Osteoporosis

The cause of osteoporosis is an imbalance between bone resorption and bone formation. In healthy individuals, bone resorption (the process by which osteoclasts break down bone and release minerals) is balanced with bone formation (the process by which new bone is made by osteoblasts). In osteoporosis, this balance is disrupted, leading to a net loss of bone mass.

Several factors contribute to this imbalance, including hormonal changes (especially reduced levels of estrogen in women after menopause), dietary factors (such as inadequate intake of calcium and vitamin D), and certain medications or medical conditions. Genetic factors also play a significant role in determining bone mass and strength, influencing individual susceptibility to osteoporosis.

Osteoporosis is often termed a “silent disease” because it can progress without any symptoms until a bone fracture occurs. However, some several signs and symptoms may suggest the presence of osteoporosis or indicate an increased risk of fractures:

• Fractures: The most significant and noticeable symptom of osteoporosis is the occurrence of fractures from minor falls or injuries that would not typically cause a bone to break. These are often referred to as fragility fractures and are commonly seen in the hip, spine, and wrist.
• Back Pain: Caused by a fractured or collapsed vertebra, back pain can be a symptom of osteoporosis. The pain may be severe and sudden if it is due to a fracture, or it may be chronic and nagging if it is due to the gradual changes in the vertebrae’s shape.
• Loss of Height Over Time: A gradual loss of height or a stooped posture (sometimes referred to as a “dowager’s hump”) can be a sign of osteoporosis. This occurs as a result of vertebral fractures or a weakening of the spinal bones, leading to a compression of the spine.
• Decreased Grip Strength: As osteoporosis can affect bones throughout the body, decreased grip strength may be an indirect symptom, especially in postmenopausal women.
• Bone Pain or Tenderness: Although less common, some individuals with osteoporosis may experience bone pain or tenderness.

Osteoporosis is diagnosed primarily through the assessment of bone mineral density (BMD), alongside a comprehensive evaluation of the patient’s medical history, risk factors, and, in some cases, the presence of fractures.

A doctor usually diagnoses osteoporosis during a routine screening study. Screening is recommended for women over age 65, and for women of any age who have an increased risk of developing osteoporosis.

The doctor will review the patient’s medical history, including any incidence of fractures, risk factors for osteoporosis (such as family history, lifestyle, and specific medications), and other conditions that might affect bone health.

They will also perform a physical exam to look for signs of osteoporosis, such as changes in posture or loss of height. They check for balance and gait issues to assess the risk of a fall that could lead to a bone fracture, and muscle strength including testing the ability to stand from a seated position without using the arms.