What is Osteoporosis?
Osteoporosis is coined from Greek word “ostoun” that means bone and “poros” to mean pore. It is the disease of the bone characterized by a reduction in the bone mineral density causing the bone to become weak and brittle making it highly fragile and high risk for fracture even with a simple budge.
The onset of osteoporosis is classified in three categories and according to the age of onset. Primary type 1 is osteoporosis that occurs post-menopausal. Primary type2 occurs to people over the age of 75 and is also referred as senile osteoporosis and can be seen in both genders although it is more common in women. Secondary Osteoporosis are those resulting from chronic predisposing medical condition or any other underlying disease and disorder while it equally affects both men and women.
The onset of osteoporosis however is more common in older people and mortality is often the result of complication from fracture. Hip fracture in senile people, mostly women, may have them stay in a hospice of nursing home while others recover and were sent home. The result however is a diminished quality of life with dependency in others for daily living. Osteoporosis is more common in white women and Asian women of postmenopausal age.
Osteoporosis is often asymptomatic during the early stage of the disease. Dull bone and muscle pain occurs as the disease progresses and the pain is usually felt on the lower back and on the neck. The onset can be generalized or regional but the key feature of osteoporosis is fracture and the manifestations depend on the site of the fracture or the bones involved.
Generalized symptom of osteoporosis may include:
- Lower back pain resulting from fracture or a collapsed vertebra.
- Marked decrease in height.
- Crouching posture.
- Bone fragility where fracture is highly probable even with the simplest budge or even when coughing.
There are cases when fractures are left undetected for some time especially when it remains asymptomatic and patient left unaware of onset of osteoporosis until another incidence of fracture that is painful and further diagnosis is applied.
Fracture of the spine can result to severe pain that is radiating from lower back to the sides of the body and chronic pain in the lower back is often the result of repeated fracture of the spine with marked decrease in height or a stooping posture resulting from a collapse vertebrae. The collapse in the vertebrae gives the patient the hump or the feature of a hunch back as often seen in older people suffering from osteoporosis.
Osteoporosis often affects the quality of life and may have a debilitating effect among older patients where some may require a long term hospitalization or residence in a nursing home care. The debilitating state of the patient often leads to serious medical complications such as pneumonia and pulmonary embolism as a consequence of prolonged bed rest following hip fracture to most cases of osteoporosis.
The incidence of osteoporosis resulted from an imbalance in bone formation in relation to new bone formation and resorption of old bone. The imbalance may be from the inability of the body to produce sufficient amount of new or there may be an excess in the reabsorption of old bone or both may occur. The foremost etiology of osteoporosis is implicated in insufficiency in certain hormones such as estrogen hormone in women and androgen in men.
Young people make new bones faster than old bones breaking down. The peak of bone mass producing faster is until the age 20 then bone mass is rapidly lost than created. The risk of suffering from osteoporosis depends on the amount of bone mass created and stored. Calcium and phosphate are the two minerals vital for proper functioning of brain, heart and other organs of the body. These minerals are being reabsorbed by the body to keep the vital organs functioning and maintain sufficient levels of calcium in the blood. Bones that have become weak may result to its fragility and weakness while making it highly prone to brittleness and fractures are the consequence of imbalance in calcium absorption and reabsorption.
The goal of treatment in osteoporosis is geared towards inhibiting the mineral loss while increasing bone density. Bone fracture is managed with prevention while thwarting further medical complications. Pain associated with fracture and disease is among the goal of treating osteoporosis.
Hormone replacement therapy is the drug of choice for post-menopausal osteoporosis although the adverse effect to other system has made a controversial issue while it is contraindicated to women with breast cancer history.
Estrogen acts by inhibiting bone loss and is prescribed to women in early menopausal stage. It is given orally or may be in the form of transdermal patch. This drug is believed to be effective in reducing hip fracture through its act of inhibiting the progression of osteoporosis.
Bisphosphonates is another drug of choice for inhibiting bone loss while actually increasing bone density.
Lifestyle change is included in managing and preventing progression of bone loss in which these lifestyles are contributory factor for osteoporosis such as cigarette smoking, excessive alcohol intake and lack of physical exercise. It is advised that adequate consumption of Vitamin D and calcium should be included accompanied by proper diet.
There are risk factors that can highly predispose an individual from osteoporosis especially those in secondary type of osteoporosis. Such risk factors are:
- Female gender are more prone than in male owing to the smaller frame including the factor of women naturally going through menopausal stage and frequent hormonal imbalance as brought by menstrual cycle and pregnancy.
- Eating disorders and malnutrition which may bring calcium deficiency resulting from improper diet and nutritional deficiency.
- Family history
- Cigarette smoking and excessive alcohol intake.
- Men with condition of hypogonadism where there is a decrease in the level of testosterone.
- Toxic effect of chemotherapy
- Young women suffering from amenorrhea.
- Vitamin D insufficiency
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