Dr. Sabarathinam. R. Subramaniyam
As we approach World Osteoporosis Day on October 20th, it is crucial to shed light on the significance of bone health in our lives, as understanding and prioritizing bone health is essential for everyone.Understanding osteoporosis is crucial because prevention and early intervention are key. As bones lose density, they lose strength, making them more prone to fractures, leading to chronic pain, disability, and a significant decline in quality of life. By raising awareness and taking proactive steps, we can work towards building and maintaining robust bone health for ourselves and future generations.
What is Osteoporosis?
Osteoporosis, a term that might sound distant, holds profound implications for our bones: derived from Greek words meaning “porous bone,” is characterised by the gradual weakening of bone density and structure. Imagine your body as a building – osteoporosis essentially weakens the foundation(bones), making it more susceptible to fractures.
The inner structure of healthy bones resembles a honeycomb, with a balanced mix of minerals and protein providing strength. However, with osteoporosis, this intricate structure begins to deteriorate. As a result, bones become more porous and fragile, resembling a sponge rather than a solid structure.
The most concerning aspect of osteoporosis is its silent progression. Individuals are unaware of the condition until a bone fracture occurs, typically in the hip, spine, or wrist. Common fractures due to osteoporosis often happen from minor falls or even routine activities, such as bending over or lifting.
Postmenopausal women are particularly vulnerable due to hormonal changes that affect bone density. Men can also develop osteoporosis, especially in later years. Factors such as a family history, poor nutritional status, certain medical conditions and medications can contribute to its development.
The Importance of Bone Health
Bones are the unsung heroes of our bodies. Our bones form the scaffold upon which our bodies are built.They provide the framework to stand, walk, run, and engage in daily activities.Beyond this foundational role, bone health is intricately linked to overall well-being:Within the bone marrow, blood cells are produced (RBC, WBC and platelets),bones protect vital organs and serve as a storehouse for essential minerals, particularly calcium and phosphorus.
As we age and become susceptible to osteoporosis, bone health becomes increasingly crucial. Strong and healthy bones contribute to an active and independent lifestyle. Conversely, weakened bones can lead to fractures, chronic pain, and a diminished ability to carry out daily tasks.
Understanding the risk factors
It’scrucial for early identification, prevention, and management of the condition. If you have concerns about your risk factors, discussing them with your healthcare provider for personalised guidance and preventive strategies is advisable.
Non-Modifiable Risk Factors:
1. Age (risk increases with age) 2. Gender (Women are more prone- particularly postmenopausal women due to a decrease in estrogen levels) 3.Family History of osteoporosis 4.Ethnicity(Asian individuals are at higher risk) 5.Medical History(such as rheumatoid arthritis, Crohn’s disease, celiac disease) 6.Hormonal Disorders(such as hyperthyroidism and Cushing’s syndrome) 7.Early Menopause(<45 years)
Modifiable Lifestyle Factors:
1.Dietary Factors (Inadequate calcium, protein intake) 2.Vitamin D Deficiency (due to insufficient sunlight exposure, poor diet) 3. Sedentary Lifestyle 4.Smoking and Excessive Alcohol Consumption5. Long-Term Use of Certain Medications (Corticosteroids and anti-epilepsy drugs)6. Some conditions that result in low estrogen levels, such as amenorrhea7. GastrointestinalSurgery (Procedures that affect nutrient absorption) 8. Poor Physical Function due to Conditions like Parkinson’s.
Empowering Individuals through Early Diagnosis: A Proactive Approach
Osteoporosis has a stealthy progression, often advancing without revealing overt symptoms until a fracture occurs. Recognising the latent nature of this condition underscores the importance of early diagnosis and intervention to mitigate the risk of fractures and preserve bone health.
1. Comprehensive Medical History and Risk Assessment (such as family history, existing medical conditions, lifestyle choices, and medications)
2. Thorough Physical Examination (Height loss or alterations in posture may serve as early indicators of vertebral fractures)
3. Bone Density Testing: Dual-Energy X-ray Absorptiometry (DEXA) Scan:This non-invasive gold standard test assesses bone mineral density (BMD) at specific sites like the spine, hip, or forearm. Results are expressed as a T-score, comparing an individual’s BMD to that of a healthy young adult.
above -1: Normal bone density
between -1 and -2.5: Osteopenia (indicating low bone density)
below -2.5: Osteoporosis
Tips for Maintaining Healthy Bones
Remember, building and maintaining strong bones is a lifelong process. By incorporating these tips into your lifestyle, you can take proactive steps to preserve and enhance the health of your bones. Remember, small, consistent efforts can yield significant long-term benefits for your skeletal system.
- Balanced Diet (protein, calcium, vitamin D, magnesium, phosphorus-rich foods),
- Supplements if Necessary (calcium and vitamin D),
- Hydration,
- Regular Exercise (Weight-bearing and resistance exercises),
- Avoid Smoking and Excessive Alcohol,
- Maintain a Healthy Body Weight
- Fall Prevention(removing tripping hazards, using handrails, and appropriate footwear),
- Regular Check-ups, including DEXA scan(especially for postmenopausal women and older adults)
Pharmacological Interventions
Once osteoporosis is diagnosed,Pharmacological therapies are central in preventing bone loss and promoting bone density. It is crucial to adhere to prescribed regimens and promptly communicate any concerns or side effects to healthcare providers.
- Teriparatide (a synthetic form of parathyroid hormone, administered through daily subcutaneous injections)
- Bisphosphonates (These drugs, including alendronate and risedronate, inhibit bone resorption and are often the first-line treatment)
- Hormone-Related Therapies(Estrogen therapy for postmenopausal women or selective estrogen receptor modulators such as raloxifene)
- Denosumab(A biologic agent inhibiting bone resorption, administered as an injection every six months.)
Spread Awareness, Break the Silence
In the bustling tapestry of our daily lives, the significance of our bones often goes unnoticed. Remember, breaking the silence on osteoporosis requires a collective effort. By actively participating in awareness campaigns and encouraging those around you to prioritise bone health, you contribute to a healthier and more informed community(Share information about osteoporosis with your family and friends, Utilize social media platforms to disseminate information about bone health, Collaborate with local organisations to organise workshops and seminars,Distribute flyers containing essential information about osteoporosis and Display them in local healthcare facilities and public spaces, Educate the younger generation on the importance of preventive measures, Encourage those at higher risk, to undergo regular health check-ups)
In Conclusion: Forging a Path to Stronger Bones
Empowering individuals with knowledge about their condition is central to successful management. Understanding the rationale behind prescribed medications, the importance of lifestyle modifications, and the role of regular follow-ups fosters a collaborative partnership between patients and healthcare providers.
As we commemorate World Osteoporosis Day, let us collectively embark on a journey of understanding and nurturing our bones. By incorporating these detailed insights into our lives, we can build a resilient foundation for a healthier and more vibrant future.
(The writer is Assistant Professor, Deptt of Orthopaedics, AIIMS, Jammu).
