Affecting nearly 55 million people in North America alone, osteoporosis is among the most common chronic musculoskeletal disorders in the US and worldwide. This condition causes the bones to become brittle and weak, exposing patients to fractures and disability.
Osteoporosis is a “silent” disorder, meaning that its symptoms are not immediately noticeable or outwardly visible, making this condition difficult to diagnose and treat. In turn, you may only receive a diagnosis after a fracture or when your bone structure has been irreversibly compromised.
But you no longer need to live with chronic pain, endure the side effects of medications, and deal with recurring fractures. With adequate lifestyle changes Neurofunctional Pain Management, you can regain control over your health without medications or invasive procedures. Learn more below.
The word “osteoporosis” derives from the Greek terms for bone (“osteon”) and small opening passageway (“poros”). This medical term describes a condition that causes the bones to lose mass and become brittle and weak.
To understand how osteoporosis develops, it is important to clarify that the bones are not static but dynamic and living bodies that change constantly and undergo what’s known as “bone metabolism.”
Bone comprises minerals (i.e., calcium) that are kept together by collagen fibers and protected by an outer shell known as cortical bone. At a microscopic level, this structure gives bones a honeycomb-like appearance, which allows them to remain strong and flexible.
The active tissue that composes the bone continuously changes and renews itself throughout life. Cells known as osteoclasts proceed to break down old tissue and regulate the rate at which bone mass is lost.At the same time, cells known as osteoblasts produce new bone material.
The speed at which bone is formed and broken down (resorption) changes throughout life:
Nonetheless, in some people, the rate at which bone mass and minerals break down is much faster than the rate at which it is replaced.
This causes the bones to lose density and the holes in the “honeycomb” to become much larger. In turn, this translates into bones that are brittle, more fragile, and prone to fracture. In people with osteoporosis, a broken bone can be caused by minimal stress, such as coughing or bending.
This disease develops without symptoms, and most patients only receive a diagnosis of osteoporosis when looking into the causes of a bone fracture.
Every year, osteoporosis causes over 2 million broken bones, but 80% of patients are not screened for this disease. However, learning more about this bone condition and finding adequate treatment is essential to safeguard your musculoskeletal health. Learn more below.
Although osteoporosis is more common in aging individuals, this condition can affect anyone. There are different types of osteoporosis, depending on the symptoms it causes and the demographic it affects. Let’s look at them below.
Primary osteoporosis is the most common form of this condition. Primary osteoporosis is subdivided into senile osteoporosis and menopausal osteoporosis, depending on whether it is triggered by age-related bone mass loss or hormonal changes (such as those occurring during menopause). It is estimated that 1 in 2 postmenopausal women may have osteoporosis to some extent.
If the cause of primary osteoporosis is unknown, this condition is known as idiopathic osteoporosis.
A person’s bone mass throughout life determines the risk of developing primary osteoporosis in later life. Still, factors such as diet, health, physical exercise, and lifestyle may also have an impact. Primary osteoporosis is commonly diagnosed in individuals aged 60 and over.
Secondary osteoporosis is a severe and progressive loss of bone mass caused by another underlying disease. It can occur at any age. Medical conditions that can cause secondary osteoporosis include leukemia and hormonal disorders such as hyperthyroidism.
Some medications can also speed up the loss of bone density. These include high-dose corticosteroids (when taken regularly, orally or inhaled), hormone replacements, and some cancer drugs.
Also known as brittle bone disease, osteogenesis imperfecta is a rare genetic or heritable disease that causes bones to break easily and without obvious cause. This condition is often seen in newborns and can lead to severe complications, including a shortened lifespan. Only around 1 in 20,000 people is affected by osteogenesis imperfecta.
Idiopathic juvenile osteoporosis is a rare condition that affects children and young adults, usually within the development period (8-14 years old). Although it is more common in individuals with a history of being overweight in childhood, there is no known cause or cure for this disease.
Any bone in the body may be affected by osteoporosis, which can start anywhere and not cause fractures for several years. However, some bones are more prone to breaking than others.
In particular, osteoporotic fractures tend to occur in the wrists, hips, spinal bones (vertebrae), and knee. These bones or joints are usually load-bearing or exposed to constant stress, which makes them more likely to break.
If you experience a fracture in any of these bones, your doctor may prescribe a diagnostic test to assess your bone mass density and identify the signs of osteoporosis.
As seen above, osteoporosis is known to be a “silent” disease. Since it does not cause pain or discomfort, most patients only find out about their condition through tests performed after breaking a bone.
However, being aware of some of the telltale signs of osteoporosis may help you prevent a fracture and obtain a timely diagnosis. Let’s look at these signs below.
Fractures are the main symptom of osteoporosis. Osteoporotic fractures can occur spontaneously (without a cause) or as a consequence of minor and normal stresses. If you suffer from osteoporosis, you may experience a fracture due to a minor fall, when coughing, or during lifting and bending motions.
Despite the efforts of the U.S. Preventive Services Task Force to increase the rate of screening tests, under 13% of patients considered to be at high risk of osteoporosis (i.e.: aging adults and menopausal women) are tested for low mineral density before a bone is broken.
Osteoporotic fractures are also the main cause of all other symptoms of osteoporosis, which we’ll see below.
When osteoporosis affects the bones of the spine, the vertebrae become weaker and compressed. This can lead to severe and chronic back pain, as well as reduced spinal flexibility. You may also suffer back pain if you have suffered a fracture in your spinal bones.
Changes in the bone structure of the spine translate to abnormalities in your posture. Compression of the vertebrae, combined with the effects of gravity, may cause you to assume a stopped or hunched posture, which is known as “dowager’s hump” or kyphosis.
Poor posture can lead to a cascade of complications, including alteration of vertebral mechanics, low back pain, and reduced flexibility. What’s more, an abnormal curvature of the spine may reduce your lung capacity and lead to shortness of breath.
Spine problems can also be complications of osteoporotic fractures in the vertebrae.
As the vertebrae in the spine or the hip bones lose density and compress, they become weaker and prone to collapse. This, coupled with the hunched posture caused by osteoporosis, can cause a loss of height (usually 0.5-2 inches).
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Osteoporosis occurs when bone minerals break down faster than they are replaced. This causes the “holes” in the honeycomb-like structure of the bone to become larger and more frequent, which can compromise the stability and strength of the bone structure as a whole.
Although this process is well-understood by doctors and physicians, the reasons why some people lose more bone density than others are not always clear.
Certainly, age plays a critical role: even in healthy individuals, 10% of bone mass is lost each decade after turning 40. However, some other factors may contribute to increasing your risk of developing osteoporosis. Let’s look at these factors below.
Calcium is the primary component of the bones, and it plays a critical role in maintaining the bones’ health, strength, and density. On the other hand, Vitamin D is the compound that allows the body to absorb and use calcium. A lack of either of these two components can increase your risk of developing osteoporosis.
Some factors that can lead to a lack of calcium or Vitamin D include:
Hormonal changes can impact bone density and health. If you have too little or too much of certain hormones, you may be at greater risk of osteoporosis.
These hormones include the following:
Menopause represents a major risk factor for women because, during this health event, estrogen levels drop suddenly.
Leading a sedentary lifestyle can lead to a cascade of musculoskeletal disorders, including osteoporosis. This is because your body will compensate for a reduced muscle mass by unloading weight, stress, and shock onto the skeleton, which can result in loss of bone mass.
Practicing sports, performing weight-bearing exercises, and engaging in activities like running, walking, and dancing can restore balance and strength, thus easing the pressure on bones.
Some genetic and hereditary factors may contribute to your risk of developing osteoporosis:
Other causes of osteoporosis include:
Statistics show that up to 50% of patients taking glucocorticoid (a type of steroid hormone) regularly may develop osteoporosis.
When left unaddressed, osteoporosis can lead to a cascade of consequences. These include:
If you are affected by regular fractures to the spine and hip, you may also experience a significant loss of work days, chronic pain, disability, and financial challenges. According to a study conducted in 2021, menopausal women, even if insured, faced the following costs in the three years after an osteoporotic fracture:
While these complications may significantly affect your life, they can easily be prevented by obtaining an accurate diagnosis of osteoporosis early on. Let’s look at how below.
Although osteoporosis is difficult to identify until a bone is broken, there are diagnostic tests that can provide patients with an accurate diagnosis of their condition. Let’s look at the methods that a doctor may use to determine your bone density:
If you believe that you are at risk of osteoporosis, it is important to consult your healthcare provider and undergo the necessary tests. Despite the guidelines provided by the U.S. Preventive Services Task Force, at-risk patients are seldom tested for this condition. As shown by a 2022 study, only 20% of at-risk women were screened for osteoporosis 2 years before a fracture.
Osteoporosis can be a life-limiting condition for which there is no definitive cure. However, if your bone density levels are still acceptable, your doctor may recommend a conservative line of treatment to prevent or reduce the symptoms of osteoporosis. These treatments often involve bed rest, lifestyle changes, and anti-osteoporosis medications.
Let’s look at these options in more detail below.
Prolonged bed rest and immobilization are some of the risk factors for osteoporosis. This occurs in individuals who have suffered a stroke or serious illness and are therefore unable to practice activities that promote bone health (i.e. weight-bearing exercises).
However, in some cases, bed rest may benefit people with complications of osteoporosis. According to new studies, a period of bed rest and immobilization following an osteoporotic vertebral fracture (a broken bone in the spine) can help the weakened bone regain stability. It is important that bed rest is supervised by a specialist and coupled with rehabilitation exercises.
If you have osteoporosis but are not recovering from a fracture, your healthcare provider will take into account factors such as your gender, age, and health. They may also recommend lifestyle changes, such as:
You may also need to take measures to prevent falls and injuries, which may easily lead to bone fractures.
Depending on how much bone mass you have lost, as well as on your gender and family history, your doctor may recommend a pharmacological treatment for osteoporosis.
When taking medications for this condition, it is important to keep in mind that drugs come with severe side effects, including joint pain, gastric ulcers, and gastrointestinal problems like nausea and heartburn.
Additionally, medications alone are unlikely to yield the expected results: you’ll still need to improve your overall lifestyle, adjust your diet, and avoid nutritional deficiencies.
Here are some of the most common medications prescribed for osteoporosis:
Weight-bearing exercises, as well as strength and resistance training, are essential to bone health at all stages of life. During childhood and adolescence, these exercises can support the building of bone mass and reduce the risk of osteoporosis later in life.
After peak bone mass is reached – usually in your late 20s – exercise no longer increases bone mass. However, it can still support the musculoskeletal system by boosting muscle strength, improving balance and coordination, reducing the risk of falls, and safeguarding the supply of oxygen and nutrients to bone tissues.
If you have osteoporosis or are recovering from an osteoporotic fracture, it is important to work with a specialized physical therapist who can recommend the best exercises to strengthen your musculoskeletal system and teach you how to exercise safely or reduce the risk of injuries.
Most osteoporotic fractures can be treated in A&E or by wearing a cast. However, if you have experienced a severe osteoporotic fracture that needs to be manipulated, you may need to undergo surgery.
Here are the types of surgical interventions available.
Spinal fractures caused by osteoporosis are the most common type of fractures requiring surgery. They occur when the bones in the spine weaken and collapse, thus compressing the spine.
Vertebroplasty and kyphoplasty are two surgical techniques that involve injecting orthopedic cement into the bone. This aims to restore spine height and correct posture problems caused by the collapse of one or more vertebrae (i.e. dowager’s hump/ kyphosis).
In vertebroplasty, the cement is injected directly into the fractured site, while kyphoplasty procedures use a medical device to decompress the bones and create space, before filling this newly-created void with cement.
Although these surgical procedures are sometimes necessary and often successful, they are not free of side effects. Some of the most common complications of vertebroplasty and kyphoplasty include:
Spinal fusion is a major and invasive surgical procedure used to permanently bind the vertebrae together using screws, rods, and bone grafts. This procedure may provide support to compromised spinal bones in people with osteoporosis and can be used to correct posture problems such as kyphosis.
Some of the complications associated with spinal fusion procedures include:
Joint replacement surgery – or arthroplasty – is a surgical procedure used to restore the function of compromised joints. During this procedure, artificial joint components made of plastic or metal are used to replace bones and cartilage. Common sites where joint replacement surgery is performed include the hips and knees.
Arthroplasty may come with severe side effects, including:
Osteoporosis is a lifelong condition, for which there is no permanent cure. Often, the treatment option recommended by your doctor will depend on your risk of breaking a bone within the next 10 years. This means that, for many, relying on medications and enduring chronic pain may seem to appear as the only options.
However, alternative treatment programs that don’t involve medications or surgery are available. With the right education and guidance, you can find treatment plans that can slow down the progress of osteoporosis, strengthen your musculoskeletal system as a whole, and magnify your quality of life.
Here are some of the therapies combined in Neurofunctional Pain Management® offered by Neuragenex:
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Some risk factors for osteoporosis – such as genetics and sex – cannot be modified. However, there is a lot that you can do throughout your life to reduce the risk of developing low bone mass density.
Working with a specialized lifestyle counselor and nutritionist can help you understand how to lower the risk of developing osteoporosis.
For most patients, osteoporosis is a lifelong condition that impacts all aspects of their lives. However, taking medications daily, enduring the side effects of pharmacological therapies, or living in fear of having to undergo surgery are no longer the only options to manage your condition.
With Neurofunctional Pain Management offered exclusively at Neuragenex, you can regain control over your bone health without medications or surgery.
We take great pride in the wealth of talent and expertise that our providers have as they improve the health outcomes of our patients, each and every day.
Dr. Victor Osisanya is Board Certified in Physical Medicine and Rehabilitation. He earned his undergraduate degree from the University of Michigan in Ann Arbor and his medical degree from Chicago Medical School. Upon completion of...
Ashley Locus is a Board-Certified Nurse Practitioner who began her career in healthcare as a registered nurse in 2013, working in a diverse array of healthcare settings including the emergency department, critical care, case management,...
Dipa is a double board-certified Nurse Practitioner in Family as well as Adult-Gerontology Acute Care. She graduated with her Bachelor’s in Nursing from Mercer University in Macon, GA and her Master’s in Nursing from Columbia...
Emma Henigman is a Board-Certified Family Nurse Practitioner. She received her Bachelor of Science in Nursing from Lakeview College of Nursing and then her Master of Science in Nursing at Olivet Nazarene University. Emma started...
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Neuragenex provides advanced treatments to reduce fractures and associated pain. Schedule a consultation today!