Orthopedic Diseases

Osteoporosis...Facts and Instructions
​What is osteoporosis?
Osteoporosis or bone thinning is a disease characterized by a decrease in bone mass and density; that's to say, bones become more porous, fragile, and breakable due to the loss of calcium. And the most common fractures are those occurring in the areas of hip, spine and wrist.
Symptoms and signs:
The symptoms do not usually show up at the early stages of osteoporosis, but some of them occur with the progress of the disease, including:
  • Back pain caused by a fractured or collapsed vertebra. 
  • Loss of height.
  • Stooped posture.
  • Easily incidence of bone fractures.
Risk factors:
There are some uncontrollable risk factors for osteoporosis, including:
  • Gender: Women are much more likely to develop osteoporosis than men.
  • Age: The older you are, the greater your risk of osteoporosis.
  • Race: You're at greatest risk of osteoporosis if you're white or of Asian descent.
  • Family history: Having a parent or sibling with osteoporosis puts you at greater risk, especially if you also have a family history of hip fractures.
  • Frame size: Men and women who have small body frames tend to have a higher risk of osteoporosis.
  • Menopause/Hysterectomy: If the removal of uterus involves the removal of ovaries, this might in turn increase the risk of developing osteoporosis. This occurs due to the loss of estrogen.
  • Rheumatoid arthritis: Rheumatoid arthritis and endocrine gland diseases, such as excessive excreting of thyroid hormone, have a direct effect on bone density.
  • Lack of the excretion of some hormones: Lack of hormones such as estrogen of women and androgenic of men put them at risk of experiencing fractures.
  • These risk factors include other diseases directly or indirectly affecting the bones, such as:
  • Asthma.
  • Malnutrition or digestive system problems.
  • Blood-linked disorders.
  • Having any form of disability.
Medications that affect the bone health:
Some medications may have side effects, which directly weaken the bones or increase the risk of fractures as a result of falling or trauma. These drugs include:
  • Steroids taken orally or inhaled.
  • Some immunity drugs.
  • Thyroid hormone drugs.
  • Some steroid hormones drugs.
  • Aromatase inhibitors.
  • Some antipsychotics.
  • Certain antibiotics.
  • Some antiepileptic drugs.
  • Antacids.
  • Proton-pump inhibitors.   
Risk factors that can be changed or controlled:
Most risk factors have a direct effect on the formation of bones and lead to a decrease in the bone mineral density. But some of them indirectly heighten the risk of experiencing fractures. These factors include:
  • Alcohol consumption.
  • Smoking.
  • Malnutrition.
  • Vitamin D deficiency:
    Vitamin D is necessary because it helps absorb calcium from the intestines to the blood. Vitamin D is formed in the skin when exposing to ultraviolet sun beams. Most people are exposed to the sun beams at least 15 minutes a day and it is usually sufficient. But for the elderly and people who cannot go out, and during winter months, getting vitamin D from food or supplementary sources is the solution.
  • Lack of physical activities:
    Those adopting a sedentary lifestyle are more vulnerable to hip fractures than those doing a lot of physical activities. And women sitting more than nine hours a day are prone to experiencing hip fractures than those sitting less than six hours daily.
Osteoporosis diagnosis:
There are no well-defined symptoms for osteoporosis as the bone mass keeps decreasing without a person sensing that, until a fracture occurs. Hence, an early examination will be very necessary. And a person suffering from osteoporosis can be detected through the following:
  • External Appearance: Back-bending and length-shortening are the sole signs showing that a person suffers from bone-thinning, with the likelihood that a patient could have a spine fracture.
  • Measuring bone mineral density: Bone density can be measured by a device using lower levels of x-rays to determine the proportion of minerals in the bones. This test usually examines the bones of hips, wrist and spine.
  • Existence of some risk factors. 

Prevention and treatment:
Osteoporosis is now a largely treatable disease, thus helping the avoidance of many fractures. Some drugs could be used to treat osteoporosis, including:

  • Binosto.
  • Atelvia, Risedronate, Actonel.
  • Ibandronate. 
  • Zometa (zoledronic acid)
Side effects of osteoporosis drugs:
The side effects include nausea, stomachache, difficult swallowing and esophagitis. The likelihood of side effects could be reduced by the proper usage of drugs.
Drugs supporting the treatment of osteoporosis:
The doctor may prescribe calcium and vitamin D as supportive drugs for treating osteoporosis.
  • Getting vitamin D.
  • Exposing to sunrays for a period not less than 20 minutes a day.
  • Avoiding hard physical activities.
  • Improving the lifestyle:
    People middle-aged and over are recommended adopting a healthy lifestyle; this is through avoiding smoking and alcoholic drinks, assessing the risk of osteoporosis, and taking medications and supplements. This is with the aim of maintaining bone mass and reducing fracture risks.  
  • Maintaining an ideal weight:
  • It is advisable to make sure of having an ideal body weight as it is among the factors causing bone thinning. 
  • Good nutrition:
    Following a balanced diet in each stage of human life enhances the strength and health of bones; meaning that it is recommended adopting a healthy diet comprising of nutritious, diverse meals that contain sufficient amounts of calories in terms of protein, fats, and carbohydrates, as well as vitamins and minerals; especially vitamin D and calcium in both childhood and adolescence stages. As such, good nutrition help build bone mass and maintain it; this in turn lessens the vulnerability to osteoporosis later, especially for adults.
Sources of calcium:
Milk and other dairy products are the most nutritious sources rich in calcium. And dairy products have one more privilege as they are excellent sources of protein and other micronutrients alongside calcium. There are also calcium-rich nutritious sources including some vegetables such as cauliflower, broccoli; and canned fish along with edible bones such as sardine and salmon; walnut and nuts especially the Brazilian ones; and some fruits such as oranges, apricots, and dried figs.

Similarly, there are calcium-enhanced foods such as calcium-enhanced bread and cereal, fruit juice, soya beverages, and some types of commercial mineral waters containing a great deal of calcium as well. These kinds of food provide a proper alternative for those having difficulty digesting lactose and vegetarians; yet, they are indispensable to milk. Therefore, calcium-enhanced dietary supplements are advised to be taken.
Factors preventing the absorption of calcium:
Some leafy produce such as rhubarb are containing oxalate which prevents absorbing calcium in these types of vegetables; still, they do not interfere with absorbing calcium from the calcium rich food eaten at the same time. The same goes for the dried beans and cereal and seed chaff containing phytic acid.
Further, caffeine and salt are instrumental in making body lose calcium and it is not recommended having excessive intake of them. In addition to this, it is advisable to cut back on fizzy drinks; especially that such beverages are inclined to force milk out of the diet of the children and adolescents.
Importance of exercising:
There is a strong relation between the physical activity and health of bones in all ages as exercises are important for building strong bones and maintaining them; and preventing muscles from getting flaccid. 
Benefits of exercises for bones:
  • Patients with diseases rendering them bedridden for longer periods such as spinal cord injuries; leading to bone loss, muscle damaging, and increasing the risk of fractures within few weeks.
  • Exercising during childhood and adolescence stages helps develop and strengthen bones; and then reducing the risk of experiencing fractures later in lifetime.
  • Many studies showed that there is a strong link between exercising and outliving in terms of keeping bone mineral density, in addition to diminishing the risk of hip and arm fractures; and spine breaking at ageing years.
  • Studies suggested that bone density of those exercising is remarkably higher than those not regularly doing exercises. There are exceptions with regard to the highly intensive activities, rather than weight, such as swimming.
  • Studies proved that exercising pre-forty lessens the risk of falls for the elderly.
  • Long-term regular exercise maintains the health of bones, and help children build strong bones; and the elderly maintain their bones. It also is instrumental in preventing osteoporosis and falling for the elderly.
  • Those suffering from fractures can benefit from exercises; namely training under a medical supervision to improve the strength and function of muscles for more agility and improving the lifestyle.
  • Exercising is remarkably significant especially for the elderly women, who have the highest rate of bone tissue loss at the post-menopausal period. That's to say, exercises build muscles, enhance balance and prevent falling, which is the principal cause of fractures, and this is important especially for the elderly.
  • There is no a specific age for exercising and it is never too late for those who have never exercised.
Last Update : 15 March 2018 10:14 AM
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