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Osteoporosis and Hip Fractures

June 6, 2017 | Internal MedicineOsteoporosis Center

Bones in the body are just another form of bodily tissue—as elements break down, they’re replaced by natural processes. However, when the rate of new bone creation doesn’t match the rate at which old bone is removed, this is a condition called osteoporosis—a medical term equating to “porous bone.”

Osteoporosis leads to bones that become so weak and brittle that even minor stress to the bone can cause a fracture. Here is some basic info on osteoporosis symptoms, causes, treatments and prevention methods.

Symptoms

In the early stages of bone loss, there are typically no symptoms. Once the bones have weakened, however, symptoms can include:

 

  • Back pain caused by fractured or collapsed vertebrae
  • Stooped posture
  • Loss of height over time
  • A bone fracture that occurs more easily than you’d expect

 

If you went through early menopause, took corticosteroids for several months consecutively or if either of your parents had a history of hip fractures, you may want to speak to your doctor about the risk of osteoporosis for your particular case.

 

Causes and Risk Factors

There are no exact known causes of osteoporosis, but doctors understand the underlying development of the disease. During young adult ages, the body creates new bone faster than old bone breaks down, leading to a general increase in bone mass – most people reach this peak by their early 20s.

However, as we age, bone mass begins to be lost more quickly than it’s created—generally by age 35. This leads to a general loss of bone mass, and osteoporosis sufferers can experience this at an even greater rate.

There are several factors that increase risk of osteoporosis:

 

  • Gender: Women are more likely to develop osteoporosis than men, particularly women over 50 or past the stages of menopause.
  • Age: Risk increases with age.
  • Race: Caucasian and Asian women are more likely to develop osteoporosis, though African-American and Hispanic women are still at risk—African American women are more likely than white women to die after a hip fracture.
  • Family history: If parents or grandparents had any signs of osteoporosis, this increases risk.
  • Bone structure and weight: Smaller, thinner people have a greater risk of osteoporosis because they have less bone to lose than people with more weight and larger frames.
  • Nutrition: If the body lacks calcium or vitamin D, this increases risk.
  • Lifestyle: People who lead an inactive lifestyle are at higher risk.
  • Medications: Certain medications, such as steroids, breast cancer treatments and seizure medications, can cause side effects that damage bone and lead to osteoporosis.
  • Smoking
  • Alcohol: One to two drinks per day, or more, increases risk.
  • Medical conditions: If you have had any of the following, consider early screening for osteoporosis: Overactive thyroid, weight loss surgery, hormone treatment, eating disorders, organ transplan, celiac disease, inflammatory bowel disease, missed periods or blood diseases like multiple myeloma.

 

Diagnosis and Treatment

Osteoporosis is diagnosed using bone mineral density tests, or bone measurements, also called dual X-ray absorptiometry. These tests use small amounts of radiation to determine bone density. All women over 65 and men over 70 (or younger men with risk factors) should consider having this test done.

Treatment methods for osteoporosis include:

 

  • Weight-bearing exercise
  • Calcium and vitamin D supplements
  • Estrogen therapy
  • Bisphosphonates: The most widely prescribed medication
  • Selective estrogen receptor modulators
  • Parathyroid hormone
  • Biologic therapy

 

Prevention

Paying close attention to diet and lifestyle are just a few ways you can help control and prevent osteoporosis. Important diet areas include:

 

  • Calcium: Calcium helps maintain strong, healthy bones. This can be found through food, drink and supplements. The body can absorb about 500 mg of calcium at one time, so be wary here if you take supplements.
  • Vitamin D: Vitamin D allows the body to absorb calcium. It can be obtained by sunlight exposure a few times a week, or by drinking fortified milk. Ask your doctor for details about how to get more vitamin D or calcium in your diet.

 

Lifestyle elements of prevention include a regular exercise program—include exercises like walking, jogging, aerobics and weightlifting that make the bones work against gravity, as these will help strengthen the bones. Also look to limit use of alcohol and tobacco.

If you’re experiencing the symptoms of osteoporosis or carry the risk factors, your doctor will advise you on your options.

 

Dr. Carlson tends to be conservative with surgical treatment, and much of his training is in minimally-invasive procedures, such as arthroscopy. He believes everyone deserves a trial of a more conservative treatment before moving to more invasive treatments such as surgery. Dr. Carlson tries to spend time with patients to better understand their goals and work together to come up with a treatment plan based on those goals and their distinct medical history.

 

Sources:

“Osteoporosis.” Cleveland Clinic. https://my.clevelandclinic.org/health/articles/osteoporosis

“Osteoporosis.” The Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/osteoporosis/home/ovc-20207808

WRITTEN BY:

Michael Carlson, MD

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This information is not intended to replace the advice of a medical professional. You should always consult your doctor before making decisions about your health.