As we age, a bone-thinning condition known as osteoporosis may develop, causing a loss of bone mass. According to the American Academy of Orthopaedic Surgeons (AAOS), Osteoporosis affects approximately 10 million people in the United States and over 200 million people worldwide. One of the dangerous of such a common and widespread condition is that osteoporosis often goes undetected do to a lack of symptoms.
What is Osteoporosis?
Osteoporosis is a condition that causes a loss of bone density that results in bones being fragile and more vulnerable to fractures.
What Causes Osteoporosis?
Bone is continually regenerating to replace old bone, thereby increasing the bone mass. But with age bone mass depletes faster than it’s created. As a result, more bone mass is lost than can be replaced, making bones brittle and weak. Generally, bone density begins to decrease in men and women after the age of 35.
Different Types of Osteoporosis
Orthopedic doctors usually distinguish between two different types of osteoporosis, primary and secondary.
Primary Osteoporosis is linked to the normal aging process. There is an association between the presence of two hormones, estrogen and progesterone, and the rate at which bone is lost. Estrogen regulates the osteoclasts that break bone down and progesterone controls osteoblasts, which help in making new bone. Other hormones are crucial too. Primary osteoporosis can be further divided into “primary type I” and “primary type II” osteoporosis.
Primary Type I Osteoporosis
Type I is generally referred to as postmenopausal osteoporosis, as this is more commonly seen among women (six times more frequent) who have gone through menopause, resulting in a drop in levels of estrogen. Primary type I osteoporosis occurs in women about 10 to 15 years after menopause, usually between the ages of 50 and 70. The loss of bone structure because of the increase in bone resorption can be connected to the estrogen deficiency in women and the lack of testosterone in men. This type is also known as a high-turnover osteoporosis because of the reduction in the amount of trabecular bone or the inner soft part of the bone. People who suffer from this type of osteoporosis are also at a higher risk of spinal and wrist fractures. This is mainly because of the loss of bone strength and reduction in the amount of trabecular bone present in the vertebral bodies of the spine and in the end of the long bones, like your wrist.
Primary Type II Osteoporosis
Type II osteoporosis (also known as senile), commonly caused by a long term calcium deficiency. Women are twice as more likely than men to suffer from Type II osteoporosis. Type II osteoporosis results in loss of the outer bone structure and also the inner trabecular bone to wear down and become thin. Studies have linked deficiency in dietary calcium and Vitamin D decline due to age, or the hyper activity of the parathyroid glands (secondary hyperparathyroidism) as risk factors that can hasten this condition. Primary type II osteoporosis is also called low-turnover osteoporosis because the rate of bone turnover is much lower in this type of osteoporosis. It typically results in hip fractures.
Secondary Osteoporosis develops when certain medical conditions and medications increase bone remodeling leading to disruption of bone reformation. The loss of bone mass occurs due to the imbalance between the production of new bone and the loss of old bone, leading to lower bone turnover rate.
An imbalance in hormones from the increased activity of the parathyroid glands or Hyperparathyroidism can result in Secondary osteoporosis. Hormonal imbalance can also occur from Hyperthyroidism, which is an excessive secretion from thyroid glands. Secondary osteoporosis is also common among patients suffering from diabetes, which can often lead to hyperglycemia or increasing levels of glycosuria. Even the long term use of oral corticosteroids can cause hypercortisolism, which increases the chance of developing this particular type of osteoporosis. Disorders leading to the expansion of the bone marrow cavity at the expense of the trabecular bone can affect bone strength, leading to osteoporosis.
Other causes of secondary osteoporosis include:
- Multiple myeloma
- Intestinal Malabsorption
- Liver Disease
- Metastatic bone disease
- Marfan’s Syndrome
- Cushing’s Syndrome
- Antacids containing aluminium
- Thyroid hormone
- Steroid (Cortisone) Therapy
Typically, people who suffer from osteoporosis may not have any symptoms and aren’t even aware of the condition until a fractures occurs.
In some cases, physical deformity may occur, such as a curved upper back (kyphosis) from vertebral collapse in the thoracic spine. However, in many cases patient will suffer from osteoporosis for many years completely unaware.
For this reason, communication and regular visits with your physician are critical for your bone health.
Your doctor will examine you and evaluate your medical history before running diagnostic tests, to determine whether or not you are suffering from osteoporosis. If diagnosed with osteoporosis, your physician will discuss treatment options with you.
While osteoporosis may not be unavoidable, there are important habits that may slow the loss of bone mass and promote healthy and strong bones.
- Healthily diet
- Regular exercise
- Reducing or eliminating alcohol and smoking
- Vitamins and calcium supplements
Discuss any changes in diet or activity levels with your physician.
*The blog is for general information and educational purposes only regarding musculoskeletal conditions. The information provided does not constitute the practice of medicine or other healthcare professional services, including the giving of medical advice, and no doctor-patient relationship is formed. Readers with musculoskeletal conditions should seek the advice of their healthcare professionals without delay for any condition they have. The use of the information is at the reader’s own risk. The content is not intended to replace diagnosis, treatment or medical advice from your treating healthcare professional.