Introduction

This silent disease has a silent progression that is quickly becoming a global epidemic. The literal translation of osteoporosis is “porous bone.” Osteoporosis is the most common chronic metabolic bone disease and is characterised by decreased bone density and quality and increased bone fragility. In this disease, the bone tissue is being resorbed faster than it is being formed, thereby increasing the risk of fracture. The hip, spine, and wrist are the most affected, which can lead to fractures, decreased mobility and spinal deformities.

Osteoporosis is a common condition, especially in older adults. It is estimated that over 200 million people worldwide suffer from osteoporosis. This article serves to guide the public on the best plan of action to manage, treat, prevent osteoporosis and have a good quality of life. With proper management and treatment, you can reduce your risk of long-term disability and reduced quality of life. This article will analyse the risk factors, causes, symptoms, diagnosis, management, treatment and prevention of osteoporosis.

Risk Factors

The risk factors for osteoporosis are:

• A family history of osteoporosis
• Low Body Mass Index
• Low oestrogen and testosterone
• Sedentary lifestyle
• Low calcium and vitamin D
• Smoking
• Excessive alcohol consumption

Causes

The causes for osteoporosis are dependent on the type. There are two types of osteoporosis: primary and secondary.

Primary Osteoporosis is caused by:

• A deficiency of oestrogen mainly affecting the trabecular bone
• Aging of cortical and trabecular bones

Secondary Osteoporosis is caused by:

• Lifestyle changes such as frequent falling, inadequate physical activity and excessive vitamin A
• Genetic diseases such as Osteogenesis imperfecta, Marfan syndrome and parental history of hip fracture
• Endocrine disorders such as Cushing’s syndrome, Athletic amenorrhea and Multiple sclerosis
• Other causes include AIDS/HIV, Rheumatoid arthritis, Ankylosing spondylitis and Hypercalciuria

Symptoms

There are no clinical manifestations until there is a fracture.

Diagnosis

The most reliable way to diagnose osteoporosis and predict fracture risk is by measuring bone density. Dual-energy X-ray absorptiometry (DXA) is the most common test for measuring bone density. DXA uses low levels of X-rays as it passes a scanner over your body while you lie on a cushioned table. There are two scores that would determine the diagnosis of osteoporosis: T-score and Z-score. The T-score compares your score to that of healthy 30-year-old adults. If the T-score is -2.5 or less you will receive the diagnosis of osteoporosis. If you have a T-score of -1 or less, you have a greater risk of having a fracture. The Z-score compares your bone mineral density to those of the same sex, weight, and age.

Management and Treatment

Osteoporosis is often managed by a multidisciplinary team including doctors, physiotherapists (physical therapists), dietitians, and sometimes specialists in endocrinology or orthopaedics. The goal of treatment is to strengthen bones and reduce the risk of fractures.

Physiotherapy (physical therapy) also serves to promote proper posture, alignment, balance, activity modifications based on the environment if necessary and to increase bone health. The physiotherapist (physical therapist) would increase bone health by encouraging weight bearing and resistance band exercises within patient tolerance. Typically, exercises are performed two to three times a week as part of an overall fitness program.

Exercises

Weight-bearing exercises such as:

• Dancing
• Jogging
• Racquet sports

Resistance exercises such as:

• Weightlifting in proper spine and lower-extremity alignment;
• Use of thera-bands
• Gravity resistance (eg. push-ups, prone trunk extension with cushion to protect lowest ribs, single-leg heel raises, squats, lunges, sustained standing yoga poses in neutral spine position)
• Exercises that reduce or stabilise kyphosis (hunchback)
• Balance exercises

Prevention

• Intake of adequate amounts of calcium and vitamin D is crucial for maintaining bone health
• Exercise at least two to three times a week
• Engage in lifestyle changes such as quitting smoking, limiting alcohol intake and maintaining a good Body Mass Index

Conclusion

This article provides a guide to the management, treatment and prevention of osteoporosis to have a good quality of life. By following this guide, you can use these methods to prevent the progression of osteoporosis. However, if you suspect a fracture, please consult your doctor or physiotherapist (physical therapist) immediately for more specific guidance. With this knowledge, you are armed and ready to be an active contributor for ensuring you have a good quality of life.