Osteoporosis: What You Need to Know

Indians are increasingly suffering from osteoporosis. Read on to know more about its causes, risk factors, prevention, and management.

What is osteoporosis?

Osteoporosis (“porous bones”) is a condition that affects the bone, causing it to become weaker and brittle. It puts you at a greater risk for fractures, especially of the spine, hip, and wrist. It’s a common condition among Indians, with 46 million women over the age of 50 suffering from the disease.

What causes osteoporosis?

Normal bones are living tissues that undergo constant breakdown and rebuilding. As we grow older, the rate of breakdown is greater than the rate of rebuilding, causing bones to lose their normal structure and strength. In addition to becoming weak and brittle, they can easily fracture from even mild stresses such as sneezing or coughing.

Why are Indians more prone to osteoporosis?

A combination of genetic and environmental factors can explain the increased incidence among Indians. These include:

Diet with limited calcium and vitamin D intake
Limited exposure to sunlight due to an increasingly indoor lifestyle
Lack of exercise or physician activity
Early menopause
Poor awareness about bone health

What are the risk factors for osteoporosis?

You may be at a greater risk of developing this disease if:

You’re a woman
You’re above 50 years of age
You’ve reached menopause
You have someone in your family suffering from the disease
You have a history of fractures in the past
You have poor eating habits with a diet low in vitamin D and calcium
You’re physically inactive
You have a low body weight
You consume large amounts of alcohol
You’re a smoker
You’ve been using corticosteroids for quite some time
You’ve been on anti-epileptic drugs for a long time
You’re suffering from medical conditions such as thyroid, parathyroid, or adrenal gland disorders, celiac disease, inflammatory bowel disease, cancer, etc.

What are the symptoms of osteoporosis?

While there are no specific symptoms in the early stages of the disease. Some common symptoms include:

Lower back pain
Bent or stooped posture
Loss of height
Difficulty in breathing (due to decreased lung capacity)
Hip discomfort or reduced range of motion
Fractures

When should I see a doctor?

You should consult your doctor if you have risk factors for osteoporosis or if you develop sudden, severe pain without any obvious or relatively mild injury.

How is osteoporosis diagnosed?

Your doctor will advise you to undergo the following tests:

Bone Mineral Density (BMD) test or dual-energy X-ray absorptiometry (DEXA) scan to know the level of calcium and other minerals in your bones. It can diagnose as well as predict your risk of developing the disease. Based on your score, you can be categorised into

DEXA scan score	Category
+1 to -1	Normal
-1 to -2.5	Osteopenia
-2.5	Osteoporosis

Radiological assessment (X-rays or MRI scans) in case of any fractures

Is osteoporosis reversible?

No, this condition is not reversible. However, you can take medications and make certain lifestyle modifications to protect and strengthen your bones.

How is osteoporosis treated?

Treatment involves a combination of supplements, exercise, lifestyle modifications, drug and hormone therapy.

Calcium and vitamin D supplements
Drug therapy
– Bisphosphonates: These prevent the breakdown of bone and help preserve their density
– Denosumab: It increases bone strength and density
– RANK ligand inhibitor: This prevents loss of bone density
Hormone therapy
– Estrogen, or a combination of estrogen and progestin: They can be used in post-menopausal women
– Estrogen agonist/antagonists: They can be used in post-menopausal women

What are the complications of osteoporosis?

Untreated or advanced-staged disease can lead to:

Fractures: Spine fractures can lead to persistent and severe pain, stooped posture, and loss of height. A hip fracture is another serious condition that can cause extreme pain and severely limit your mobility. Fractures, in turn, can cause:

– Difficulty in performing your day-to-day activities
– Frequent hospital admissions, surgical interventions, and increased bed rest
– Depression
– Overall decreased quality of life

How can I reduce my chances of developing osteoporosis?

Simple lifestyle changes that can lower your risk include:

Eating a balanced diet with adequate calcium and vitamin D
Staying active and exercising regularly
Doing strength and resistance training
Consuming alcohol in moderation
Quitting smoking
Identifying any factors that put you at a greater risk

What foods are rich in calcium and vitamin D?

Top foods that are rich in calcium and vitamin D include:

Dairy products like milk, cheese, curd, paneer, buttermilk, etc.
Fatty fish like salmon, sardines, or tuna
Eggs
Spinach
Oranges
Soya or tofu
Ladies finger, okra, or bhindi
Sesame seeds

Additionally, just sitting under the sun daily for 10-20 minutes between 10 am to 3 pm can naturally increase your vitamin D levels.

How can I safeguard myself and my loved ones from falls and injuries?

To avoid falls and injuries:

Ensure your house is well-lit
Get regular eye checkups for good vision
Use walking aids for proper balance
Wear comfortable footwear
Install handrails in the bathroom, toilet, and around the house

What’s the difference between osteoporosis, osteopenia, and osteoarthritis?

Osteoporosis and osteopenia affect your bones, while osteoarthritis is an age-related condition that affects your joints and their surrounding tissues. Osteopenia is the preceding stage, where your bones are weaker than normal but not weak enough to be classified as osteoporosis. It can be diagnosed with a DEXA scan. Osteoarthritis, on the other hand, can be diagnosed with an X-ray.