Osteoporosis affects one in every three women in a given population and although it also affects men too, women are more at risk especially during the menopause age. The disease is characterised by bone loss prone to fractures that usually occur at the hip, spine, ankle and waist.

According to Dr A. Shirazi, an orthopedist at Ultima Trauma Centre, bones are made up of calcium and collagen which provide strength and a soft framework respectively. These two make bones flexible and strong at the same time so they can withstand stress.

He says, “Bone density accumulates during childhood and reaches a peak by 25. It is then is maintained for about 10 years and after 35, both men and women lose some bone density each year as part of the aging process. However, the loss will be more rapid in women due to reduced estrogen levels.”

Since osteoporosis does not cause symptoms, it can be present without symptoms for decades until a person develops bone fractures. Bone loss occurs gradually over time and the bones become fragile that fractures can occur even after minor falls.

Risk factors
Family history of osteoporosis and history of fracture as an adult
Smoking and excessive consumption of alcohol
Sedentary lifestyle and immobility, such as after any condition that interferes with walking
Low calcium intake and mal-absorption of nutrients resulting from bowel diseases
Low estrogen levels in women which occurs during menopause

Certain medications such as oral corticosteroids, anti-convulsion medicines and blood thinners can cause osteoporosis.
An X-ray can reveal osteoporosis because the bones appear much thinner and lighter than normal bones but by the time X-rays can detect osteoporosis, a good amount of the bone has been lost.

Treatment & prevention
Treating osteoporosis is aimed at the preventing bone fractures by reducing bone loss or increasing bone density and strength. Although early diagnosis and timely treatment of osteoporosis can decrease the risk of future fractures, it may be difficult to completely rebuild bone that has been weakened by osteoporosis.

Dr Shirazi says, “Lifestyle changes such as quitting cigarette smoking, curtailing excessive alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin D can be helpful in preventing osteoporosis.”

Although exercise has a wide variety of beneficial health effects, it does not bring about substantial increases in bone density. “For osteoporosis, exercise helps to decrease the risk of falls, because balance is improved and muscle strength is increased. Weight-bearing exercise such as brisk walking daily is recommendable.”

Before you start on your exercises, it is important that you see an orthopedist and a fitness instructor to spell out the right exercises you should be doing.

“It is important to avoid exercises that can injure already weakened bones. If you are over 40 or have diabetes mellitus, heart disease, obesity and high blood pressure, exercise should be prescribed and monitored by physicians,” he advises.

Extreme levels of exercise (such as marathon running) may not be healthy for the bones. Marathon running in young women that leads to weight loss and loss of menstrual periods can actually promote osteoporosis. Smoking decreases estrogen levels and leads to bone loss in women before menopause thereby increasing the risk of osteoporosis.
Building strong and healthy bones requires adequate dietary intake of calcium from childhood and adolescence for both sexes.

Complications
Osteoporotic bone fractures are responsible for considerable pain, decreased quality of life, lost workdays, and disability. The pain and overall impact on health and economic costs will be enormous.

He adds that, “Osteoporosis leads to bone fracture which is associated with severe pain. The recurrent fractures lead to deteriorating skeletal structure. Repeated vertebral compression from fractures can lead to severe deformity of the spine that compromises breathing. This increases the risk of respiratory infections.”

Hip fractures are a particularly dangerous consequence of osteoporosis among women and only a few people are able to regain their pre-fracture level of function in the hip.