What is it?

This is a disease that has the hallmark of brittle bones. The weak bones are due to a decreased absorption and depletion calcium and bone protein and is a common type of metabolic bone disease in which bones become thinner and weaker as a part of aging. The bones are subject to fracture, and heal slowly, occurring especially in women following menopause. If it is left untreated, bones will become extremely fragile and some of them will be likely to break or fracture.

Osteoporosis is most common in women over the age 50. Following the menopause women experience a rapid bone loss due to the decrease in estrogen production. Any bone can be affected, but of special concern are fractures of the hip and spine. Spinal or vertebral fractures can lead to a loss of height, severe back pain, and deformity.

The following risk factors are associated with osteoporosis: smoking, chronic diseases, alcohol consumption, high caffeine consumption, early hysterectomy with associated removal of ovaries, hyperthyroidism and chronic steroid medication usage. Vitamin D plays a crucial role in calcium absorption. Building strong bones by eating calcium-rich foods, maintaining a well-balanced diet and exercising during early life can be the best defense against osteoporosis.
What are the symptoms?
Bone loss occurs without symptoms. People can lose bone mass over a long time without being aware of it. The first indication of osteoporosis is frequently a fracture of the spine, hip or wrist, following a simple fall.

When bone loss is severe and osteoporosis is advanced, the following symptoms can occur:

Pain in the lower back
Neck pain
Leg cramps at night
General bone pain and tenderness
Abdominal pain
Rib pain
Broken bones
Brittle fingernails

How is it diagnosed?
Osteoporosis is diagnosed with spinal X-rays, spinal CT and a bone density scan (Dexa scan). A suspicion of osteoporosis is usually present when a spinal fracture occurs when there has been only a small amount of force present, such as a small fall.

What is the treatment?
The best treatment is prevention. Adequate calcium and vitamin D intake and exercise are important preventative aids against osteoporosis. Avoiding smoking and excessive alcohol intake is another important factor.
There are a number of drugs that may help to increase bone density. The anti-resorptive medications, bisphosphonates (alendronate, ibandronate and risedronate), calcitonin, estrogens and raloxifene affect the bone remodeling cycle. Teriparatide, a form of parathyroid hormone, is a newly approved osteoporosis medication. It is the first drug to increase the rate of bone formation in the bone remodeling cycle.
Fractures that are sustained because of osteoporosis can be treated with kyphoplasty, vertebroplasty, bed rest or external bracing.

Loss of height and stooped posture are the main effects of osteoporotic spinal fractures.

Are there any complications of the treatment?
There is a small risk with vertebroplasty and kyphoplasty that the bone cement may leak out into the blood vessels or into the spaces that the nerves are located in. This is rare and is avoided by careful surgical techniques. Speak to your doctor about the risks involved and ascertain that your doctor has had the proper training.
What are the long-term expectations?
This is a progressive disease that can lead to ongoing fractures that can be disabling. Prevention is the best but there is hope with newer treatments that are available. It is very important to diagnose osteoporosis as early as possible.