Normal bone, in a young adult, is a strong substance. It has a built in safety margin, being able to absorb about twenty times the normal physiological stresses before it is likely to break. However, for a variety of reasons, bone gradually loses substance as people get older.
There are two factors of major significance with relation to osteoporotic fractures:
The incidence of osteoporosis is increasing in the Western world. The relative number of elderly people is also increasing.
Elderly people tend to suffer falls. This, combined with the fact that their bone may be weak, has lead to the number of osteoporosis related fractures having greatly increased over the last few years; to the extent that their numbers have been described as having reached ‘epidemic proportions’. Many of these fractures are significant injuries, requiring hospitalization and often surgical correction. Another feature of osteoporosis is back pain which can arise as a result of a fracture of the spine or, it is felt, is due to the occurrence of ‘microfractures within the spine. Overall, the cost to society of treating these injuries is becoming astronomical.
The best way to treat it is by prevention; but in this there is a problem as it is impossible to accurately forecast those who will develop the condition. For this reason all individuals, particularly if there is a family history of the condition, are extolled to take as many safeguards as possible.
- Take moderate amounts of exercise, from as early a date as possible. It has been shown that reasonable exercise in adolescence and early adulthood builds up a good ‘stock of bone’ which will last the individual many more years than if she did not exercise.
- Take a balanced diet. Too low an intake of protein and calcium in the diet will lead to weakening of the bones. If concerned, discuss your diet with your general practitioner or a dietician.
- Vitamin D an important factor necessary for bone formation, is a relatively common condition. Deficiencies of this vitamin in children affects their ability to walk and, in severe cases leads to Ricketts which is shown by bending of the leg bones, In addition to osteoporosis, Vitamin D deficiency in the adult manifests with bone and muscular pains. There are a number of causes of Vitamin D deficiency. If the condition is suspected it requires a blood test to show the levels of Vitamin D in the blood and a physician should be consulted for investigation and treatment.
- Ensure that your intake of alcohol is moderate. It has been shown that a high intake of alcohol can lead to weakening of the bones.
- Osteopaenia affects predominantly post menopausal women. Hormonal replacement therapy is a treatment for the prevention of osteoporosis but, as it has potential side effects, its use is controversial and should be discussed with your general practitioner or Gynaecologist.
- Long term use of steroid preparations and of anti-epileptic agents has been shown to cause osteoporosis in susceptible individuals and people who are taking these types of medications should discuss this aspect with their doctors.
Where osteoporosis has been shown to be present, various treatments can be administered.
- Gentle, progressive exercise has been shown to be beneficial at any age.
- Calcium supplementation can be of some benefit in slowing the course of the condition.
- Presently diphosphonate agents are being used with benefit in some situations, particularly where it is shown that there is an increased loss of calcium from the bones.