Osteoporosis is a condition where loss of bone develops to the point where
our bones break easily. It is a serious condition that increases slowly as
we age. Generally osteoporosis is asymptomatic - we are unaware that we have it - until
there is a fall or injury resulting in a fracture. We all get osteoporosis as
we age so it is important that we learn about it and try to do something to slow
it down or reverse the process.
Common areas of the body where osteoporosis fractures occur:
- the wrist - usually following a fall on the outstretched hand
- the hip - often from slipping and twisting during a fall
- the spine - from bending forward or heavy lifting
Bone tissue is a rigid, living structure that is constantly renewing itself.
It is not an unchanging skeleton made of calcium. Microscopic holes are constantly
created by bone-eating cells called osteoclasts. Once these bone cavities
are created, bone-building cells called osteoblasts form new bone. This process
rejuvenates the bone and repairs any damage.
In early childhood and adolescent years our bones grow rapidly. Good dietary
calcium intake and regular exercise in these formative years are important for
good bone health and peak bone mass. Bones may reach their mature length or
height in the late teens but bone density and strength continue to build along
with body weight and muscle strength into one's 20s and possibly 30s.
Once peak bone mass is reached, both women and men start losing bone at a
rate of ½% to 1% loss per year. By age 60, your bone mass can have decreased
by 30% compared to your bone mass at age 30. In women, the hormone estrogen
contributes to the bone-building process, so as estrogen levels fall when women
approach menopause, the bone loss accelerates to a rate of 2% to 3% per year.
In this case, bone mass can decrease over 50% by age 60, compared to bone mass
at age 30. This makes it particularly important to increase your intake of vitamin
D and calcium, and explore other treatments such as with calcitonin and
As we approach our later decades of life, many changing conditions make us
more susceptible to fractures related to osteoporosis. The most important of
these are decreased bone strength and increased risk of falls.
We are more likely to fracture a bone as we get older because of these reasons:
Decreased bone strength due to:
- decreased bone strength due to reduced bone density
Increased tendency to fall due to:
- reduced muscle strength so we are less likely to break a fall
- decreased vision, making it more likely to trip
- poor balance mechanism making us more unsteady on our feet
- posture changes resulting in center of gravity changes and more sway as
- changes in blood pressure or heart rate resulting in dizziness and unpredictable
- medications that result in weakness or lightheadedness
Obviously, efforts should be made to minimize osteoporosis fractures before
they happen. Physicians can identify individuals at high risk of osteoporotic
fractures by doing a bone density test. It is also important to investigate
whether the person is at a higher risk than normal for falling, especially if
something can be done to reduce that risk.