Patient Information > Osteoporosis

Osteoporosis

What is Osteoporosis?
Symptoms of Osteoporosis?
Causes
Long-term effects and complications
Treatment
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What is Osteoporosis?

Osteoporosis is a general thinning of bone. It is a condition that happens slowly over many years and affects the whole skeleton.

In healthy people, there is a delicate balance between bone growth and bone loss, which keeps the skeleton in good shape. In people with osteoporosis, the rate of bone loss outweighs the rate of bone formation. As a result, the bones are more fragile and are more likely to break, especially bones in the wrist, hip and spine.

Approximately every 8 minutes someone is admitted to an Australian hospital with an osteopathic fracture. 1 in 2 women and 1 in 3 men over 60 years of age in Australia will suffer from osteopathic fracture.

Symptoms of Osteoporosis?

Osteoporosis develops slowly as a ‘silent’ condition, meaning that most people have no symptoms to begin with. The first time they find out they have osteoporosis may be years after it had developed, when they break a bone. A simple fall or minor injury may result in a broken wrist or hip bone, which can cause serious problems in elderly people. Fractures can also happen in the bones of the spine (vertebrae), causing severe back pain – this does not mean that you have broken these bones. If several fractures happen, the vertebrae become compressed, leading to a gradual loss of height, a stooping posture or curvature in the spine (known in the past as ‘dowager’s hump’).

Causes

Bone loss happens naturally as we get older, so everyone is at risk of osteoporotic fractures. However, after the menopause, women are much more at risk than men. The menopause is the time when a woman’s periods stop, usually around their late forties or early fifties. At that time, the ovaries stop producing the female hormone, oestrogen, which normally helps the lining of the womb to get ready for a possible pregnancy. Oestrogen also helps to maintain healthy bone, so a reduction in this hormone after the menopause greatly speeds up bone loss.

There are other factors that increase the risk of someone developing osteoporosis.

These include: 

• being related to someone with the condition; 
• having your ovaries removed during a hysterectomy;
• receiving steroid drug treatment; or
• having other medical problems.

Lifestyle factors can also play an important part, including smoking, drinking a lot of alcohol, dieting or suffering from an eating disorder.

Long Term Effects

Broken bones due to osteoporosis are especially serious for people over 50, and not just because of the pain. A broken hip is very traumatic for the body, and many people who were previously independent can become unable to walk properly and may need long-term care.

Severe loss of height and a stooping posture can also make life very difficult, affecting movement and general fitness, and leading to a very restricted lifestyle.

Osteoporosis cannot be cured. However, the good news is that there are several treatments that can help to improve bone structure and strength, and help prevent fractures before they happen.

Treatment

It is particularly important to try to prevent osteoporosis happening in the first place. A balanced diet rich in calcium and regular weight-bearing exercise help to build up bone from childhood until the age of about 30 and these simple steps can slow down bone loss in older people with the condition.

Avoiding smoking and drinking too much alcohol are also important. Calcium and vitamin D supplements are thought to be of benefit to older people or people with a poor diet. An appropriate medication will reduce bone loss or increase bone formation, or do both.

Once osteoporosis is diagnosed, there are several prescription medicines available. The choice of therapy is a very individual one, which you should discuss with a doctor. The most common treatments aim to slow down the rate of bone loss, maintain the density of bone and, most importantly, prevent bones breaking in the future.

Strontium Ranelate is a recently introduced non-hormonal drug that helps to reduce bone loss whilst maintaining bone formation.

Bisphosphonates are non-hormonal drugs that can slow down bone loss.

Selective Oestrogen Receptor Modulators (or SERMS) act like oestrogen in the bone and help to maintain bone density.

Hormone Replacement Therapy or HRT replaces lost oestrogen and is used to treat a variety of problems after the menopause. It can be prescribed in osteoporosis if other treatments are not suitable. It is important to discuss the risks and benefits of HRT with a doctor in the light of recent clinical trials.

Calcitonin is another hormone treatment that is occasionally used. It works by affecting the rate of calcium loss from the bones.

Many other treatments are currently being researched.