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There is another silently progressing, common disease other than diabetes and hypertension that can cause potentially serious risk to your health in old age. Osteoporosis meaning “porous bones” indicates a condition where your bones become more porous, thinner and weaker due to accelerated loss of bone or reduced bone formation or both. It is most evident in the vertebrae of spine, hip bones and in the wrists.
Thin and porous vertebrae fracture easily. They crumble on their own or due to minor stresses during daily activities like coughing, sneezing, bending forwards. These fractures can be painless and go unnoticed in multiple levels till the spine develops a forward bend and a noticeable loss of height. Or it can cause significant pain and disability, limitation in daily activities and increased dependence on others. A simple slip and fall at home can cause a fracture in the hip bones that can make the patient completely bed ridden. These situations commonly cause depression and general deterioration of health and leads to other risky complications in old age.
Though it is most common women after menopause, it also happens in men above age of 65 years and in those with certain risk factors like liver or kidney disease, thyroid or parathyroid disorders, and certain tumours. Smoking has been proven to cause osteoporosis. Long term steroid intake given for various conditions and medications given for seizure disorders also can cause osteoporosis.
Osteoporosis can be detected easily by a screening test called the dexa scan. Any one above the age of 50 years should consult an orthopaedic surgeon to know if they are at risk of osteoporosis and whether he/she needs a dexa scan. If the dexa scan reveals that you have osteoporosis, you must be evaluated by an orthopaedic surgeon and an endocrinologist to look for other treatable conditions that can cause osteoporosis. There are medications that are prescribed to strengthen the bones and reduce the risk of fractures in future. Diet rich in calcium and vitamin d and supplementary calcium and vitamin d medications are also an essential part of treatment.
Although the vertebral osteoporotic fractures commonly heal in a few weeks with bed rest and medications, some of them may not heal in time or cause severe pain and disability. These patients might need surgical intervention. Vertebroplasty is a procedure that involves injection of bone cement into the broken vertebra and can give immediate pain relief. Kyphoplasty is a similar procedure that can restore the height of the fractured vertebral body and reduce the forward stoop in the spine. Open surgery might be required sometimes if the collapsed vertebra causes a compression of the spinal cord or nerves in the spine. Osteoporotic hip fractures and wrist fractures often need surgical treatment for fixation.
Prevention of osteoporosis should begin in childhood. Growing bones accumulate calcium and the calcium in bones reaches a peak at around age of 26 to 30 years. After that age, there is a slow decline in the bone calcium, which accelerates in old age especially in women after menopause. So those who reach a lower peak of calcium in bones by the age of 30 are at a higher risk of developing osteoporosis in old age. This means that adequate intake of dietary calcium, vitamin d and adequate exercise from young age is very important to prevent osteoporosis.
Prevention of falls and resultant fractures in those who are osteoporotic is an important aspect of treatment. This needs modification of their living spaces to remove the risks of a slip and fall. Routine exercises and an active lifestyle load the bones and make them stronger and it is a must for all those with osteoporosis and those at risk of developing osteoporosis.