Osteoporosis (Weak Bone Disease) Causes, Symptoms, Treatment

Often referred to as a “silent disease,” osteoporosis is a condition that weakens bones, making it fragile and more prone to fractures. It is a common condition with potentially serious consequences if left unmanaged. Although more common in older women, osteoporosis can affect men and even children. Early intervention can help maintain bone health and improve quality of life.

What is Osteoporosis?

Osteoporosis is a medical condition where there is a reduction in bone density and quality, leading to fragile bones fragility and susceptibility to fractures. It typically develops over several years and is most commonly observed in older adults, especially postmenopausal women. Most people do not know that they have osteoporosis until a routine bone scan is conducted or with a fracture. It is not uncommon for cases of severe osteoporosis to result in repeated fractures, even with a slight injury.

Causes of Osteoporosis

The development of osteoporosis can be attributed to several factors:

• Age-Related Bone Loss: Bone density naturally decreases with age, especially after the age of 30 when bone resorption outpaces bone formation.
• Hormonal Changes: Reduced levels of estrogen in women after menopause and testosterone in men can significantly impact bone density.
• Nutritional Deficiencies: Inadequate calcium and vitamin D intake can impair bone health.
• Sedentary Lifestyle: Lack of physical activity, particularly weight-bearing exercises, can weaken bones over time.
• Medical Conditions: Certain diseases like rheumatoid arthritis, hyperthyroidism, and gastrointestinal disorders can affect bone health.
• Medications: Long-term use of corticosteroids and some other drugs can contribute to bone loss.
• Lifestyle Factors: Smoking, excessive alcohol consumption, and low body weight are associated with higher risks of osteoporosis.

Symptoms of Osteoporosis

Osteoporosis is often called a “silent” condition because it typically shows no symptoms until a fracture occurs. Even a minor fall or impact can result in a fracture when there is underlying osteoporosis.  It is therefore recommended that high risk individuals undergo frequent bone density scans.

• Back Pain: Caused by a fractured or collapsed vertebra.
• Loss of Height: Often due to spinal compression fractures.
• Stooped Posture: A noticeable curvature of the spine (kyphosis) can develop.

Typically there is no pain in the affected bones, unlike with other bone conditions like osteomyelitis (bone infection).

Diagnosis of Osteoporosis

Early detection is crucial in managing osteoporosis effectively. Diagnostic methods include:

• Bone Mineral Density (BMD) Test: The most common test is a dual-energy X-ray absorptiometry (DEXA or DXA) scan, which measures bone density in the hips and spine.
• Medical History and Risk Assessment: Evaluating family history, lifestyle factors, and medical conditions.
• Blood and Urine Tests: These may be done to identify underlying causes or contributing factors, such as calcium and vitamin D levels.
• Imaging Studies: X-rays may be used to detect fractures or significant bone loss.

Treatment of Osteoporosis

While there is no cure for osteoporosis, several treatments can help manage the condition and reduce fracture risk. This often requires a combination of lifestyle changes and medication. Regular follow-ups with your doctor is necessary to assess treatment effectiveness and adjust the approach as required.

Lifestyle Modification

• Diet: Ensure adequate intake of calcium-rich foods and vitamin D.
• Exercise: Engage in regular weight-bearing and muscle-strengthening exercises.
• Avoid Smoking and Limit Alcohol: These habits can negatively impact bone health.

Medication

• Bisphosphonates: These drugs slow bone resorption and are commonly prescribed.
• Selective Estrogen Receptor Modulators (SERMs): Help maintain bone density in postmenopausal women.
• Hormone Replacement Therapy (HRT): Used in some cases to manage postmenopausal osteoporosis.
• Parathyroid Hormone Analogues: Stimulate new bone growth in severe cases.
• Monoclonal Antibodies: Such as denosumab, which slows bone resorption.

For more information and assistance, refer to the National Osteoporosis Foundation of South Africa (NOFSA) website.