Osteoporosis (OS-tee-oh-puh-RO-sis) is a disease that causes bone loss. Over time, the bones can become thinner and weaker. The inner part of the bones, which is full of tiny holes, like a sponge, becomes lighter and has more empty space. As bones thin, they are more likely to break or fracture. This happens most often in the hip, spine (back), and wrist.
About 1.4 million people in Canada have osteoporosis. Women get it more often than men do. Approximately one in four women and one in eight men have osteoporosis. When a man does get osteoporosis, he is just as likely to break a bone as a woman with the disease.
Osteoporosis occurs more often in women after the “change of life” (menopause). This happens because the body produces little estrogen after menopause. Estrogen is the female sex hormone that helps keep bones strong.
Osteoporosis is caused by bone loss. Bone is living tissue. Old bone is always being replaced by new bone. When old bone disappears faster than new bone is made, bone loss occurs. A person has osteoporosis when so much bone loss has occurred that the bones are weak and break easily.
Some things in our lifestyle can help prevent bone loss. Calcium in the food we eat helps to build new bone and keep bones strong. Vitamin D helps the body absorb calcium. Exercise is important for strong bones too.
Other things make bone loss happen faster. Bone loss begins naturally as early as age 30. It continues throughout life. Low sex hormones at menopause cause faster bone loss. Some medications do too. Some people have faster bone loss than others and pass it on to their children.
People who are more likely to get osteoporosis include:
- Age ≥ 65
- Anyone with a family history of osteoporotic fracture
- Anyone who has a bone fracture after age 40
- Women who have gone through menopause
- White or Asian women
- Small-boned or thin women
- Women who stopped having periods early for any reason (such as hysterectomy, too much exercise, anorexia, bulimia)
- Those who don’ t get enough calcium in their diets
- Those who don’ t get enough vitamin D (Vitamin D is made when your body is in sunlight. It is also found in many vitamin pills.)
- Those who smoke
- Those who drink too much alcohol
- Those who don’ t get enough weight-bearing exercise (such as walking, jogging, dancing)
- Those who take certain medications (for asthma, rheumatoid arthritis, thyroid conditions, seizures, gastrointestinal disease)
Osteoporosis is sometimes called a “silent disease.” That’ s because early bone loss may have no symptoms. You may not even know you have it until a bone breaks. Without treatment, osteoporosis can cause:
- Stooped posture, called “dowager’s hump”
- Loss of height
- Broken bones from regular movement, such as leaning over or lifting something, or from a slight fall
- Multiple fractures (broken bones)
The broken bones and fractures that result from untreated osteoporosis can also lead to disability and loss of independence.
Osteoporosis can be diagnosed before the first symptoms appear. The following people should be tested for steoporosis:
- Women under 65 years of age who have risk factors for osteoporosis
- Women over 65 years of age
Diagnosis is made with a bone mineral density (BMD) test. There are several kinds of BMD tests. DEXA scans and ultrasound scans are the two most common tests and measure the mass (thickness) of bones.
These tests measure the mass in the bones that fracture most often (spine, hip, or wrist). Some newer tests measure bone in the middle finger, heel, or shin. The tests are quick and painless and help to determine which of the following bone mass groups you are in:
- Normal bone mass, or low risk of fracture
- Osteopenia (OS-tee-oh-pee-nee-uh), or low bone mass, which can lead to osteoporosis if not treated
- Osteoporosis, or very low bone mass, which has a high risk of fracture
Your health care provider may make lifestyle recommendations to help prevent further bone loss if you have osteopenia or osteoporosis. (See “How can I take better care of my bones?” )
Medicines that treat osteoporosis can also slow bone loss and help build new bone. This may increase bone mass.
Not all medications are alike. Some are taken by mouth. Some are injected. Some are taken as a nasal spray. Your healthcare provider will know which choice is best for you.
Here are some tips for keeping bones strong and healthy:
- Get enough calcium and vitamin D in your diet every day. Ask your health care provider how much you need.
- If you smoke, quit.
- If you drink alcohol, drink in moderation (1 drink per day for women; 2 drinks per day for men).
- Follow an exercise program that includes walking, jogging, or dancing. Muscle strengthening using free weights, weight machines or calisthenics is also helpful to keep bones healthy. Your healthcare provider can help plan a program that’ s right for you.
- Reduce your chance of falling by getting rid of hazards, such as throw rugs, which may cause you to trip.
Your test results will help your healthcare provider decide if you need treatment. Your risk factors are also very important. A healthier lifestyle could reduce your risk factors and help slow bone loss.
Osteoporosis treatment can prevent serious problems. If it is not treated, osteoporosis may cause a bone to break or fracture. Bones in the wrist, spine, and hip break most often.
- Fractures in the spine may cause a person to lose height or look deformed. These fractures can also cause severe pain.
- A hip fracture is also a serious problem. The person often requires surgery to help with healing and will likely need to be hospitalized.