What is Osteoporosis?

Osteoporosis is a condition caused by a reduction in bone density. When bones become less dense, they are weaker and more fragile, which ultimately leads to an increased risk of developing low impact fractures. Osteoporosis can be categorised as primary or secondary. Primary osteoporosis is related to the aging process in combination with the decline of reproductive hormones (such as postmenopausal). The less common, secondary osteoporosis, refers to other diseases or their  treatments resulting in the condition. Osteoporosis is not to be confused with osteoarthritis, the most common joint disease worldwide. 

Who is affected by osteoporosis?

Osteoporosis commonly affects older females, however older males can also be affected. You are more likely to develop the condition if you have risk factors. Some risk factors are unchangeable, while others are lifestyle factors which can be changed. Recent statistics from the International Osteoporosis Foundation indicate that worldwide, 1 in 3 women over the age of 50 years and 1 in 5 men will experience osteoporotic fractures in their lifetime.

Unchangeable risk factors:
  • Age
  • Family history of osteoporosis
  • Female gender
  • Age at menopause
  • Prior fragility fracture
Changeable lifestyle risk factors include:
  • Smoking
  • High alcohol intake 
  • Low calcium diet
  • Low body weight / muscle mass
  • Repeated falls 
  • Inactive/sedentary lifestyle

Symptoms of osteoporosis

If you are suffering from osteoporosis, you may experience back pain or notice a gradual reduction in your height. These are quite generalised symptoms, and could indicate a range of conditions/normal aging processes. Osteoporosis is a silent disease, meaning there are no telling clinical symptoms until a fracture occurs. Unfortunately, each osteoporotic fracture is an indication of another impending one. Osteoporotic fractures lead to a decreased quality of life, increased disability, and financial burden to the health systems. Since diagnosis of osteoporosis is vital to minimising the risk of developing osteoporotic fractures, if you are a male aged 50 or over, or a postmenopausal woman you can check with your GP if you are at risk, and implement strategies to reduce your chances of developing the disease.

How is osteoporosis diagnosed?

Osteoporosis is diagnosed by your medical doctor through history, physical examination and bone mineral density test. The bone density test is done using a special kind of x-ray (DEXA scan). The DEXA scan provides 2 scores and is measured in standard deviations. The T-score is the tested bone mineral density compared to healthy young adults, while the Z-score is the tested bone mineral density compared to age matched adults. A T-score OF +1 or -1 indicates normal bone density, while a T-score of -2.5 or less indicates osteoporosis.

Can osteoporosis be prevented?

While osteoporosis cannot be entirely prevented, implementing some changes to your lifestyle, along with other amazing health benefits, may help to reduce your risk of developing the condition. These include: 

  • Quitting smoking
  • Reducing your alcohol intake 
  • Maintaining a healthy weight 
  • Ensuring you receive adequate intake of Vitamin D (while being sun safe)
  • Eating a healthy balanced diet with enough calcium 
  • Exercising regularly

Exercising regularly provides us with a plethora of health benefits. There are often opposing views on what types of exercise are best for us, it can become all too overwhelming. When it comes to exercise, we think it's best to find something you enjoy doing, so you are better able to stick with it. Below is a list of exercises that can help treat and may prevent osteoporosis. They include activities that involve: 

Resistance training

This includes activities such as weight training or the use of bands 

Weight bearing

Supporting your body weight against gravity, such as hiking, walking, dancing, etc

Higher impact activities

These include jogging or jumping, and sports that involve directional change such as soccer, netball or tennis.

Treatment for osteoporosis

Although there is no cure for osteoporosis, there are many ways in which the symptoms of the condition can be managed. Treatment/management of the condition aims to strengthen the existing bone and prevent further loss of bone mineral density, therefore reducing the risk of low impact fractures. If you have been given the diagnosis of osteoporosis, your doctor may recommend medicines to strengthen your bones. Implementing the lifestyle changes mentioned above all play an important role in the management of osteoporosis. Your chosen health care professional can assist in creating a safe exercise plan appropriate to your needs/requirements. Since fractures are the main concern with those suffering from the disease, your health care professional may discuss with you how you can modify your workplace/home/wardrobe to reduce your risk of falls.

By: Dr Naomi Erickson

References:

  1. Porter JL, Varacallo M. Osteoporosis. [Updated 2020 Nov 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan,
    https://www.ncbi.nlm.nih.gov/books/NBK441901/
  1. Ewald, D. (2021). RACGP – Osteoporosis – prevention and detection in general practice. Royal Australian College of General Practitioners,
    https://www.racgp.org.au/afp/2012/march/osteoporosis-prevention-and-detection/
  1. Sozen, T., Ozisik, L., & Calik Basaran, N. (2017). An overview and management of osteoporosis. European Journal Of Rheumatology, 4(1), 46-56. doi: 10.5152/eurjrheum.2016.048
  1.  Benedetti, M., Furlini, G., Zati, A., & Letizia Mauro, G. (2018). The Effectiveness of Physical Exercise on Bone Density in Osteoporotic Patients. Biomed Research International, 2018, 1-10. doi: 10.1155/2018/4840531