What is Osteoporosis?

Osteoporosis is a condition where your bones become thin, fragile and brittle, leading to a higher risk of fractures (breaks or cracks) than in normal bone. Osteoporosis occurs when more calcium is taken out of your bones than replaced. This leads to a reduced bone density or “honeycombing” of your bone.

What Causes Osteoporosis?

There is no specific cause for osteoporosis. Your bones are constantly being renewed in a process where old bone is broken down and new bone is produced to replace the old. This process occurs throughout our life and is usually in balance. However, due to a number of reasons, it can get out of balance and thinning of the bones can occur.

As we grow older our ability to lay down new bone lessens and if we become increasingly less active, we are increasing our risk of developing osteoporosis.

Risk Factors for Osteoporosis

A number of risk factors have been identified that can increase your inability to lay down dense bone, these include:

  • Lack of Weight-Bearing Exercise
  • Menopause
  • Rheumatoid ArthritisAnkylosing Spondylitis
  • Overactive thyroid or parathyroid glands
  • Coeliac disease and other chronic stomach conditions
  • Chronic liver or kidney disease
  • Type 1 diabetes
  • Some cancers
  • Smoking
  • Excessive alcohol consumption
  • Diet lacking in calcium
  • Lack of sunlight exposure, which may cause vitamin D deficiency.

However, the most important factor is thought to be a lack of bone stress stimulating exercise. Exercise, especially weight bearing and resistance exercises, helps you to stimulate the production of new bone and when you are younger and limits the loss of bone when we are older.

What are the Symptoms of Osteoporosis?

If you have easily fractured a bone in your body or had a couple of fractures in a short time period, our GP may discuss investigations for osteoporosis. Otherwise there are not many symptoms to indicate you have osteoporosis.

How is Osteoporosis Diagnosed?

Osteoporosis is diagnosed with a special scan called a bone densitometry scan. This is usually done of the lumbar spine or the upper thigh bone, takes about 15 minutes and lets you know how dense the bone is compared to people of your age.

Osteoporosis Treatment

The treatment of osteoporosis involves reducing any of the factors contributing to poor bone health. Your doctor may advise you to address current exercise regime, review your medications or review current lifestyle factors that predispose you to osteoporosis. Your doctor may also advise you to increase your:

  • Calcium intake via your diet or with supplements. Calcium is used to build and maintain bone health.
  • Vitamin D intake via supplements or exposure to low levels of sunlight. Vitamin D is used to absorb calcium in the bone and regulate calcium in the blood.

Osteoporosis Medications

Osteoporosis can be treated by your doctor with medications designed to help reduce or reverse your bone loss.

These medications include:

  • Bisphosphonates (Fosamax, Risedronate Actonel, Zoledronic/ Aclasta).
  • Denosumab (Prolia)
  • Strontium ranelate (Protos)
  • Selective oestrogen receptor modulators (SERMS) (Raloxifene/Evista)
  • Hormone replacement therapy (HRT)
  • Teriparatide

*For more information regarding medications please consult your GP or specialist*

Exercise & Osteoporosis

Bones become stronger when a certain amount of impact or extra strain is placed on them. Regular weight-bearing and resistance exercises help you to stimulate the production of new bone (osteogenesis). Different forms of exercise have varying osteogenic effects on bone health depending on the impact they put through the bones.

In addition to improving your osteoporosis, exercise benefits your strength, co-ordination and balance, which helps you to prevent falls and to improve your general physical health and well-being.

If you have moderate to severe osteoporosis, are at greater risk of falling or had an osteoporotic fracture, you do need to have appropriate exercises prescribed. Please ask your physiotherapist for the specific osteoporosis-appropriate exercises most suitable for you.

Osteoporosis Prevention

Osteoporosis is best prevented when you are younger. Your bone mass is at its peak between 18 and 25. The more bone mass that you have before you age, the greater our chance of not being affected by osteoporosis. In fact, if you can increase bone mass by about 10% you can delay the development of osteoporosis by 13 years and potentially reduce fracture risk by 50%.

Osteoporosis Related Conditions

General Information

Joint Injuries

Muscle-related Injuries

Bone-related Injuries

Disc-related Injuries

Nerve-related / Referred Pain

Systemic Diseases

Article by Z.Russell, N.Stewart

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