Definition: what is Osteoporosis?
Osteoporosis is a disease which causes a loss of resilience in the bones, a reduction in the bone mineral density associated with a deterioration of the micro-architecture of the skeleton. In effect, the bones become more fragile, which considerably increases the risk of fractures even with the slightest of pressure.
Osteoporosis is a common disease in women, in particular after menopause. According to calculations, 25% of women over 65 suffer from this disease, and 50% of women over 80. Osteoporosis is an issue for between 2.5 and 3.5 million women in the UK. Nevertheless, it can occur in younger women as well.
Causes: why does Osteoporosis happen?
In order to know the cause of Osteoporosis, it’s necessary to know that the bone is a living tissue, continuously reconstructing itself in order to conserve its solidarity. This replenishment is the product of the work of two types of cells: the cells that destroy old bones, the osteoclasts, and those that fabricate new ones, the osteoblasts. On the subject of good health, these destructive and reconstructive activities balance out with the help of a number of factors.
Vitamin D and sexual hormones are included among these factors. A lack of vitamin D or an imbalance in hormone production can cause a disturbance in this balance. The destruction can therefore outweigh the reconstruction. In certain people, this phenomenon isn’t so serious, whereas in others, it can lead to Osteoporosis.
However, certain factors can encourage Osteoporosis, including a strong treatment with corticosteroids. In women, Osteoporosis can also be caused by premature menopause (before 40 years old), an excessive thinness (body mass index of below 19) as well as a history of fractures without major trauma in the femoral neck in one of the parents.
Lastly, certain factors, combined or associated with other factors, can also enhance the chances of Osteoporosis. Some of these factors include a prolonged physical inactivity, a vitamin D or calcium deficit, tobacco dependence and alcoholism.
Symptoms: how to spot Osteoporosis
Osteoporosis isn’t painful, but a silent disease. That is why its detection should be caught early, preferably before the first fracture. The first signs are often a wrist or spinal fracture. The fractures are painful, except in the case of spinal fractures, which are cause no pain, and are responsible for vertebral collapse.
The illness can be suspected during spontaneous fractures or following minor traumas. If the encouraging factors are present, the doctor can perform an exam called a bone densitometry which uses X-Rays to measure the bone mineral density.
Two parts of the body, the spine and the neck of the femur are exposed to these rays. The denser the bones are, the more rays they will absorb. The obtained results are then compared to benchmark results of the same age and same sex, which allows the doctor to confirm whether the patient has Osteoporosis.
Treatment: how to treat Osteoporosis
Osteoporosis treatment starts by adopting certain lifestyle changes, meaning a varied diet that is rich in calcium. It is equally important to fight against the physical inactivity by doing exercise and getting out every day in order to absorb vitamin D from the sun’s rays which will protect the skeleton. It is also recommended to quit smoking should it be the case.
As a second measure, there are many medications which halt bone deterioration, whilst reducing the risks of fractures significantly. The main ones are:
- Bisphosphonates which slow down the loss of bone mass
- Raloxifene which reproduces the beneficial effects of oestrogen in the bones
- Strontium ranelate which reduces bone destruction and promotes construction
Fluoride can be used to stimulate the replenishment of bone tissue, but it must be accompanied by a sufficient calcium intake in order to avoid fractures in the lower limbs.
Calcitonin injections can ease the pain in case of a fracture in the spine, as well as halting the loss of bone mass. Some anabolic steroids can also be given as an injection. They temporarily reinforce muscles and moderately affect the quantity of bone tissue.
However, in women, they can cause some embarrassing secondary effects including more masculine qualities such as chin hair, a moustache and a deeper voice. The treatment must be followed no matter what, even when the patient doesn’t have a fracture. If it is interrupted, the beneficial effects will not last long term.
Because of fractures, Osteoporosis can lead to a considerable loss of independence for the patient. That’s why it is important to maintain a good lifestyle and to follow the treatment.