Osteoporosis is defined as a reduction in the strength of bone that leads to an increased risk of fractures. The World Health Organization (WHO) defines osteoporosis as a bone density that falls 2.5 standard deviations (SD) below the mean for young healthy adults of the same sex and race. When osteoporosis affects the spine, it is called spinal osteoporosis. Osteoporosis of the spine leads to a 4 to 6-fold rise in the chances of compression fracture of the spine. Around 9 million osteoporotic fractures occur annually. Even a minor fall, picking up grocery bags, getting up from a chair, or sneezing can result in a fracture.
What are the causes of Osteoporosis?
According to Dr Ashish Dagar, Consultant - Spine Surgery, Manipal Hospital, Gurugram, there are a lot of etiological factors but the most important ones are advanced age, genetic predisposition, steroid use, smoking, loss of mechanical stimulus (sedentary lifestyle), and female sex.
Females are more prone to develop osteoporosis because of loss of gonadal activity (menopause) after the age of 45 to 50 years. Estrogen, a hormone released by ovaries, plays a role in determining the life span of bone cells by controlling the rate of apoptosis. After menopause, bone loss accelerates to about 3 per cent per year compared with 0.3 per cent during the preceding two decades. Bone loss in females can be further accelerated in cases of a Family history of osteoporosis, Low peak bone mass attained in the third decade of life (sedentary lifestyle in early adulthood), Early onset of menopause, slim or emaciated build, Oophorectomy (surgical removal of ovaries), Nutritional insufficiency, smoking and Chronic lack of exercise.
Symptoms of Osteoporosis
Women suffering from osteoporosis might present with complaints of back pain, generalised body pain, height loss, or deformity of the spine. Acute or chronic back pain might lead to reduced motion, and strength, and significant functional impairment in physical, emotional, and psychosocial domains leading to anxiety/depression and loss of self-esteem.
Treatment of Osteoporosis
Treatment of osteoporosis depends on the value of the T score in the DEXA scan. We usually prescribe calcium, vitamin D, and Magnesium to overcome any deficiency. A group of drugs called bisphosphonates is used in early cases of osteoporosis. In advanced cases of osteoporosis, injectable drugs such as Denusumab or teriparatide are usually used. Protein supplements can be added to treatment if the patient is emaciated. Patients are advised to increase physical activities as they act as positive stimulants for bone formation. You are advised to start with isometric muscle strengthening exercises and then gradually add aerobic exercises. Swimming is a good aerobic exercise that puts minimal stress on our skeletal system. Patient are also advised some balancing exercises to improve their proprioception. This helps in the prevention of falls and resulting fractures. It is also advisable to make your home fall-proof by making some minor changes as installing Night Lights In Bathroom And Hallways, grab bars in shower/toilet areas, rails in stairways, anti-skid tapes in stairways, and Nonslip Mats in the bathroom. High-risk patients should avoid certain movements such as Spine Flexion, Full Spine Rotation, Strenuous Overhead Lifts and Activities That Increase the Risk Of A Fall.
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