Definition of Osteoporosis
Osteoporosis is a systemic skeletal disease, which can be described as a condition leading to loss of the required normal density of bones. This disease leads to the bones becoming fragile which in turn leads to risks of fractures, for the smallest of injuries. Patients diagnosed with Osteoporosis, have a disorder in the skeleton leading to abnormally porous bone structure unlike the normal dense structure of bones.
Osteoporosis can happen to any of your bones, but is most common in the hip, wrist, and in your spine, also called your vertebrae. Vertebrae are important because these bones support your body to stand and sit upright.
Osteoporosis, which means "porous bones," causes bones to become weak and brittle - so brittle that even mild stresses like bending over, lifting a vacuum cleaner or coughing can cause a fracture. In most cases, bones weaken when you have low levels of calcium, phosphorus and other minerals in your bones.
A common result of osteoporosis is fractures - most of them in the spine, hip or wrist. Although it's often thought of as a women's disease, osteoporosis also affects many men. And aside from people who have osteoporosis, many more have low bone density.
There have been an increasing number of people who have been diagnosed with Osteoporosis, in the recent years. A majority of these people have been women in their old age. Medical practitioners often term as 'the silent disease', since people are often not aware of this condition unless diagnosed by a doctor leading to a bone mineral density test.
Symptoms of Osteoporosis
Usually, osteoporosis does not cause any symptoms at first. Osteoporosis is often called the "silent" disease, because bone loss occurs without symptoms. People often don't know they have the disease until a bone breaks, frequently in a minor fall that wouldn't normally cause a fracture. Many people confuse osteoporosis with arthritis and believe they can wait for symptoms such as swelling and joint pain to occur before seeing a doctor. It should be stressed that the mechanisms that cause arthritis are entirely different from those in osteoporosis, which usually becomes quite advanced before its symptoms appear.
Patients with uncomplicated osteoporosis may be asymptomatic or may have pain in the bones or muscles, particularly of the back. Vertebral crush fractures may develop with minimal or no trauma, usually in weight-bearing vertebrae (T-8 and below); isolated fractures of T-4 or above suggest malignancy. When symptomatic, the pain is of acute onset, usually does not radiate, is aggravated by weight bearing, may be associated with local tenderness, and generally begins to subside in 1 wk. However, residual pain may last >= 3 mo. Multiple compression fractures eventually may cause dorsal kyphosis with exaggerated cervical lordosis (dowager's hump). Abnormal stress on the spinal muscles and ligaments may cause chronic, dull, aching pain, particularly prominent in the lower thoracic and lumbar area. Fractures at other sites, commonly the hip or distal radius, usually result from a fall.
In the latter stages of the disease, pain, disfigurement, and debilitation are common. Early spinal compression fractures may go undetected for a long time, but after a large percentage of calcium has been lost, the vertebrae in the spine start to collapse, gradually causing a stooped posture called kyphosis, or a "dowager's hump." Although this is usually painless, patients may lose as much as 6 inches in height.
Strangely and unfortunately, the symptoms of the disease occur and are understood by the ordinary person only until the disease is at an advanced stage. Some of these symptoms noticed are:
- Bone pain and tenderness, accompanied by cramps in the legs at night are common symptoms.
- Weakened spines, resulting in height Loss. A patient may loose as much as 6 inches in height due to Osteoporosis.
- Regular pain in the spine or muscles pertaining to the lower back.
- Problem in the neck areas without any specific injury.
- Abdominal and rib pain.
- A tendency of brittle fingernails, frequent fractures or broken bones.
- Evident spinal deformities, like stooped posture, outward curve at the top of the spine resulting in vertebral collapse in the back.
In case of early detection and awareness of Osteoporosis, treatment and normal life is possible. Diagnosis for Osteoporosis is done by doing a background check of family history, blood tests, bone density test, spine X-ray and spine CT tests. Measuring of the bone mass of the spine and the hip is a good indication of the body's overall bone health. This is done to gauge presence of Osteoporosis.
Types of Osteoporosis
There are predominantly two types of Osteoporosis: primary and secondary. Primary osteoporosis has a type I, and a type II.
Primary Osteoporosis is mostly found in women, who are in the 50's or usually after their menopause. Older women, those in their 70's, are more prone to the disease. Primary osteoporosis can be subdivided into Type I is found in the post-menopause stage. Up to 80% of the women in the United States affected by Osteoporosis in the age group of 50 and 75 are of primary Type I. This is because of the sudden postmenopausal decrease in estrogen levels, which results in a rapid depletion of calcium from the skeleton. It is associated with fractures that occur when the vertebrae compress together causing a collapse of the spine, and with fractures of the hip, wrist, or forearm caused by falls or minor accidents. Primary Type 1 osteoporosis accounts for the significantly greater risk for osteoporosis in women than in men.
The type II Primary Osteoporosis is more or less related to age. Type II osteoporosis (senile osteoporosis) typically happens after the age of 70 and affects women twice as frequently as men. Type II osteoporosis results when the process of resorption and formation of bone are no longer coordinated, and bone breakdown overcomes bone building. It may result from age-related reduction in vitamin D synthesis or resistance to vitamin D activity (possibly mediated by decreased or unresponsive vitamin D receptors in some patients). In older women, types I and II often occur together.
The second type of Osteoporosis is the Secondary type. This type affects both the young and middle age group of people. Secondary osteoporosis is caused by other conditions, such as hormonal imbalances, certain diseases, or medications (such as corticosteroids). Details on the many other causes of secondary disease are included throughout this report. Secondary osteoporosis accounts for < 5% of osteoporosis cases. Causes include endocrine disease (eg, glucocorticoid excess, hyperparathyroidism, hyperthyroidism, hypogonadism, hyperprolactinemia, diabetes mellitus), drugs (eg, glucocorticosteroids, ethanol, dilantin, tobacco, barbiturates, heparin), and miscellaneous conditions (eg, immobilization, chronic renal failure, liver disease, malabsorption syndromes, chronic obstructive lung disease, RA, sarcoidosis, malignancy, prolonged weightlessness as found in space flight).
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