Osteoporosis Part III: Precautions and Treatment

PREVENTION: Elderly people with osteoporosis should take every precaution to avoid accidental falls.  This disease is responsible for many of the hip, wrist, and spinal fractures that occur in elderly women.  If glasses are necessary for general vision, they should always be worn.  A cane or walker should be used if you do not feel steady on your feet, or if one has been recommended.  Shoes and slippers should have skid-resistant soles.  Additionally, handrails in bathrooms and sturdy banister rails along all stairs inside and outside should be installed for safety.

TREATMENT: Treatment of osteoporosis is geared toward halting, or at least slowing down the progress of the disease.  This may involve increased calcium intake, estrogen replacement therapy (provided there are no contraindications), physical therapy and weight-bearing exercise. 

At least six glasses of milk or equivalent servings of other high-calcium foods such as cheese or yogurt and a small supplement of vitamin D may be prescribed to be taken daily.  Oral calcium supplements may also be prescribed.  For postmenopausal women with osteoporosis, estrogen-replacement therapy has been shown to be the most effective way of slowing down bone loss.  Today, many doctors prescribe a combination of estrogen with a synthetic progesterone to simulate the hormonal environment existing before menopause.  As with any medication, there may be certain side effects from such a regimen; report any you notice to your physician.

Exercise is very important, especially the kind of exercise that allows your body weight to bear down on your skeletal frame.  Those who are bedridden, confined to a wheelchair, or with limited ability to move, physical therapy should be received on a regular basis.  While swimming and bicycling are great cardio-workouts, simple walking or light jogging is better for those with osteoporosis.  Walking is one of the best exercises for those who do not want to take part in active sports or who cannot do so because of their general health.

SUMMARY: Bone loss to some degree is inevitable as we grow older; however, with osteoporosis, the process is much more pronounced.  Bones are weaker and thinner (especially those of the sping), and fractures can occur more easily.  New treatments are being developed that may increase bone formation and thereby reverse osteoporosis.  Meanwhile, however, the object of treatment is to stop or slow down the process of the disease.  Current treatment involves an increased intake of calcium, estrogen replacement therapy, physical therapy and weight bearing exercise.  Preventative therapy for premenopausal women consists of a diet high in calcium and vitamin D and regular exercise.

Osteoporosis Part II

Osteoporosis is sometimes called the "silent disease" because it generally remains undiscovered until a fracture occurs.  One of the earliest and most common signs of osteoporosis is a gradual decrease in height and rounding of the shoulders following menopause as a result of small, spontaneous fractures occurring in the spinal column.  The wrists and hips are also very susceptible to easy fracture.

The change in curvature of the spine may produce a nagging backache.  Severe or sharp back pains are rare, but they should be brought to your doctor's attention immediately, as they may be the result of spontaneous collapse or fracture of one or more of the bones that make up the spinal column.  As the spinal column becomes more compressed, people with osteoporosis become progressively shorter.  10-15 years after menopause a woman may lose 1-3 inches in height; 25-30 years after menopause a woman may lose as much as 6 inches or more if they have severe kyphosis (rounding of the back)

PREVENTION: By paying attention to the amount of calcium you are receiving in your diet, the amount of exercise you do daily, and the amount you smoke or drink, you can help protect yourself from developing osteoporosis. 
     Calcium: To reduce the risk of developing post menopausal osteoporosis, docotor now advise any woman who is 45 or older to increase her clcium intake.  One way of accomplishing this is by increasing your consumption of foods that are naturally high in calcium.  Some of these foods include kale, spinach, turnip greens, raw oysters, sardines and canned salmon.  The greatest source of calcium however is dairy products such as milk and cheese.  If you find it difficult to get enough calcium from your meals alone, your doctor may prescribe calcium supplements and sometimes vitamin D, which helps the body absorb calcium better.
   Exercise: Any kind of physical activity can help slow down the rate of bone loss associated with osteoporosis.  Therefore, it is highly desirable to exercise regularly.  While it may not be possible for you to engage in strenuous physical activities, you can always take daily walks.  Regular exercise, particularly if it stresses weight bearing can be very effective, since it keeps both bone and muscle healthy.
   Cigarettes and alcohol: Although there is no direct link between these two substances and osteoporosis, an unusually high percentage of women who have osteoporosis are cigarette smokers.  Also, some sources believe excessive alcohol intake may increase the risk of developing osteoporosis.

OSTEOPOROSIS

Osteoporosis is a disease marked by thinning of the bones, making them brittle and more vulnerable to spontaneous fractures.  The disease affects some twenty million people in the United States.  After the age of forty-five, it is nine times more common in women than men.  Older persons are more susceptible than middle-aged people, and whites/Orientals more than blacks.  Fair-haired, fair-skinned people are particularly vulnerable.  Osteoporosis tends to run in families; a person who has a close relative with the disease is likely to develop it later in life.  Osteoporosis is irreversible after a certain stage.  However, with treatment, its progression can be halted or at least slowed down.  You may already have osteoporosis or be at risk of getting it; in either case, there is a lot you can learn and do about the disease.

Bone Changes: Bone is living tissue that is constantly being broken down and rebuilt in very complex ways, even in adults.  Bones require calcium, vitamin D, and phosphorus; the availability and use of these substances by the skeleton is regulated by hormones and physical stress on the ends of the bones is necessasary to help them form and grow.  The contribution made by calcium in association with vitamin D seems to be the most important factor in this process.  The absorption of calcium into bone in women is ultimately dependent upon the hormone estrogen.  Some degree of bone loss is an inevitable consequence of aging.  In people with osteoporosis however, the rate of bone loss considerably exceeds that of bone formation.

Causes: Exactly what causes the increased bone loss due to osteoporosis is unknown.  However, there appears to be many contributing factors, including hormonal imbalances, which affect the absorption of calcium and phosphorus, and the decrease in estrogen production in menopausal women.  Almost one in four postmenopausal women has osteoporosis: the disease also develops early in women who have had a premature menopause due to surgical removal of the ovaries.  Women with small bones appear to be particularly susceptible to this disease.  Other factors relating to an individual's life-style may have an effect on the development of osteoporosis.  Prolonged bed rest, immobilization and inactivity promote bone loss in young people and to an even greater extent, in the elderly.  Inadequate nutrition, including a diet lacking in calcium, vitamin D, and protein, is also thought to contribute to the onset of the disease.