Osteoporosis

Osteoporosis

 

What Is Osteoporosis?

Osteoporosis is a disease that weakens the bones. Weakened bones are more likely to fracture (break). Osteoporosis affects men and women, but postmenopausal women are most at risk. To help prevent osteoporosis, you need to exercise and nourish your bones throughout your life.

Childhood

The body builds the most bone during these years. That's why boys and girls need foods rich in calcium. They also need plenty of exercise. A healthy diet and exercise helps bones grow strong.

Young Adulthood to Age 30

During young adulthood, bones become their strongest. This is called peak bone mass. The same habits that kept bones healthy in childhood help keep bone healthy in adulthood.

Age 30 to Menopause

Bone mass declines slightly during these years. Your body makes just enough new bone to maintain peak bone mass. To keep your bones at their peak mass, be sure to exercise and get plenty of calcium.

After Menopause

Menopause is when a woman stops having monthly periods. After menopause, the body makes less estrogen (female hormone). This increases bone loss. At this point, treatment may be needed to reduce risk of fracture. Exercise and calcium can also help keep your bones strong.

Later in Life

In later years, both men and women need to take extra care of their bones. By this point, the body loses more bone than it makes. If too much bone is lost, you may be at risk for fractures. You can lessen bone loss by staying active and increasing your calcium intake. If you have osteoporosis, you can also learn ways to increase everyday safety.

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Preventing Osteoporosis: Meeting Your Calcium Needs

Your body needs calcium to build and repair bones. But it can't make calcium on its own. That's why it's important to eat calcium-rich foods. Some foods are naturally rich in calcium. Others have calcium added (fortified). It's best to get calcium from the foods you eat. But if you can't get enough, you may want to take calcium supplements. To meet your daily calcium needs, try the foods listed below.

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Preventing Osteoporosis: Avoiding Bone Loss

Certain factors can speed up bone loss or decrease bone growth. For example, alcohol, cigarettes, and certain medicines reduce bone mass. Some foods make it hard for your body to absorb calcium.

Things to Avoid

  • Alcohol is toxic to bones. It is a major cause of bone loss. Heavy drinking can cause osteoporosis even if you have no other risk factors.

  • Smoking reduces bone mass. Smoking may also interfere with estrogen levels and cause early menopause.

  • Inactivity makes your bones lose strength and become thinner. Over time, thin bones may break. Women who aren't active are at a high risk for osteoporosis.

  • Certain medications such as cortisone increase bone loss. They also decrease bone growth. Ask your healthcare provider about any side effects of your medications.

  • Protein-rich or salty foods eaten in large amounts may deplete calcium.

  • Caffeine increases calcium loss. People who drink a lot of coffee, tea, or colas lose more calcium than those who don't.

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Preventing Osteoporosis: Staying Active

Certain factors can speed up bone loss or decrease bone growth. For example, a lack of activity makes bones lose their strength. Exercise plays a big part in maintaining bone mass no matter what your age. The amount and type of activity you do also play a part in keeping your bones strong. Weight-bearing and resistance exercises, such as walking, aerobic dancing, and bicycling, are just a few of the activities that are good for your bones.

  • Check with your health care provider before starting any new exercise program.

  • Stop any exercise that causes pain.

Resistance exercises, such as weight training, help maintain bones by strengthening the muscles around them. Swimming is also a good choice.

Weight-bearing exercises, such as walking briskly for 30 minutes or more a day, are a great way to maintain bone mass. Try aerobic dancing, too.

Vary your activities so you exercise all parts of your body. Try tennis, bicycling, or hiking.

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Living with Osteoporosis: Preventing Fractures

If you have osteoporosis, you can do a lot to reduce its effect on your life. Knowing how to prevent fractures and spinal curvature can help you live more comfortably and safely with this disease.

Reducing Your Risk of Fractures

The most common fracture sites in people with osteoporosis are the wrist, spine, and hip. These fractures are often caused by accidents and falls. All fractures are painful and may limit what you can do. But hip fractures are very serious. They require surgery, and it can take months to recover. To reduce your risk of fractures:

  • Get regular exercise. Try walking, swimming, or weight training.

  • Eat foods that are rich in calcium, or take calcium supplements.

  • Make your home safe to avoid accidents.

Understanding Spinal Fractures

Your spine is made up of many bones called vertebrae. Osteoporosis can cause the vertebrae in your spine to collapse. As a result, your upper back may arch forward, creating a curvature. Spine fractures may also result from back strain and bad posture. You will also lose height. Your lower spine must then adjust to keep your body balanced. This can cause back pain. To prevent or lessen these spinal changes:

  • Practice good posture.

  • Use proper techniques if you need to lift heavy objects.

  • Do back exercises to help your posture.

  • Lie on your back when you have pain.

  • Ask your health care provider about these and other ways to help your spine.

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Living with Osteoporosis: Regular Exercise

  • Check with your health care provider before starting any new exercise program.

  • Use weights only as instructed.

  • Stop any exercise that causes pain.

You can protect against fracture and spinal changes by exercising and by doing other physical activities. Exercises that increase muscle strength and improve flexibility help prevent falls. A variety of exercises is best. Physical activity will slow further bone loss. It can also be fun.

Resistance exercises build muscle strength and maintain bone mass. They also make you less prone to injury.

Weight-bearing activities, such as dancing, walking, gardening, and even housework, help your whole body and help you maintain bone mass.

Non-weight-bearing exercises, such as swimming or water exercises, help prevent back strain and pain. They do this by building the trunk and leg muscles.

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Osteoporosis: Understanding Bone Loss

The body has a natural system for maintaining bone. Understanding this system can help you learn how to maintain your bones.

A Balanced System Supports the Body

The body is always making and losing (resorbing) bone. This process is called remodeling. Bone-making cells form new bone using calcium and other minerals. These minerals come from the food you eat. Bone-resorbing cells take bone apart. They do this so the minerals can be used to repair an injury or make new bone. When this bone-making system is in balance, the same amount of bone is built and resorbed.

An Unbalanced System Can't Give Support

Changes in hormone levels, activity, medications, or diet can affect the bone-making system. When the system gets out of balance, the amount of bone lost is greater than the amount of bone made. This can cause osteopenia (when bone starts to become less dense). Left untreated, bone loss gets worse, leading to osteoporosis. Weak bones can't support the body. In fact, they can fracture just from the weight of your body. This often happens in vertebrae (bones of the spine). When vertebrae fracture, parts of the spine compress. This causes the back to bend or hump over.

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Osteoporosis: Screening for Bone Loss

The strength of bones is measured by their density (thickness). High bone density means bones are less likely to fracture. If you are at risk for bone loss, your healthcare provider may refer you for bone density testing.

Bone Density Testing

Bone density testing is safe, quick, easy, and painless. Testing can detect osteoporosis before a fracture happens. It can also predict the risk of future fractures. And testing can measure the response to treatment. There are two types of tests that you may have:

  • Peripheral tests are used for screening. They measure density in the finger, wrist, knee, shin, or heel. A common peripheral test is the quantitative ultrasound (QUS).

  • Central tests are used for diagnosis. They measure density in the hip or spine. The main central test is the dual energy x-ray absorptiometry (DXA). The DXA is the standard bone density test.

Who Should Be Tested?

  • All postmenopausal women under age 65, with one or more risk factors in addition to menopause.

  • All women age 65 and older.

  • Postmenopausal women with fractures.

  • Women who are thinking about treatment for osteoporosis.

  • Women who have been on hormone therapy for a long time.

  • Men or women with certain medical conditions or who are taking certain medications (such as glucocorticoids or prednisone) for a long period.

Common Testing Sites

Any bone can fracture, but with osteoporosis some bones fracture more easily. These include bones in the spine, wrist, shoulder, and hip. That's why bone density testing may be done at one or more of these sites.

Understanding Your Results

The results of your test may seem confusing at first. Don't be afraid to ask your provider to explain. Your bone mineral density (BMD) describes the thickness of the bone that was scanned. Your healthcare provider will compare your BMD with the BMD of young, healthy bone. The result is called a T-score. Bones remodel at different rates. So, a healthy T-score in the wrist doesn't mean the spine is also healthy. That's why more than one site may be scanned.