Edited by Ryan Jien.
What is Osteoporosis?
Source: Endocrine Society
Osteoporosis is defined as the medical condition in which an individual faces the breakage or fractures of bones, loss of tissue, and lack of mobility due to hormonal changes or deficiencies in calcium and vitamin D. Osteoporosis, unlike many other medical conditions, is usually diagnosed after a fracture has occurred. The condition affects individuals from a multitude of backgrounds, with post-menopause white and Asian women being particularly high-risk groups. The weakening of bones resulting from osteoporosis may lead to decreased bone density and increased susceptibility to fractures. The condition often results in brittle and fragile bones, making individuals more prone to fractures, especially in the hip, spine, and wrist.
Increased Risk of Fractures
Fractures are characterized as a break or crack in a bone, usually occurring after a force is exerted upon the bone that is stronger than what the bone can withstand. Osteoporosis increases an individual's risk of fractures across the body. The impact of osteoporosis on fractures and mobility may be significant and can affect various aspects of a person’s life. Osteoporosis increases the risk of hip fractures, which may reduce the independence an individual has and may shorten their life. Studies show that about half the people who have a hip fracture may be unable to regain the ability to live independently, leading to complications such as blood clots. Furthermore, osteoporosis may lead to compression fractures in the spine, causing pain, loss of height, and significant changes in an individual's posture. Effects of vertebral fractures may include pain in the back or neck, tingling or numbness, weakness or paralysis of limbs, uncontrolled muscle spasms, and loss of control of urinary and bowel systems. These fractures can affect mobility and lead to a decrease in overall physical function.
Impaired Mobility and Pain
Subsequent to the diagnosis of osteoporosis, individuals may experience muscle weakness and decreased muscle mass, parallel to the loss of bone structure and lack of nutrients such as calcium and vitamin D. Weakened muscles may interfere with an individual's ability to move, sit up, stand, walk, and maintain their own balance. Muscles cannot bear a large load, leading to impaired mobility and making it challenging for a person with osteoporosis to engage in regular physical activities. Pain and discomfort are also other side effects of osteoporosis. Fractures and the associated pain with osteoporosis may limit mobility and reduce the ability of an individual to engage in regular physical activities. Fear of falling may restrict movements, leading to an inactive lifestyle. Osteoporosis impacts the ability for an individual to walk, dress, and bathe themselves, resulting in a limited lifestyle with the need for aid from others. The reduced mobility and functional limitations may negatively impact an individual’s overall quality of life, as they may need assistance as they lose independence.
Risk of Recurrent Fractures
Once an individual experiences a fracture due to osteoporosis, they are at an increased risk of subsequent fractures. Osteoporosis, a condition prevalent in individuals of old age, results in secondary fractures leaving men and women more prone to further breakage of bones. Various factors affect an osteoporosis patient’s risk of recurrent fractures, including weakened bone structure and underlying bone health. The breakage of bones may lead to alterations in the microarchitecture of bones, creating an environment conducive to recurrent fractures. Furthermore, the underlying bone health of individuals with osteoporosis is generally compromised, making their bones more susceptible to fractures even with minimal trauma. This risk may continue, adding to an ongoing risk regarding recurring fractures. The site of the initial fracture may also influence the risk of recurrent fractures, as fractures in one area may lead to subsequent fractures in the same area. Fractures in individuals may also take longer to heal, and the process of healing may be incomplete. The incomplete healing of fractures is attributed to a lack of nutrients such as calcium and vitamin D in osteoporosis patients and may leave affected bones more vulnerable to future fractures.
Fall Risk in Osteoporosis Patients
Because of decreased bone strength, people with osteoporosis have a higher risk of fall-related fractures. This is due to the weakened muscles and impaired balance which increases their likelihood of falling. These fall-related fractures may have large-scale consequences, including changes in posture, height loss, chronic pain, and in extreme cases, mortality. Psychologically, falling may instill a sense of fear and anxiety in those with osteoporosis, leading to reduced confidence and increased anxiety regarding daily activities. Social isolation may occur as well, as osteoporosis patients may have a decreased willingness to engage in physical activities resulting from increased anxiety.
Common Medical Treatment
Common medical treatment for osteoporosis aims to increase bone density to combat the high risk of fracture relating to brittle bones. Commonly prescribed medications for osteoporosis may reduce the risk of fractures and manage the underlying causes of bone loss. Two types of primary treatment are used to combat the condition: nonpharmacological (not relating to oral medication) and pharmacological treatment (relating to drugs or supplements that may be taken). Nonpharmacological management of the condition includes taking in adequate calcium and vitamin D through various foods and liquids such as milk, salmon, eggs, and oranges. Furthermore, taking on weight-bearing exercises may help an individual prevent or manage osteoporosis, strengthening bones to prevent the breakage of bones. On the other hand, pharmacological therapy can also be used to reduce the risk of fractures. Medications to treat osteoporosis include antiresorptive medications, inhibiting resorption, or anabolic medications, increasing resorption for the formation of bones. Some examples of antiresorptive medications include bisphosphonates, estrogen agonists/antagonists, estrogens, calcitonin, and denosumab. Anabolic medications include teriparatide. Bisphosphonates inhibit bone resorption by osteoclasts, increasing bone density. Estrogen agonists and antagonists mimic estrogen’s bone protective effects, improving bone density and reducing risk. Calcitonin inhibits bone resorption by osteoclasts and reduces pain in vertebral fractures. Denosumab inhibits bone resorption by targeting proteins involved in bone breakdown. Lastly, teriparatide stimulates bone formation through the use of a hormone that stimulates bone formation.
Source: CreakyJoints
To conclude, osteoporosis stands as a health condition where the risk of fractures and compromised mobility poses considerable threats to well-being. The choice of treatment depends on factors such as the severity of osteoporosis, the patient's overall health, and individual risk factors. While medical treatments play a crucial role in managing osteoporosis, many preventative measures can be taken to avoid the risk of developing the condition. Maintaining individual health and making sure to eat a well-balanced meal, these measures may be paramount to the development of the condition and improve the health and quality of a person’s life.
References:
Bergland, A., Thorsen, H., & Kåresen, R. (2017, November 9). Effect of exercise on mobility, balance, and health-related quality of life in osteoporotic women with a history of vertebral fracture: a randomized, controlled trial. Springer Link. Retrieved February 5, 2024, from https://link.springer.com/article/10.1007/s00198-010-1435-7
Bone fractures. (n.d.). Better Health Channel. Retrieved February 5, 2024, from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bone-fractures
Gasnick, K. (2023, December 28). Muscle Weakness: 47 Causes, Diagnosis, Treatment. Verywell Health. Retrieved February 5, 2024, from https://www.verywellhealth.com/muscle-weakness-5199929
Hsu, C.-L., Chen, H.-M., Chen, H.-J., Chou, M.-Y., Wang, Y.-C., Hsu, Y.-H., Liang, C.-K., & Chu, C.-S. (2017, November 9). YouTube: Home. Retrieved February 5, 2024, from https://www.sciencedirect.com/science/article/abs/pii/S0167494320300157
Mayo Clinic Staff. (2022, May 5). Hip Fracture - Symptoms & causes. Mayo Clinic. Retrieved February 5, 2024, from https://www.mayoclinic.org/diseases-conditions/hip-fracture/symptoms-causes/syc-20373468
Penn Medicine. (n.d.). Vertebrae (Spinal) Fractures. Penn Medicine. Retrieved February 5, 2024, from https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/vertebral-fracture
Smulders, E., Lankveld, W. v., Laan, R., Duysens, J., & Weerdesteyn, V. (2011, January 3). Does osteoporosis predispose falls? a study on obstacle avoidance and balance confidence - BMC Musculoskeletal Disorders. BMC Musculoskeletal Disorders. Retrieved February 5, 2024, from https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-12-1
Comments