Osteoporosis is “a systemic skeletal disease characterized by low bone mass and micro-architectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fracture” (WHO, 1994). Worldwide, osteoporosis is a serious public health concern, estimated to affect over 200 million people .
Approximately 30 % of hip fractures and 20 % of clinical vertebral fractures are attributed to osteoporosis. It is a ‘Silent Disease’ as the bone loss occurs without symptoms and sometimes first sign maybe fracture with trivial trauma. BMD begins to decline after third decade and is influenced by genetic and environmental factors. Osteoporosis and osteoporotic fractures increase with advancing age with loss of bone mineral density (BMD) at 1 % per year above 30 years of age. Women lose bone mass faster after menopause. 90% Indians have subnormal Vitamin-D levels.
Clearly, osteoporosis remains underdiagnosed and undertreated.
Classified by T-score on Dexa study
T-score
- -1 or above – Normal
- -1 to -2.5 – Osteopenia
- -2.5 or less – Osteoporosis
Symptoms:
- Early Fatigue.
- Repeated pain in body, especially lower back, neck & joints pain.
- Fracture with low energy injury.
Reasons behind osteoporosis:
- Lack of exercise/yoga and routine physical activity (sedentary lifestyle).
- Lack of calcium and Vitamin-D in diet.
- Insufficient exposure to sunlight.
- Irregular menstrual cycle.
- Consumption of alcohol and smoking.
- Protein deficiency.
- Obesity.
- Systemic disorders/ syndromes/
Test to diagnose:
- Routine X-rays after the age of 50yrs.
- DEXA study (Dual Energy Xray Absorptiometry.
- Blood levels of calcium and vitamin-D.
Prevention & Treatment:
- Routine exercise/yoga.
- Daily exposure to sunlight for atleast 10mins, with bare back, arms and legs.
- Routine healthy diet rich in calcium and vitamin-D.
- Green leafy vegetables and Dairy products.
- High Protein foods like soyabean, tofu, dal, sprouts and fish.
- Avoid smoking and alcohol.
- Daily 1500mg intake of calcium is recommended.
- Bisphosphonates- Zoledronic acid infusion has been found to be useful in studies conducted.
- Fixation of fractures, either as a treatment or prophylactically.