Osteoporosis is a loss in bone mass and bone strength. Bones become less dense. This makes them weak and easier to break. Any bone can be affected. The hips, wrists, and spine are the most common sites. Peak bone mass is reached between the ages of 25 and 35. After age 35, bone mass starts to drop.
Signs & Symptoms
Osteoporosis is a “silent disease.” It can progress without any noticeable signs or symptoms. Often, the first sign is a fracture of the hip, wrist or spine. When signs and symptoms occur, they include:
Gradual loss of height.
Rounding of the shoulders.
Sudden back pain.
Stooped posture.
“Dowager’s hump.”
Causes & Risk Factors
Osteoporosis occurs when new bone does not replace old bone fast enough.
Risk Factors
Being female. Women are 4 times more likely to develop osteoporosis than men. Their bones are thinner and lighter. They live longer on average than men. They have rapid bone loss at menopause due to a sharp decline of estrogen. The risk also increases for women who:
Go through menopause before age 45. This could be natural menopause or one that results from surgery, which removes both ovaries.
Experience a lack of or irregular menstrual flow.
Family history of osteoporosis and/or bone fractures.
Having a thin, small framed body.
Caucasian and Asian Americans. African Americans and Hispanic Americans have a lower but significant risk.
Long-term bed rest.
Smoking cigarettes.
Lack of physical activity, especially walking, running, tennis, and other weight-bearing exercises.
Exercise too much to the point where menstrual periods cease.
Low calcium and vitamin D intake or absorption.
Drinking too much alcohol, which may damage bones. Heavy drinkers often eat poorly, too. They are also more prone to fractures from falls.
Taking certain medicines for a long time. Examples are corticosteroids, some antiseizure medicines, overuse of thyroid hormones, and antacids with aluminum.
Having certain health problems, such as anorexia nervosa, an over-active thyroid gland, or rheumatoid arthritis.
Persons with Crohn’s disease, ulcerative colitis, and celiac disease.
Treatment
There is no cure for osteoporosis. The focus of treatment is to prevent the disease, to prevent further bone loss, and build new bone.
Special X-rays, such as one known as DEXA, can measure bone density in various sites of the body. These tests can help doctors decide if and what kind of treatment is needed. Treatment includes:
Medications. There are different kinds, and your doctor will prescribe one(s) best suited for you.
A balanced diet rich in calcium and vitamin D and taking supplements of these, as needed.
Weight-bearing exercises, as advised by your doctor.
Proper posture.
Fall Prevention Measures
Wear flat, sturdy, non-skid shoes.
Get regular vision exams. Wear corrective glasses, etc., as needed.
Ask your doctor if any medications you take could increase the risk of falls. Ask how to deal with this. Let your doctor know if your medicine(s) affect your vision, balance, etc.
Use grab bars and safety mats or nonskid tape in your tub and shower.
Use handrails on stairways.
Pick things up by bending your knees and keeping your back straight. Don’t stoop.
Use a cane or walker, if necessary.
If you use throw rugs, use ones with nonskid backs.
Ensure that halls, stairways and entrances are well lit. Use night lights in hallways, bathrooms, etc.
Stay home if it is icy or slippery outside.
Self-Care / Prevention
To Treat Osteoporosis
Take medications, as prescribed.
Do the daily exercises approved by your doctor.
Do regular, weight-bearing exercises at least 3 or 4 times a week. Examples are walking and low-impact or non-impact aerobics. (If you have osteoporosis, follow the exercise program outlined by your doctor.)
Practice good posture.
Do not smoke.
Limit alcohol.
Use fall prevention measures.
To Treat, Slow and Prevent Osteoporosis
Eat a balanced diet. Get the calcium and vitamin D you need daily.
Daily Needs for Calcium*
Ages
Milligrams (Mgs.) Calcium/Day
9-18 years
1,300
19-50 years
1,000
51+ years
1,200 (women)
1,000 (men)
Pregnant and breastfeeding women:
14-18 years
1,300
19+ years
1,000
*Follow your doctor’s advice for calcium.
Source: National Academy of Medicine.
Choose High Calcium Foods Daily
Skim and low-fat milks, yogurts and cheeses. {Note: If you are lactose intolerant, you may need to use dairy products that are treated with the enzyme lactase, or you can add this enzyme using over-the-counter drops or tablets.}
Soy and other plant-based milk and yogurts with added calcium.
Soft-boned fish and shellfish, such as salmon, sardines and shrimp.
Vegetables, especially broccoli, kale and collards.
Beans and bean sprouts, as well as tofu (soy bean curd), if processed with calcium.
Calcium-fortified foods, such as some orange juices.
Take calcium supplements, as advised by your doctor.
Get Your Recommended Daily Need for Vitamin D
Choose nonfat and low-fat dairy products that are fortified with vitamin D, saltwater fish, liver and egg yolks. You also get vitamin D from direct exposure of sunlight on your skin. Fifteen minutes of midday sun exposure (without sunscreen) may meet the daily need.
Take vitamin D supplements, as advised by your doctor. The best source of vitamin D for bone health is vitamin D3.
Daily Needs for Vitamin D*
Ages
International Units (IUs)
1-70 years
600
>70 years
800
Follow your doctor’s advice for vitamin D.
Source: National Academy of Medicine. The National Osteoporosis
Foundation advises 400-800 IUs for adults under age 50 years; 800-1,000 IUs for adults age 50 years and older.
For More Information:
National Bone Health & Osteoporosis Foundation
bonehealthandosteoporosis.org
Triage Questions
Question 1
After a fall, are you not able to get up or do you have wrist, hip or back pain?
