Osteoporosis Management
Q1. Does osteoporosis simply mean fragile bones?
Osteoporosis is characterised by the gradual loss of and decrease in bone density, resulting in an increased risk of bone fractures. Fractures caused by osteoporosis typically occur in the lumbar spine, hips and wrists. Bone fractures can have a severe impact on one’s life by way of acute back pain, nerve compression, etc., which adversely impair one’s mobility. Osteoporosis is far more than a score or fragile bones.
Q2. Are the elderly more likely to develop osteoporosis?
People reach their peak bone mass between the ages of about 25 and 30, after which there is a gradual decline. The older we get, the more bone loss occurs. Therefore, the elderly have a higher chance to develop osteoporosis. Bone loss speeds up after menopause in women. Apart from age and menopause in women, many other illnesses can cause secondary osteoporosis, including endocrine disorders such as diabetes mellitus, hyperthyroidism, or Cushing's syndrome, which is caused by excessive cortisol. Certain rheumatic diseases like rheumatoid arthritis can also increase the risk of developing osteoporosis.
Q3. What types of medication can cause osteoporosis?
Many medications can lead to osteoporosis. The common ones like corticosteroids, immunosuppressants, chemotherapy and hormone therapy for breast and prostate cancer treatment, and gastric medications like proton pump inhibitors which reduce calcium absorption and thus can lead to osteoporosis.
Q4. How can I know if I have osteoporosis?
Dual-Energy X-ray Absorptiometry (DXA) scan is a simple and standard diagnostic test for the diagnosis of osteoporosis. It is more like X-ray examination and is mainly used for lumbar spine and hip assessment with a scale called “T-score”. A T-score below –2.5 indicates the presence of osteoporosis.
Q5. Should osteoporosis patients cut back on exercise to avoid falls and injuries?
Absolutely not. Osteoporosis patients should do more resistance training while avoiding falls and injuries. Walking is recommended for the elderly as the ideal exercise. Tai Chi is another good choice. It helps enhance balance and muscle strength, thereby reducing the risk of falls. Doing squats with small dumbbells can also improve hip bone density.
Q6. How to manage osteoporosis?
To manage osteoporosis, one must avoid unhealthy habits such as smoking, alcohol consumption, and excessive caffeine intake. A daily intake of 1,000 to 1,200mg of calcium is also recommended. Also important is vitamin D, as one should take a minimum of 800IU to 1,000IU per day. Currently, there are many different osteoporosis medications, such as bone-building drugs, antiresorptive drugs for preventing bone loss, and those with both functions. These medications can be taken orally or administered through injections. Patients diagnosed to have osteoporosis should consult their doctors for the most appropriate medications.
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