Osteoporosis is a condition that has virtually no symptoms until severe bone damage has already occurred. Once the bones have been weakened by bone density loss, symptoms may include:
- Back pain
- Loss of height over time with stooped posture
- Fractures of the vertebrae, wrists, hips or other bones
Without treatment, a person with osteoporosis is likely to have fractures, most often in the spine or hips (which support the body's weight) or in the wrists from bracing against a fall. Fractures of the spine can happen even without a fall or an injury. The bones of the spine become so weak that they start to compress. These types of fractures can cause severe pain and require a long recovery period. They also cause a loss of height and stooped posture.
Hip fractures, the second most common type of fracture due to osteoporosis, usually result from a fall. Although most people do relatively well with modern surgical treatment, hip fractures can result in disability and even death from postoperative complications.
Causes and Risk Factors
The strength of the bones depends on their size and density. Bone strength ultimately depends on how much calcium, phosphorus and other minerals they contain. Bone density loss can occur for a variety of reasons, including:
- Endocrine imbalances
- Not getting enough vitamin D and calcium in the diet
- Falling estrogen levels associated with menopause. Women who have reached menopause lose bone at a rate of one to three percent a year. While this slows down around the age of 60, it doesn't stop entirely. Older women may have lost between a third to a half of their bone mass, while men may lose between 20 and 35%.
The chance of developing osteoporosis increases for those who:
- Are sedentary. Exercising regularly can help ensure that your bones stay strong throughout your life.
- Are a woman. Twice as many women have bone fractures from osteoporosis as men. This happens because women are smaller and have less bone mass to begin with and because they tend to live longer. Menopause also causes bone loss to accelerate.
- Are a man with low levels of testosterone
- Have a family history of osteoporosis
- Are older
- Are slender and small framed
- Smoke or use tobacco
- Take certain diuretics (furosemide [Lasix], bumetanide [Bumex], ethacrynic acid [Edecrin] and torsemide [Demadex]), which cause your body to excrete fluids. This can lead to a loss of calcium.
- Take corticosteroid drugs, such as prednisone, cortisone, prednisolone and dexamethasone on a long-term basis. These drugs are commonly used to treat asthma, rheumatoid arthritis and psoriasis. If you need to take a steroid medication for long periods, your doctor may monitor your bone density and recommend other drugs to help prevent bone loss.
- Take the blood-thinning drug heparin, methotrexate, some antiseizure drugs and aluminum-contain antacids
- Are Caucasian or Southeast Asian. African Americans have the lowest risk of osteoporosis; Hispanics and Native Americans appear to have an intermediate risk.
- Have short-term exposure to estrogen. Risks are higher for women who began menstruating at a later than average age and who had an earlier than average menopause. Risks are also higher for women who have had their ovaries surgically removed before age 45 without receiving hormone replacement therapy (HRT).
- Have an overactive thyroid (hyperthyroidism) or take too much thyroid hormone medication to treat an underactive thyroid (hypothyroidism)
- Have had certain medical conditions or procedures that decrease calcium absorption. These include stomach surgery, Crohn's disease, anorexia nervosa or Cushing's disease (a rare disorder in which the adrenal glands produce too much corticosteroid hormones).
- Drink too much alcohol on a regular basis, which interferes with your body's ability to absorb calcium. For men, alcoholism is one of the highest risk factors for osteoporosis.
- Are depressed. Recent studies show that women who experience depression have increased rates of bone loss.