Osteoporosis

Osteoporosis is often called a “silent disease” because it usually doesn’t cause noticeable symptoms. Healthy bones naturally experience a continuous process called “remodeling.” This is where weak bone tissue is broken down and new, strong bone tissue forms to replace that loss. As the body ages, bone loss may occur more quickly, new bone tissue may not be replenished fast enough, or a combination of the two may occur. These factors cause the bones to weaken and for osteoporosis to occur. 

Since bone tissue loss is a gradual process, patients do not feel their bones becoming weaker and symptoms typically do not present themselves. 

Usually, patients realize they may have osteoporosis when they fracture a bone from a minor fall, strain or bump. However, there are a few symptoms that can occur in the earlier stages of osteoporosis that you may want to look out for, such as:

• Loss of height, such as getting shorter by an inch or more
• Stooped posture where you feel the need to bend forward
• Weak and brittle nails
• Receding gums (can occur if your jaw is losing bone mass)
• Weakened grip strength
• Back or neck pain

Although osteoporosis most commonly occurs in people over the age of 50, that doesn’t mean that osteoporosis is natural “wear and tear.” While age is a risk factor for developing osteoporosis, there are other major osteoporosis causes.

Some health conditions or medical procedures can increase a person’s chance of developing osteoporosis. This includes:

• Autoimmune disorders like rheumatoid arthritis, lupus or multiple sclerosis
• Breast cancer or prostate cancer
• Blood and bone marrow disorders, like thalassemia
• Endocrine disorders like diabetes, hyperparathyroidism, hyperthyroidism, premature menopause or Cushing’s syndrome
• Digestive and gastrointestinal disorders like celiac disease or inflammatory bowel disease
• Neurological disorders like stroke or Parkinson’s disease
• Medical procedures like gastrectomy or bypass procedures 

There are risk factors that increase a person’s likelihood of developing osteoporosis. While some factors like age, gender and family history cannot be avoided, there are some preventable factors, such as lifestyle habits, that are good to be aware of.

Risk factors for osteoporosis include:

• Age (Risk increases after the age of 50.)
• Gender (Women account for 80% of Americans with osteoporosis.)
• Menopause
• Tobacco use
• Alcohol use
• Poor diet and nutrition
• Sedentary lifestyle
• Family history of osteoporosis
• Low body weight

One of the best ways to prevent the development of weak bones is to work on building strong bones. Exercise and diet are two of the most prominent lifestyle changes you can make to strengthen your bones and prevent osteoporosis. 

This means you should focus on:

• Consuming the recommended daily amount of calcium and Vitamin D
• Staying active with weight-bearing exercises like walking, dancing, or resistance or weight training
• Avoid smoking and alcohol consumption. 

Remember to always check with your doctor before starting a new exercises program and for dietary recommendations best suited for you.

Osteopenia vs Osteoporosis 

Patients who think they may have osteoporosis may actually have a condition called osteopenia. They’re both similar conditions resulting from bone loss, but are differentiated by the extent of the patient’s degree of bone loss. 

To form a correct diagnosis, a doctor will conduct a bone density test to find your T-score, which shows how your bone mass differs from that of an average, healthy 30-year-old adult. The lower your T-score, the more porous and weak your bones are.

A diagnosis of osteopenia is confirmed with a bone density T-score that falls in the -1 to -2.5 range. A T-score of -2.5 or lower indicates osteoporosis.

Having osteopenia doesn’t mean that you’ll develop osteoporosis. If you take a bone density test and find your range is lower than you’d like, or falls in the range of osteopenia, work with your doctor to develop a plan to prevent further bone loss. This prevention plan may include a calcium and vitamin D rich diet or supplements, reducing alcohol consumption, or engaging in strengthening exercise.

Osteoporosis vs Arthritis

Since osteoporosis and arthritis both affect the musculoskeletal system, people often wonder if they’re related. Osteoporosis and arthritis have very different causes, symptoms, diagnosis methods, and treatments, making them two very distinct conditions despite their similarities.

Arthritis affects the joints and surrounding tissues, typically in the knees, wrists, fingers, toes, and hips. The most common types of arthritis are osteoarthritis and rheumatoid arthritis. 

Osteoarthritis is a degenerative joint disease that affects the hips, knees, lower back, neck, or joints in the hands, and is typically caused by overuse or repeated trauma. 

Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that affects joints in the fingers, wrists, elbows, shoulders, knees, feet, and ankles. With RA, the body releases enzymes that break down the lining of healthy joints and cause pain, stiffness, malformation, and reduced mobility. Severe arthritis can put patients at greater risk for developing osteoporosis. Often, arthritis can lead to a sedentary lifestyle, which can contribute to developing osteoporosis. If you’re diagnosed with arthritis — particularly RA — you may want to discuss osteoporosis prevention methods with your doctor. 

While you cannot reverse bone loss, you can slow down or stop further bone loss. Your primary care provider or orthopedic specialist can help create a treatment plan tailored to your needs. Most treatment options involve recommendations for diet and lifestyle or medications.

At Citrus Spine Institute, we begin a treatment plan for osteoporosis with a bone density test. We can start with a more conservative approach using calcium and vitamin D, versus a more extensive treatment with bisphosphonates, an oral bone density medication, or with injectable medication such as Priola, Forteo or Evenity. Our fracture liasion will create customized treatment options for osteoporosis based on your test results and individual needs.

Among the most common fracture that occurs due to osteoporosis is a compression fracture.  At Citrus Spine Institute, we treat compression fractures with bracing or a kyphoplasty procedure, and we also help prevent future compression fractures by treating the osteoporosis that causes them.