Osteoporosis is a disease related to bones, which means ‘porous bones’ in Latin. Healthy bones have small spaces inside, similar to honeycombs. The condition of osteoporosis increases dimensions of these spaces, such that bones lose their density & strength. Simultaneously, outermost portion of the bone grows thinner & weaker. Patients with osteoporosis are at greater risk of experiencing fractures while engaged in simple routine activities like walking or merely standing. According to recent reports, about 50 million people in the world either have osteoporosis or are at risk of developing it. Most commonly affected bones by osteoporosis are hips, wrists, ribs & spine.
Osteoporosis causes bones to become brittle & weak, such that a fall or even mild stresses caused by coughing or bending over can lead to fractures. Bone is a living tissue that is steadily being broken down & replaced all the time. Osteoporosis appears when formation of new bone does not keep pace with removal of old bone. Osteoporosis affects men & women of all age groups & races; however Asian & Caucasian women, especially of older age are at the highest risk. Healthy diet, medications & weight-bearing exercises can, however, help strengthen weak bones or prevent further bone loss.
Orthopedists have yet to determine the exact medical and scientific causes of osteoporosis, but they have identified major factors that can develop this disease
- Natural Aging – Everyone loses bone density with age. After 30 years of age, new bone buildup of the body to replace the old one becomes less. In general, as one ages bone mass becomes low &risk for osteoporosis increases.
- Heredity – Family history of bone fractures, slim body build, fair skin & Asian or Caucasian ethnicity can enhance risk of developing osteoporosis. Heredity is a major factor which may also help explain why some patients develop osteoporosis earlier in their lives.
- Lifestyle & Nutrition – Low body weight, poor nutrition, including low calcium diet & sedentary life have been linked to osteoporosis.
- Medications & Illnesses – Osteoporosis has been associated with use of several medications like steroids & other illnesses, including thyroid problems.
Several risk factors associated with osteoporosis include the following.
- Physical inactivity
- Taking excessive alcohol
- Tobacco use
- Lowered sex hormones
- Small-boned frame
- Gastrointestinal surgery
The risk of osteoporosis is greater in patients who have certain medical problems, including the following.
- Celiac disease
- Kidney or Liver disease
- Inflammatory Bowel disease
- Multiple Myeloma
- Rheumatoid Arthritis
Typically, there are no specific signs or symptoms in the initial stages of bone loss, but once bones have been depleted by osteoporosis, patients may have the enumerated signs & symptoms.
- Stooped posture
- Back pain, caused by collapsed or fractured vertebra
- Loss of height over specific span of time
- Bone fractures that have happened much more easily than expected
Patients should talk to an orthopedist about osteoporosis if they have experienced an early menopause or took corticosteroids for various months at a time, or if either of their parents had hip fractures.
Mainly, there are four types of osteoporosis; primary osteoporosis, secondary osteoporosis, osteogenesis imperfecta & idiopathic juvenile osteoporosis.
- Primary Osteoporosis – Primary osteoporosis is one of the most frequent types of osteoporosis. It is more commonly seen in women than men. Heavy bone loss in women begins after monthly menstrual periods stop. This usually happens when production of estrogen slows down, mostly between the ages of 50& 55 years. In men, progressive bone thinning starts between 45 to 50 years of age, when production of testosterone slows down.
- Secondary Osteoporosis – Secondary osteoporosis can occur at any age. Secondary osteoporosis has similar symptoms as primary osteoporosis, but it occurs as a result of having certain health conditions like leukemia, hyperthyroidism or hyperparathyroidism. It may also occur as a result of consuming medications known to cause bone disintegration such as oral or inhaled corticosteroids or high doses of aromatase inhibitors.
- Osteogenesis Imperfecta – Osteogenesis imperfecta is a rare form of genetic osteoporosis that is usually present from birth. Genetic mutation causes a decrease in Type I collagen that results in failure of connective tissue that progressively causes bones to become weaker. Diagnosing osteogenesis imperfect is often based upon signs & symptoms which can be confirmed by DNA or collagen testing.
- Idiopathic Juvenile Osteoporosis- This type of osteoporosis is very rare. It generally occurs in children between the ages of 7& 14 years or during growing years. Any specific cause for this type of osteoporosis is still not known. In this condition, very little bone formation is seen with excessive bone loss. It may increase chances of fracture in children.
- Risk Assessment Tools – If orthopedists suspect that patients have osteoporosis, they can make an evaluation using an online program such as Q-Fracture or FRAX. These tools aid to figure out a person’s risk of fracture between the ages of 30 & 90 years.
- DEXA Scan – Doctors may refer patients for a DEXA (DXA) scan to calculate bone mineral density. It is a painless & quick procedure that takes just a few minutes, depending upon the portion of body being scanned. Bone mineral density of respective patients can then be compared to bone mineral density of a healthy young adult who belongs to same age & sex. Difference is measured as a standard deviation (SD) & is known as T-score. Standard deviation is the magnitude of variability based upon an expected or average value of T-score.
- Above 1 standard deviation is considered as normal
- Between 1 -2.5 standard deviation is considered as lesser bone mineral density compared with peak bone mass
- 5 is clearly defined as osteoporosis
Doctors will recommend a suitable treatment depending upon the results & risk of fracture.
Family doctors of patients may recommend bone density testing. Screening tests for osteoporosis are generally suggested for all women by age 60 years. Some guidelines also suggest screening men by age 75 years, especially if they have medical issues likely to cause osteoporosis. Following information may help patients to get ready for initial appointment.
- Patients should frankly discuss symptoms they have experienced though it is highly possible they may not have any.
- Patients should note down important personal information, including any major stresses or traumatic events.
- Patients should clearly prepare a list of all medications, vitamins or other health supplements that they are currently consuming or have taken in the past.
- Patients should also prepare a list of questions to ask surgeons regarding osteoporosis.
Following is a list of questions which may help the patients to clear their concerns regarding the treatment of osteoporosis. Patients should not hesitate to ask anything during the appointment with orthopedic surgeons.
- What is osteoporosis?
- What kind of tests do I require to confirm diagnosis?
- Which treatment procedure do you recommend for me?
- What kind of side effects & complications can I expect from the suggested treatment?
- What medications can help me?
- Are there any other options to the primary approach that you have suggested for me?
- I have other medical conditions. How can I manage them together?
- Are there any activity limitations that I should follow?
- Do I need to make any specific changes in diet?
- Do I need to take medical supplements?
- Will physical therapy programs benefit me?
Treatment Options for Osteoporosis
Treatment recommendations for osteoporosis are often based upon evaluation of risk of breaking bone in the next 7 – 10 years of time by using the bone density test. When risk is less, treatment might not involve medications& might focus instead on correcting risk factors for bone loss & falls.
For patients, both men & women at high risk of fractures, the most broadly prescribed osteoporosis medications are bisphosphonates. Some of them are given below.
- Zoledronic acid (Reclast)
- Alendronate (Fosamax)
- Ibandronate (Boniva)
- Risedronate (Actonel, Atelvia)
Side effects of these medications include abdominal pain, nausea & heartburn-like symptoms. These are less likely to appear if medications are taken appropriately. Using bisphosphonate therapy for more than four years has been linked to another problem in which the center portion of thighbone cracks & might even break entirely.
Estrogen therapy specifically, when started soon after menopause can aid manage bone density. However, estrogen therapy can enhance chances of breast cancer, blood clots, endometrial cancer & possibly heart disease. Therefore, it is typically used for bone health in young women. In men, osteoporosis is associated with gradual age-related degeneration in testosterone levels. Testosterone replacement therapy can help improve symptoms of low testosterone & osteoporosis in men.
In case patients cannot tolerate the above-mentioned treatments for osteoporosis or if they fail to work well enough, doctors might recommend the following.
- Teriparatide (Forteo) – This is a powerful drug similar to parathyroid hormone& meant to boost new bone growth. It is generally given on daily basis via injections under skin. After few years of treatment with teriparatide, another osteoporosis drug is also given for maintaining new bone growth.
- Denosumab (Prolia) – Compared with bisphosphonates, denosumab forms similar or better bone density outcomes & minimizes chances of fractures at the same time. Denosumab is given via shots under patient’s skin for every six months.
- Ipriflavone – When combined with calcium, ipriflavone stimulates bone density & helps in preventing any bone loss. It reduces severe pain which is associated with compression fractures in patient’s spine.
Following suggestions may help minimize the risk of experiencing broken bones after treatment of osteoporosis.
- Quit Smoking –Smoking enhances rate of bone loss & risk of experiencing fractures again.
- Avoid Excessive Alcohol –Consuming excessive alcohol may decrease the formation of bones. Being under the influence of alcohol can also increase the risk of falling.
- Prevent Falling –Patients should wear low-heeled shoes with non-slip soles &check their home for electrical cords, slippery surfaces & area rugs that might cause them to fall or trip. They should keep the rooms brightly lit& ensure they can get in & out of bed easily.
Major complications of osteoporosis are fractures & severe pain & disability which eventually follow treatment. Proper medications & lifestyle changes, such as fall prevention measures can help avoid serious fractures in future. Pain management & suitable plan for relief can ease impact of fractures. There are several risk factors for osteoporosis that nobody can control. These include being older, sex & having a family background of osteoporosis. Some of the most appropriate ways to prevent osteoporosis include the following.
- Getting plenty of vitamin D &calcium
- Stopping use of cigarette or completely quitting smoking
- Engrossing in weight-bearing exercises such as lifting weights or walking
- For women, scaling the pros & cons of hormone therapy
Osteoporosis affects a number of patients all over the world. Osteoporosis can be controlled by various suitable treatments. Treatments such as hormone therapy, medications & exercise can strengthen bones & slow bone loss. With proper lifestyle changes, one can live a better life with osteoporosis.
Medical Tourism for Best Treatment of Osteoporosis
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Apart from these factors, there are several rehabilitation & physical therapy centers across these countries that cater to international patients allowing for healthy recovery in a relaxing ambience.
Affordable Treatment of Osteoporosis with Travcure Medical Tourism
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