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==Overview==
==Overview==
Osteoporosis is the thinning of bone tissue and loss of bone density over time.
[[Osteoporosis]] is the thinning of [[bone]] [[tissue]] and loss of [[bone density]] over time.


==What are the symptoms of Osteoporosis?==
==What are the symptoms of osteoporosis?==
There are no symptoms in the early stages of the disease.
There are no [[symptoms]] in the early stages of the [[disease]]. [[Symptoms]] occurring late in the [[disease]] include:


Symptoms occurring late in the disease include:
* [[Bone pain]] or [[tenderness]]
* [[Fractures]] with little or no [[trauma]]
* Loss of height (as much as 6 inches) over time
* [[Low back pain]] due to [[fractures]] of the [[Vertebrae|spinal bones]]
* [[Neck]] pain due to [[fractures]] of the [[Vertebrae|spinal bones]]
* Stooped [[posture]] or [[kyphosis]], also called a "dowager's hump"


* Bone pain or tenderness
==What causes osteoporosis?==
* Fractures with little or no trauma
* [[Osteoporosis]] is the most common type of [[bone]] [[disease]]. Researchers estimate that about 1 out of 5 American women over the age of 50 have [[osteoporosis]]. About half of all women over the age of 50 will have a [[fracture]] of the [[hip]], [[wrist]], or [[vertebra]] (bones of the [[spine]]). [[Osteoporosis]] occurs when the body fails to form enough new [[bone]], when too much old [[bone]] is reabsorbed by the body or both.
* Loss of height (as much as 6 inches) over time* Low back pain due to fractures of the spinal bones
* Neck pain due to fractures of the spinal bones
* Stooped posture or kyphosis, also called a "dowager's hump"


==What causes Osteoporosis?==
* [[Calcium]] and [[phosphate]] are two [[minerals]] that are essential for normal [[bone]] formation. Throughout youth, your body uses these [[minerals]] to produce [[bones]]. If you do not get enough [[calcium]], or if your [[body]] does not absorb enough [[calcium]] from the [[diet]], [[bone]] production and [[bone]] [[tissues]] may suffer.
Osteoporosis is the most common type of bone disease. Researchers estimate that about 1 out of 5 American women over the age of 50 have osteoporosis. About half of all women over the age of 50 will have a fracture of the hip, wrist, or vertebra (bones of the spine). Osteoporosis occurs when the body fails to form enough new bone, when too much old bone is reabsorbed by the body, or both.


Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, your body uses these minerals to produce bones. If you do not get enough calcium, or if your body does not absorb enough calcium from the diet, bone production and bone tissues may suffer.
* As you age, [[calcium]] and [[phosphate]] may be reabsorbed back into the body from the [[bones]], which makes the [[bone]] tissue weaker. This can result in brittle, fragile [[bones]] that are more prone to [[fractures]], even without [[injury]]. Usually, the loss occurs gradually over years. Many times, a person will have a [[fracture]] before becoming aware that the [[disease]] is present. By the time a [[fracture]] occurs, the [[disease]] is in its advanced stages and damage is severe. The leading causes of [[osteoporosis]] are a drop in [[estrogen]] in women at the time of [[menopause]] and a drop in [[testosterone]] in men. Women over age 50 and men over age 70 have a higher risk for [[osteoporosis]].


As you age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bone tissue weaker. This can result in brittle, fragile bones that are more prone to fractures, even without injury. Usually, the loss occurs gradually over years. Many times, a person will have a fracture before becoming aware that the disease is present. By the time a fracture occurs, the disease is in its advanced stages and damage is severe. The leading causes of osteoporosis are a drop in estrogen in women at the time of menopause and a drop in testosterone in men. Women over age 50 and men over age 70 have a higher risk for osteoporosis.
* Other causes include:
 
** Being confined to a bed
Other causes include:
** Chronic [[rheumatoid arthritis]], [[chronic kidney disease]], [[eating disorders]]
 
** Taking [[corticosteroid]] medications ([[prednisone]], [[methylprednisolone]]) every day for more than 3 months, or taking some [[Anticonvulsant|antiseizure]] drugs
* Being confined to a bed
** [[Hyperparathyroidism]]
* Chronic rheumatoid arthritis, chronic kidney disease, eating disorders
** [[Vitamin D deficiency]]
* Taking corticosteroid medications (prednisone, methylprednisolone) every day for more than 3 months, or taking some antiseizure drugs
* Hyperparathyroidism
* Vitamin D deficiency
 
White women, especially those with a family history of osteoporosis, have a greater than average risk of developing osteoporosis. Other risk factors include:
 
* Absence of menstrual periods (amenorrhea) for long periods of time
* Drinking a large amount of alcohol
* Family history of osteoporosis
* History of hormone treatment for prostate cancer or breast cancer
* Low body weight
* Smoking
* Too little calcium in the diet


==Who is at highest risk?==
==Who is at highest risk?==
White women, especially those with a family history of [[osteoporosis]], have a greater than average risk of developing [[osteoporosis]]. Other risk factors include:


* Absence of [[menstrual periods]] ([[amenorrhea]]) for long periods of time
* Drinking a large amount of [[alcohol]]
* [[Family history]] of [[osteoporosis]]
* [[History & Symptoms|History]] of [[hormone]] treatment for [[prostate cancer]] or [[breast cancer]]
* Low [[body weight]]
* [[Smoking]]
* Too little [[calcium]] in the [[diet]]


==Diagnosis==
==Diagnosis==
Bone mineral density testing (specifically a densitometry or DEXA scan) measures how much bone you have. Your health care provider uses this test to predict your risk for bone fractures in the future. For information about when testing should be done, see bone density test.
* [[Bone mineral density]] testing (specifically a [[densitometry]] or [[DEXA scan|DEXA]] scan) measures how much [[bone]] you have. Your health care provider uses this test to predict your risk for [[bone fractures]] in the future. For information about when testing should be done, see the [[bone density]] test.
 
* A special type of [[spine]] [[Computed tomography|CT]] that can show loss of [[bone mineral density]], quantitative [[computed tomography]] (QCT), may be used in rare cases.
A special type of spine CT that can show loss of bone mineral density, quantitative computed tomography (QCT), may be used in rare cases.
* In severe cases, a [[spine]] or [[hip]] [[X-ray]] may show [[fracture]] or collapse of the [[Vertebra|spinal bones]]. However, simple [[X-rays]] of [[bones]] are not very accurate in predicting whether someone is likely to have [[osteoporosis]].
 
* You may need other [[blood]] and [[Urinalysis|urine tests]] if your [[osteoporosis]] is thought to be due to a medical condition, rather than simply the usual [[bone loss]] seen with older age.
In severe cases, a spine or hip x-ray may show fracture or collapse of the spinal bones. However, simple x-rays of bones are not very accurate in predicting whether someone is likely to have osteoporosis.
 
You may need other blood and urine tests if your osteoporosis is thought to be due to a medical condition, rather than simply the usual bone loss seen with older age.


==When to seek urgent medical care?==
== When to seek urgent medical care? ==
Call your health care provider if you have symptoms of osteoporosis or if you wish to be screened for the condition.
* Call your [[health care provider]] if you have symptoms of [[osteoporosis]] or if you wish to be [[Screening (medicine)|screened]] for the condition.


==Treatment options==
==Treatment options==
The goals of osteoporosis treatment are to:
There are several different treatments for [[osteoporosis]], including lifestyle changes and a variety of medications. The goals of [[osteoporosis]] treatment are to:
 
* Control pain from the disease
* Slow down or stop bone loss
* Prevent bone fractures with medicines that strengthen bone
* Minimize the risk of falls that might cause fractures
 
There are several different treatments for osteoporosis, including lifestyle changes and a variety of medications.
 
Medications are used to strengthen bones when:


Osteoporosis has been diagnosed by a bone density study.
* Control [[pain]] from the [[disease]]
Osteopenia (thin bones, but not osteoporosis) has been diagnosed by a bone density study, if a bone fracture has occurred.
* Slow down or stop [[bone loss]]
* Prevent [[bone fractures]] with medicines that strengthen [[bone]]
* Minimize the risk of falls that might cause [[fractures]]


BISPHOSPHONATES
[[Medications]] are used to strengthen [[bones]] when:
* Bisphosphonates are the primary drugs used to both prevent and treat osteoporosis in postmenopausal women.
* Bisphosphonates taken by mouth include alendronate (Fosamax), ibandronate (Boniva), and risedronate (Actonel). Most are taken by mouth, usually once a week or once a month.
* Bisphosphonates given through a vein (intravenously) are taken less often.


CALCITONIN
* [[Osteoporosis]] has been diagnosed by a [[bone density]] study.
* [[Osteopenia]] (thin [[bones]], but not [[osteoporosis]]) has been diagnosed by a [[bone density]] study, if a bone [[fracture]] has occurred.


* Calcitonin is a medicine that slows the rate of bone loss and relieves bone pain. It comes as a nasal spray or injection. The main side effects are nasal irritation from the spray form and nausea from the injectable form.
''BISPHOSPHONATES''
* Calcitonin appears to be less effective than bisphosphonates.
* [[Bisphosphonates]] are the primary drugs used to both prevent and treat [[osteoporosis]] in [[postmenopausal]] women.
* [[Bisphosphonates]] taken by mouth include [[alendronate]] (Fosamax), [[ibandronate]] (Boniva), and [[risedronate]] (Actonel). Most are taken by mouth, usually once a week or once a month.
* [[Bisphosphonates]] given through a [[vein]] ([[intravenously]]) are taken less often.


HORMONE REPLACEMENT THERAPY
''CALCITONIN''
* [[Calcitonin]] is a [[medicine]] that slows the rate of [[bone loss]] and relieves [[bone pain]]. It comes as a [[nasal spray]] or injection. The main side effects are nasal irritation from the spray form and [[nausea]] from the [[Injection (medicine)|injectable]] form.
* [[Calcitonin]] appears to be less effective than [[bisphosphonates]].


* Estrogens or hormone replacement therapy (HRT) is rarely used anymore to prevent osteoporosis and are not approved to treat a woman who has already been diagnosed with the condition.
''HORMONE REPLACEMENT THERAPY''
* Sometimes, if estrogen has helped a woman, and she cannot take other options for preventing or treating osteoporosis, the doctor may recommend that she continue using hormone therapy. If you are considering taking hormone therapy to prevent osteoporosis, discuss the risks with your doctor.
* [[Estrogens]] or [[Hormone replacement therapy|hormone replacement therapy (HRT)]] is rarely used anymore to prevent [[osteoporosis]] and are not approved to treat a woman who has already been diagnosed with the condition.
* Sometimes, if [[estrogen]] has helped a woman, and she cannot take other options for preventing or treating [[osteoporosis]], the doctor may recommend that she continue using [[hormone]] therapy. If you are considering taking [[hormone]] therapy to prevent [[osteoporosis]], discuss the risks with your doctor.


PARATHYROID HORMONE
''PARATHYROID HORMONE''
* [[Teriparatide]] (Forteo) is approved for the treatment of [[postmenopausal]] women who have severe [[osteoporosis]] and are considered at high risk for [[fractures]]. The medicine is given through daily shots underneath the [[skin]]. You can give yourself the shots at home.


* Teriparatide (Forteo) is approved for the treatment of postmenopausal women who have severe osteoporosis and are considered at high risk for fractures. The medicine is given through daily shots underneath the skin. You can give yourself the shots at home.
''RALOXIFENE''
 
* [[Raloxifene]] (Evista) is used for the prevention and treatment of [[osteoporosis]]. [[Raloxifene]] is similar to the [[breast cancer]] drug [[tamoxifen]]. [[Raloxifene]] can reduce the risk of [[Vertebral fracture|spinal fractures]] by almost 50%. However, it does not appear to prevent other [[fractures]], including those in the [[hip]]. It may have protective effects against [[heart disease]] and [[breast cancer]], though more studies are needed.
RALOXIFENE
* The most serious side effect of [[raloxifene]] is a very small risk of [[blood clots]] in the leg [[veins]] ([[Deep vein thrombosis|deep venous thrombosis]]) or in the [[lungs]] ([[pulmonary embolus]]).
 
* Raloxifene (Evista) is used for the prevention and treatment of osteoporosis. Raloxifene is similar to the breast cancer drug tamoxifen. Raloxifene can reduce the risk of spinal fractures by almost 50%. However, it does not appear to prevent other fractures, including those in the hip. It may have protective effects against heart disease and breast cancer, though more studies are needed.
* The most serious side effect of raloxifene is a very small risk of blood clots in the leg veins (deep venous thrombosis) or in the lungs (pulmonary embolus).


'''EXERCISE'''
'''EXERCISE'''


Regular exercise can reduce the likelihood of bone fractures in people with osteoporosis. Some of the recommended exercises include:
Regular [[Physical exercise|exercise]] can reduce the likelihood of [[bone fractures]] in people with [[osteoporosis]]. Some of the recommended [[Physical exercise|exercises]] include:


* Weight-bearing exercises -- walking, jogging, playing tennis, dancing
* Weight-bearing [[Physical exercise|exercises]] -- walking, jogging, playing tennis, dancing
* Resistance exercises -- free weights, weight machines, stretch bands
* Resistance [[exercises]] -- free weights, weight machines, stretch bands
* Balance exercises -- tai chi, yoga
* Balance [[exercises]] -- [[Tai chi]], [[yoga]]
* Riding a stationary bicycle
* Riding a stationary bicycle
* Using rowing machines
* Using rowing machines
* Avoid any exercise that presents a risk of falling, or high-impact exercises that may cause fractures.
* Avoid any [[exercise]] that presents a risk of falling, or high-impact [[exercises]] that may cause [[fractures]].


'''DIET'''
'''DIET'''


Get at least 1,200 milligrams per day of calcium and 800 - 1,000 international units of vitamin D3. Vitamin D helps your body absorb calcium.Your doctor may recommend a supplement to give you the calcium and vitamin D you need. Follow a diet that provides the proper amount of calcium, vitamin D, and protein. While this will not completely stop bone loss, it will guarantee that a supply of the materials the body uses to form and maintain bones is available.
Get at least 1,200 milligrams per day of [[calcium]] and 800 - 1,000 [[international units]] of [[vitamin D3]]. [[Vitamin D]] helps your body absorb [[calcium]]. Your doctor may recommend a supplement to give you the [[calcium]] and [[vitamin D]] you need. Follow a diet that provides the proper amount of [[calcium]], [[vitamin D]], and [[protein]]. While this will not completely stop [[bone loss]], it will guarantee that a supply of the materials the body uses to form and maintain [[bones]] is available.


High-calcium foods include:
High-[[calcium]] foods include:


* Cheese
* Cheese
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'''STOP UNHEALTHY HABITS'''
'''STOP UNHEALTHY HABITS'''


Quit smoking, if you smoke. Also limit alcohol intake. Too much alcohol can damage your bones, as well as put you at risk for falling and breaking a bone.
Quit [[smoking]], if you smoke. Also, limit [[alcohol]] intake. Too much [[alcohol]] can damage your [[bones]], as well as put you at risk for falling and breaking a [[bone]].


'''PREVENT FALLS'''
'''PREVENT FALLS'''


It is critical to prevent falls. Avoid sedating medications and remove household hazards to reduce the risk of fractures. Make sure your vision is good. Other ways to prevent falling include:
It is critical to prevent falls. Avoid sedating [[medications]] and remove household hazards to reduce the risk of [[fractures]]. Make sure your [[vision]] is good. Other ways to prevent falling include:


* Avoiding walking alone on icy days
* Avoiding walking alone on icy days
Line 138: Line 126:
'''MONITORING'''
'''MONITORING'''


Your response to treatment can be monitored with a series of bone mineral density measurements taken every 1 - 2 years. Women taking estrogen should have routine mammograms, pelvic exams, and Pap smears.
Your response to treatment can be monitored with a series of [[bone mineral density]] measurements taken every 1 - 2 years. Women taking [[estrogen]] should have routine [[Mammogram|mammograms]], [[Pelvic exam|pelvic exams]], and [[Pap smear|Pap smears]].


'''RELATED SURGERIES'''
'''RELATED SURGERIES'''


There are no surgeries for treating osteoporosis itself. However, a procedure called vertebroplasty can be used to treat any small fractures in your spinal column due to osteoporosis. It can also help prevent weak vertebrae from becoming fractured by strengthening the bones in your spinal column.
There are no [[surgeries]] for treating [[osteoporosis]] itself. However, a procedure called [[vertebroplasty]] can be used to treat any small [[fractures]] in your [[spinal column]] due to [[osteoporosis]]. It can also help prevent weak [[vertebrae]] from becoming [[Bone fracture|fractured]] by strengthening the [[bones]] in your [[spinal column]]. The procedure involves [[Injection|injecting]] a fast-hardening glue into the areas that are [[Fractures|fractured]] or weak. A similar procedure called [[kyphoplasty]], uses balloons to widen the spaces that need the glue. The balloons are removed during the procedure.


The procedure involves injecting a fast-hardening glue into the areas that are fractured or weak. A similar procedure, called kyphoplasty, uses balloons to widen the spaces that need the glue. (The balloons are removed during the procedure.)
==Where to find medical care for osteoporosis?==
[http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Osteoporosis}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wl Directions to Hospitals Treating Osteoporosis]


==Diseases with similar symptoms==
==What to expect (outlook/prognosis)?==
[[Medications]] to treat [[osteoporosis]] can help prevent [[fractures]], but [[vertebrae]] that have already collapsed cannot be reversed. Some persons with [[osteoporosis]] become severely disabled as a result of weakened [[bones]]. [[Hip fractures]] leave about half of the patients unable to walk independently. This is one of the major reasons people are admitted to [[nursing homes]]. Although [[osteoporosis]] is debilitating, it does not affect [[life expectancy]].


==Possible complications==
* Compression [[fractures]] of the [[spine]]
* Disability caused by severely weakened [[bones]]
* [[Hip fracture|Hip]] and [[Wrist fracture|wrist fractures]]
* Loss of ability to walk due to [[hip fractures]]


==Where to find medical care for Osteoporosis?==
==Prevention of osteoporosis==
[[Calcium]] is essential for building and maintaining healthy [[bone]]. [[Vitamin D]] is also needed because it helps your body absorb [[calcium]]. Following a healthy, well-balanced [[diet]] can help you get these and other important nutrients throughout life.


Other tips for prevention:


==What to expect (Outlook/Prognosis)?==
* Avoid drinking excess [[alcohol]]
* Do not [[smoke]]
* Get regular [[exercise]]


A number of [[medications]] are approved for the prevention of [[osteoporosis]].


==Possible complications==
==Sources==
http://www.nlm.nih.gov/medlineplus/ency/article/000360.htm


​
​


{{WH}}
[[Category:Medicine]]
{{WS}}
[[Category:Endocrinology]]
[[Category:Up-To-Date]]

Latest revision as of 23:28, 29 July 2020

Osteoporosis

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

When to seek urgent medical care?

Diagnosis

Treatment options

Where to find medical care for Osteoporosis?

What to expect (Outlook/Prognosis)?

Possible complications

Prevention of Osteoporosis

Osteoporosis On the Web

Ongoing Trials at Clinical Trials.gov

Images of Osteoporosis

Videos on Osteoporosis

FDA on Osteoporosis

CDC on Osteoporosis

Osteoporosis in the news

Blogs on Osteoporosis

Directions to Hospitals Treating Osteoporosis

Risk calculators and risk factors for Osteoporosis

For the WikiDoc page for this topic, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Osteoporosis is the thinning of bone tissue and loss of bone density over time.

What are the symptoms of osteoporosis?

There are no symptoms in the early stages of the disease. Symptoms occurring late in the disease include:

What causes osteoporosis?

  • As you age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bone tissue weaker. This can result in brittle, fragile bones that are more prone to fractures, even without injury. Usually, the loss occurs gradually over years. Many times, a person will have a fracture before becoming aware that the disease is present. By the time a fracture occurs, the disease is in its advanced stages and damage is severe. The leading causes of osteoporosis are a drop in estrogen in women at the time of menopause and a drop in testosterone in men. Women over age 50 and men over age 70 have a higher risk for osteoporosis.

Who is at highest risk?

White women, especially those with a family history of osteoporosis, have a greater than average risk of developing osteoporosis. Other risk factors include:

Diagnosis

When to seek urgent medical care?

Treatment options

There are several different treatments for osteoporosis, including lifestyle changes and a variety of medications. The goals of osteoporosis treatment are to:

Medications are used to strengthen bones when:

BISPHOSPHONATES

CALCITONIN

HORMONE REPLACEMENT THERAPY

PARATHYROID HORMONE

  • Teriparatide (Forteo) is approved for the treatment of postmenopausal women who have severe osteoporosis and are considered at high risk for fractures. The medicine is given through daily shots underneath the skin. You can give yourself the shots at home.

RALOXIFENE

EXERCISE

Regular exercise can reduce the likelihood of bone fractures in people with osteoporosis. Some of the recommended exercises include:

  • Weight-bearing exercises -- walking, jogging, playing tennis, dancing
  • Resistance exercises -- free weights, weight machines, stretch bands
  • Balance exercises -- Tai chi, yoga
  • Riding a stationary bicycle
  • Using rowing machines
  • Avoid any exercise that presents a risk of falling, or high-impact exercises that may cause fractures.

DIET

Get at least 1,200 milligrams per day of calcium and 800 - 1,000 international units of vitamin D3. Vitamin D helps your body absorb calcium. Your doctor may recommend a supplement to give you the calcium and vitamin D you need. Follow a diet that provides the proper amount of calcium, vitamin D, and protein. While this will not completely stop bone loss, it will guarantee that a supply of the materials the body uses to form and maintain bones is available.

High-calcium foods include:

  • Cheese
  • Ice cream
  • Leafy green vegetables, such as spinach and collard greens
  • Low-fat milk
  • Salmon
  • Sardines (with the bones)
  • Tofu
  • Yogurt

STOP UNHEALTHY HABITS

Quit smoking, if you smoke. Also, limit alcohol intake. Too much alcohol can damage your bones, as well as put you at risk for falling and breaking a bone.

PREVENT FALLS

It is critical to prevent falls. Avoid sedating medications and remove household hazards to reduce the risk of fractures. Make sure your vision is good. Other ways to prevent falling include:

  • Avoiding walking alone on icy days
  • Using bars in the bathtub, when needed
  • Wearing well-fitting shoes

MONITORING

Your response to treatment can be monitored with a series of bone mineral density measurements taken every 1 - 2 years. Women taking estrogen should have routine mammograms, pelvic exams, and Pap smears.

RELATED SURGERIES

There are no surgeries for treating osteoporosis itself. However, a procedure called vertebroplasty can be used to treat any small fractures in your spinal column due to osteoporosis. It can also help prevent weak vertebrae from becoming fractured by strengthening the bones in your spinal column. The procedure involves injecting a fast-hardening glue into the areas that are fractured or weak. A similar procedure called kyphoplasty, uses balloons to widen the spaces that need the glue. The balloons are removed during the procedure.

Where to find medical care for osteoporosis?

Directions to Hospitals Treating Osteoporosis

What to expect (outlook/prognosis)?

Medications to treat osteoporosis can help prevent fractures, but vertebrae that have already collapsed cannot be reversed. Some persons with osteoporosis become severely disabled as a result of weakened bones. Hip fractures leave about half of the patients unable to walk independently. This is one of the major reasons people are admitted to nursing homes. Although osteoporosis is debilitating, it does not affect life expectancy.

Possible complications

Prevention of osteoporosis

Calcium is essential for building and maintaining healthy bone. Vitamin D is also needed because it helps your body absorb calcium. Following a healthy, well-balanced diet can help you get these and other important nutrients throughout life.

Other tips for prevention:

A number of medications are approved for the prevention of osteoporosis.

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000360.htm

​ ​

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