OSTEOPOROSIS

General Information

DEFINITION--Loss of normal bone density, mass and strength, leading to increased thinning and vulnerability to fracture.

BODY PARTS INVOLVED--Bones.

SEX OR AGE MOST AFFECTED--Women after menopause.

SIGNS & SYMPTOMS

Early symptoms:

• Backache.
• No symptoms (often).

Late symptoms:

• Sudden back pain with a cracking sound indicating fracture.
• Deformed spinal column with humps.
• Loss of height.
• Fractures occurring with minor injury, especially of the hip or arm.

CAUSES--

Loss of bony structure and strength. Factors include:

• Prolonged lack of adequate calcium and protein in the diet.
• Low estrogen levels after menopause.
• Decreased activity with increased age.
• Smoking (possibly).
• Use of cortisone drugs.
• Prolonged disease, including alcoholism.
• Vitamin deficiency (especially of vitamin C).
• Hyperthyroidism.
• Cancer.

RISK INCREASES WITH

• Aging.
• Surgery to remove the ovaries.
• Radiation treatment for ovarian cancer.
• Chronic or recurrent urinary-tract or other pelvic infections.
• Poor nutrition, especially inadequate calcium and protein.
• Body type. Thin women with a small frame are more susceptible.
• Family history of osteoporosis.
• Smoking.
• Heavy drinking of alcohol.
• Long-term use of cortisone drugs.

> Ensure an adequate calcium intake--up to 1500mg a day--

with milk and milk products or calcium supplements.

• Regular weight-bearing exercise, such as brisk walking, which is better for preventing osteoporosis than swimming.
• Seek medical advice about taking estrogen, calcium and fluoride after menopause begins or the ovaries have been removed.
• Avoid risk factors where possible.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• X-rays of bones and bone density studies.

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment.

POSSIBLE COMPLICATIONS

• Bone fracture, especially of the hip or spine, after a fall. Sometimes a bone will break or collapse without injury or a fall.
• Severe, disabling pain.

PROBABLE OUTCOME--Diet, calcium and fluoride supplements, vitamin D, exercise and estrogen can halt--and may reverse--bone deterioration. Fractures will heal with standard treatment.

How To Treat

GENERAL MEASURES--

• Avoid all circumstances that may lead to injury. Stay off icy streets and wet or waxed floors. Hold banisters when using stairs.
• If estrogen is prescribed, get regular medical pelvic exams and Pap smears. Examine your breasts for lumps once a month. Report any vaginal bleeding or discharge.
• Use heat or ice in any form to ease pain.
• Sleep on a firm mattress.
• Use a back brace, if prescribed.
• Use correct posture when lifting.
• See Resources for Additional Information.

MEDICATION--

• For minor pain, you may use non-prescription drugs such as acetaminophen.
• Your doctor may prescribe calcium, vitamin-D supplements, estrogen or fluoride.

ACTIVITY--Stay active, but avoid the risk of falls. Exercise--especially weight-bearing exercise, such as walking--helps maintain bone strength.

DIET--

• Eat a normal, well-balanced diet high in protein, calcium and vitamin D.
• Reducing diet if you are overweight (see Weight Loss Diet in Appendix).

Call Your Doctor If

• You have symptoms of osteoporosis.
• Pain develops, especially after injury.
• New, unexplained symptoms develop, such as vaginal bleeding. Drugs used in treatment may produce side effects.