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Osteoporosis
 
This is an abbreviated version of the complete article.*
Basic Facts
Osteoporosis is a condition in which bones decrease in density over time, weakening them and leaving them at risk for fractures.
Osteoporosis initially causes no symptoms; the first symptom a person may experience may occur when a bone collapses or breaks.
Treatments for spinal fractures caused by osteoporosis include vertebroplasty and kyphoplasty.
Osteoporosis is a condition in which bones decrease in density over time, weakening them and making them susceptible to fractures. The condition is a gradual process that begins in a person's late 20s or early 30s. If left untreated, osteoporosis can cause fractures in the bones, which occur most often in the hips, spine, and wrist. Fractures in the spine can cause loss of height, severe back pain, and deformity. Treatment for osteoporosis focuses on slowing the progression of the disease, preventing bone fractures, and controlling pain.

WHAT ARE THE SYMPTOMS?

Osteoporosis initially causes no symptoms. When symptoms occur, they can include:
  • Dull pain in the bones or muscles;
  • Sudden sharp pain; and
  • Broken bones.
CAUSES AND RISK FACTORS

The most frequent cause of osteoporosis is a lack of the hormone estrogen in women and androgen in men. Factors that increase the risk of osteoporosis include:
  • Female sex;
  • Advancing age (older than 45 years);
  • Family history of osteoporosis;
  • Being past menopause;
  • Abnormal absence of menstrual periods;
  • Anorexia or bulimia;
  • Inadequate calcium intake;
  • Long-term use of medications such as corticosteroids or anticonvulsants;
  • Hyperthyroid;
  • Serotonin reuptake inhibitors (SSRIs);
  • Lack of exercise;
  • Smoking; and
  • Excessive alcohol use.
DIAGNOSIS

To diagnose osteoporosis, physicians often use bone mineral density (BMD) tests using one of several types of machines, including:
  • Dual-energy x ray absorptiometry (DEXA);
  • Single-energy x ray absorptiometry (SXA);
  • Peripheral dual-energy x ray absorptiometry (P-DEXA);
  • Dual photon absorptiometry (DPA);
  • Ultrasound; and
  • Quantitative computed tomography (QCT).
TREATMENT APPROACH

Treatment for osteoporosis focuses on slowing the progression of the disease, preventing bone fractures, and controlling pain. It can include lifestyle changes, including:
  • Consuming adequate amounts of calcium and vitamin D;
  • Increasing exercise;
  • Quitting smoking; and
  • Consuming alcohol moderately.
Physicians may also prescribe medications. Hormone replacement therapy (HRT) used to be the standard treatment for osteoporosis. Other medications used to treat osteoporosis include:
  • Bisphosphonates;
  • Raloxifene (Evista);
  • Calcitonin;
  • Teriparatide (Forteo); and
  • Tamoxifen.
For spinal fractures that have already occurred, the physician may perform vertebroplasty or kyphoplasty.
Medical Review Date: December 7, 2009
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