Author: University of Washington Orthopaedics and Sports Medicine Seattle, WA 2008-08-15
Osteoporosis: Loss of bone mass
Osteoporosis (Greek: bone with too many passages) is a condition in which the holes in the bones become larger. Instead of bone, the spaces are filled with fat or bone marrow cells and the bone density is decreased. The bones are weak and break easily.
Osteoporosis
(Greek: bone with too many passages) is a condition in which the holes
in the bones become larger. Instead of bone, the spaces are filled with
fat or bone marrow cells and the bone density is decreased. The bones
are weak and break easily.
Osteoporosis
does not cause symptoms unless the bones break. Usually the broken
bones are painful, especially fractures of the wrist, ankle or hip.
These serious fractures happen after a fall or injury.
The
most common misconception is that osteoporosis is a disease of old
women. Osteoporosis is frequently seen in men and it can occur at any
age.
Another myth is that hip fractures cause falls. In 95%
of cases, the hip breaks after a person falls. There might be rare
exceptions.
Both
the amount of bone mass you have as a young adult and how fast you lose
it as you age determine your risk for osteoporosis. Throughout life,
your body removes and replaces small amounts of old bone. The amount of
bone you have is called bone mass. As you age, your bones lose mass and
may become porous, or less dense. This happens because you lose more old
bone than your body can replace.
Bones that have less mass are
more likely to break or fracture, even in a minor fall. The first
warning that you have osteoporosis may be a broken bone. Broken bones
limit activities for many older adults.
Women
Women
are at greater risk of losing bone mass than men because they start
with 30 percent less than men and lose it faster after menopause.
Caucasian and Asian women have less bone mass than African American
women, which puts them at greater risk.
A third or more of the
women in the United States over age 45 may be affected at any point in
time. Half may experience a broken bone from osteoporosis during their
lifetime.
Bone mass in women is affected by levels of the hormone
estrogen. Bone mass builds in younger years, levels off at ages 30 to
35, and remains stable until menopause. After menopause, women lose bone
mass rapidly, about two to three percent each year. This loss continues
for five to ten years. Women are more likely to break bones in the
wrist or spine in the years after menopause, usually from ages 45 to 60,
because of the drop in estrogen levels. Fractures of the spine, can
cause loss of height and rounded shoulders, sometimes called dowager's
hump.
Hip fractures
Both men and women tend to
break hips in their 70s and 80s. Since men are affected, factors other
than lack of estrogen must be important in causing hip fractures.
Reducing your risk
You
can take steps now to reduce your risk of developing osteoporosis. If
you already have osteoporosis, many of the same steps for reducing your
risk can be used as treatment.
Before age 35, your body is
building bone mass. During these years, you can take steps to build as
much bone mass as possible. These same steps may help slow the rate of
bone loss later. The steps include: increasing calcium in your diet,
avoiding smoking, avoiding heavy alcohol use, and doing weightbearing exercise regularly.
If
you are a woman, your doctor may recommend taking estrogen after
menopause to slow bone loss. For women, taking estrogen is one of the
most effective ways to prevent fractures from osteoporosis.
As
you get older, you are more likely to fall and break a bone. You can
reduce your risk of falling with exercise, regular eye exams, good
lighting, and home safety.
Checking your risk
Researchers
cannot yet predict exactly who will develop osteoporosis. The check
list below shows risk factors that are common in people with
osteoporosis. If you have one or more of these risk factors, you are at
greater risk of breaking a bone.
Risk factors you can change:
- Eating a low-calcium diet
- Smoking cigarettes
- Drinking more than two alcoholic drinks a day
- Not exercising regularly
Risk factors your doctor can help you change:
- Having low bone mass
- Going through menopause before age 45 (especially after surgery to remove the ovaries)
- Taking drugs that reduce bone strength (cortisone, anticonvulsants, or heparin)
- Having diseases that affect calcium levels (disorders of intestines, liver, kidneys, or glands that produce hormones)
- Having poor eyesight or balance
Risk factors you cannot change:
- Being female
- Being Caucasian or Asian
- Being thin and small-boned
- Having a history or wrist, spine, pelvic, or hip fractures
Avoiding falls and injuries
Preventing
falls, especially in the home, reduces your risk of fractures from
osteoporosis. You may reduce your chances of falling with exercise,
regular eye exams, and home safety.
As you get older, you may
experience certain changes that increase your chances for falling and
breaking a bone. These changes include loss of the ability to move
easily, poor eyesight, and dizziness caused by illness or medications.
Even a minor fall can break a bone already weakened by osteoporosis.
There
are things you can do to reduce your risk of falling. Exercising
regularly and wearing low-heeled shoes with firm, non-slip soles may
help improve your balance. Having regular vision checks and wearing
glasses, if you need them, can improve eyesight. Ask your doctor if you
are taking any medications which might cause dizziness.
Many
older people break a wrist or hip by falling at home. You can avoid
falls by making your home a safer place. You can make your home safer in
several simple ways:
Lights:
- Night lights in hallways, bathrooms, and bedrooms
- Flashlight beside the bed
- Hallways, stairs, and rooms well lit
Floors:
- No throw rugs, or use rugs with non-slip backing
- Carpet edges tacked down
- Non-skid wax on floors
- No electrical cords in walkways
Stairs:
- Light switches at top and bottom of stairs
- Stairs covered with non-slip surface
- Sturdy handrails
Bathroom:
- Handrails beside bathtub, toilet, and in shower
- Bathtub with rubber mats for traction
Kitchen:
- Items within easy reach
- Stable step stool for reaching items on top shelves
http://www.orthop.washington.edu/osteoporosis