Osteoporosis : Bone disease : Tests & Treatment

In osteoporosis the bone mass in the body becomes reduced or porous like and the skeletal system of your body is deeply affected and brings about a lot of changes to your system.

Osteoporosis is defined as that category of decreased bone mass where the disturbance is a failure of the osteoblasts to lay down bone matrix. Three factors which influence osteoblastic activity are: steroidal hormones, mechanical stresses and strains, and nitrogenous building blocks.

Tests & Diagnostics

Bone mineral density testing (specifically a densitometry or DEXA scan) measures how much bone you have. Your health care provider uses this test to predict your risk for bone fractures in the future. For information about when testing should be done, see bone density test.

A special type of spine CT that can show loss of bone mineral density, quantitative computed tomography (QCT) may be used in rare cases.

In severe cases, a spine or hip x-ray may show fracture or collapse of the spinal bones. However, simple x-rays of bones are not very accurate in predicting whether someone is likely to have osteoporosis.

You may need other blood and urine tests if your osteoporosis is thought to be due to a medical condition, rather than simply the usual bone loss seen with older age.

Treatments

The goals of osteoporosis treatment are to:

  1. Control pain from the disease
  2. Slow down or stop bone loss
  3. Prevent bone fractures with medicines that strengthen bone
  4. Minimize the risk of falls that might cause fractures

There are several different treatments for osteoporosis, including lifestyle changes and a variety of medications.

Medications are used to strengthen bones when:
(a) Osteoporosis has been diagnosed by a bone density study.
(b) Osteopenia (thin bones, but not osteoporosis) has been diagnosed by a bone density study, if a bone fracture has occurred.

(1) Bisphosphonates are the primary drugs used to both prevent and treat osteoporosis in postmenopausal women.

(2) Calcitonin is a medicine that slows the rate of bone loss and relieves bone pain. It comes as a nasal spray or injection. The main side effects are nasal irritation from the spray form and nausea from the injectable form.

(3) Estrogens or hormone replacement therapy (HRT) is rarely used anymore to prevent osteoporosis, and are not approved to treat a woman who has already been diagnosed with the condition.

(4) Teriparatide (Forteo) is approved for the treatment of postmenopausal women who have severe osteoporosis and are considered at high risk for fractures.

(5) Raloxifene (Evista) is used for the prevention and treatment of osteoporosis. Raloxifene is similar to the breast cancer drug tamoxifen.
The most serious side effect of raloxifene is a very small risk of blood clots in the leg veins (deep venous thrombosis) or in the lungs (pulmonary embolus).

(6) Regular exercise can reduce the likelihood of bone fractures in people with osteoporosis. Avoid any exercise that presents a risk of falling, or high-impact exercises that may cause fractures.

(7) Get at least 1,200 milligrams per day of calcium, and 800 – 1,000 international units of vitamin D3. Vitamin D helps your body absorb calcium.Your doctor may recommend a supplement to give you the calcium and vitamin D you need.
Follow a diet that provides the proper amount of calcium, vitamin D, and protein. While this will not completely stop bone loss, it will guarantee that a supply of the materials the body uses to form and maintain bones is available.

(8) Quit smoking, if you smoke. Also limit alcohol intake. Too much alcohol can damage your bones, as well as put you at risk for falling and breaking a bone.

(9) It is critical to prevent falls. Avoid sedating medications and remove household hazards to reduce the risk of fractures. Make sure your vision is good.

(10) Your response to treatment can be monitored with a series of bone mineral density measurements taken every 1 – 2 years. Women taking estrogen should have routine mammograms, pelvic exams, and Pap smears.

Complications

  1. Compression fractures of the spine
  2. Disability caused by severely weakened bones
  3. Hip and wrist fractures
  4. Loss of ability to walk due to hip fractures

Prevention

Calcium is essential for building and maintaining healthy bone. Vitamin D is also needed because it helps your body absorb calcium. Following a healthy, well-balanced diet can help you get these and other important nutrients throughout life.
Other tips for prevention:
(a) Avoid drinking excess alcohol
(b) Don’t smoke
(c ) Get regular exercise
A number of medications are approved for the prevention of osteoporosis which will be prescribed by your doctor.

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