% of women more than 60 years old have osteoporosis. Women who either have had early menopause or their ovaries surgically removed before age 45, without receiving estrogen treatment, also are more likely to develop osteoporosis.

Other factors that make you likely to get osteoporosis include small body frame, excessive use of alcohol, smoking cigarettes and doing excessively strenous exercise that stops menstrual periods

Additional factors known to cause or lead ot osteoporosis include:

• A family history of the disease
• Low dietary intake of calcium
• The use of some medications such as prednisone or other steroids
• Certain hormonal disorders such as hyperthyroidism, hyperparathyroidism and Cushings disease
• Smoking
• Other diseases such as chronic liver disease and intestinal disorders
• Aging

Do men get osteoporosis?
Yes, but much less commonly than women. The cause of osteoporosis in men is often chronic alcoholism. Loss of testosterone (a male hormone similar to estrogen in women) is another cause, as well as advancing age.

How is osteoporosis diagnosed?
Bone density testing is used to diagnose osteoporosis. X-rays are used to rule out other bone or arthritic conditions. Thin bones may be detected on an X-ray, but bone density testing is more accurate.

A bone density test measures bone mineral content. The greater the bone mineral content, the stronger or more dense the bone is. If you have a low bone density, you may be at risk for fractures in the future. The test also can be used to show rate of bone mineral loss in those not receiving treatment, and rate of bone gain in those being treated.

The most common bone density test (also considered to be the most accurate) is a DEXA (dual energy X-ray absortiometry) test. This painless test is similar to having an X-ray. A miniature X-ray of the spine or hip is done along with measuring bone mineral content. A person may have osteoporosis if the amount of bone mineral content is below normal.

People who are at risk of osteoporosis, as well as those who have thin bones or evidence of spinal fractures, should be testeed for osteoporosis. Some risk factors for osteoporosis are:

• Early menopause
• Caucasian race or Asian ethnicity
• Small body frame
• Family history of osteoporosis
• Certain medications (prednisone, for example)
• Certain conditions (malabsorption, for example)

Does back pain mean I have osteoporosis?
No, having back pain does not mean you have osteoporosis. The most common cause of back pain is muscle strain and other conditions such as arthritis.

What can I do to prevent osteoporosis?
You can do several things to maintain strong bones and prevent osteoporosis.

Exercise - Doing weight-bearing exercise daily helps reduce bone mineral loss, as well as maintains good muscle tone and heart function.

Nutrition - The mineral calcium, along with vitamin D, is needed for healthy bones. Taking the recommended amounts of calcium and vitamin D is important for people of all ages as peak bone mass is reached during the late 20s and into the 30s. Most adults need 1000 to 1500 mg of calcium and at least 400 units of vitamin D each day.

Tobacco and alcohol - Tobacco and alcohol use also increases your risk of developing osteoporosis. Do not use any type of tobacco and limit alcohol intake to no more than two drinks a day.

Physical examinations - See your Health Care provider for general physical examinations, regularly, especially after age 50. Talk wih your physician about your risk for osteoporosis and the need for bone density testing.

Is there a way to treat osteoporosis with medications?
Although there is no cure for osteoporosis, there are several medications that slow and sometimes stop bone mineral loss. These drugs are called antiresoptive drugs and they include Estrogen, Alendronate (Fosomax™) and Calcitonin.

Your physician can help you decide which treatment will best meet your needs. Regardless of the choice of drug treatment, you should take 1500 mg of calcium and 400 units of vitamin D daily.

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