Osteoporosis Awareness
Early detection of osteoporosis is key to successful treatment and prevention. One of the biggest challenges of osteoporosis is that there are usually no symptoms in the early stages. This is why it is important to monitor the density of your bones regularly, especially as you age and your risk of osteoporosis increases.
Bone density tests are the most commonly used methods for detecting osteoporosis. These tests are quick, non-invasive, and measure the density of bones in your spine, hip, and wrist. The results of these tests can help your doctor determine if you have osteoporosis or if you’re at risk of developing the condition.
What is Osteoporosis?
Osteoporosis is a health condition that weakens bones, making them fragile and more likely to break. It develops slowly over several years and is often only diagnosed when a fall or sudden impact causes a bone to break (fracture). Often called ‘the silent disease’ as no symptoms are experienced until a bone breaks
It is a progressive bone disease that weakens the bones and may increase the risks of fractures.
Osteoporosis involves a gradual loss of calcium, as well as structural changes, causing the bones to become thinner, more fragile and more likely to break. This develops slowly over several years and is often only diagnosed when a fall or sudden impact causes a bone to break (fracture). The most common injuries in people with osteoporosis are broken wrist and broken hip.
What causes Osteoporosis?
Bone material is constantly being broken down, generated and replaced. This is a natural bodily function. While young, our bodies generate new bone material faster than it breaks down old bone material. As a result, a healthy young person’s bone mass increases until they are in their twenties and the regeneration process begins to slow down.
By age 30, most people have reached their highest level of bone mass. As one continues to age, the regeneration process becomes slower than the process of breaking down the bone material. In this case, bone mass is lost.
That is why the amount of bone mass accrued in one’s youth and how one takes care of their bones is so essential to bone health later in life. The more bone mass the individual has as backup, the less likely they will be to develop osteoporosis later in life.
What are the Symptoms of Osteoporosis?
In the early stages there are virtually no symptoms at all but, as your bones weaken, the symptoms will gradually increase. Because your spine has tiny fractures, they usually go unnoticed and are painless. Normally healthy bone looks like a honeycomb. If they have lost density, they can easily break and are called porous bones.
What are the Risk Factors for Osteoporosis?
There are many risk factors for Osteoporosis. Having one or more risk factors does not mean you will develop Osteoporosis. Similarly, having not risk factors does not mean you will not develop Osteoporosis.
Genetic & Biological Factors
- Rheumatoid Arthritis
- Thyroid Disease
- Dementia
- Celiac Disease
- Inflammation
- Crohn’s Disease
- Obesity
Lifestyle Factors
- Smoking
- Alcohol consumption
- Excessive caffeine
- Lack of Exercise
- Low calcium intake
- Long periods of inactivity
Genetic & Biological Factors
- Family history
- Being a women
- Low body weight
- Advanced age
- Early menopause
Medication
- Some cancer treatments
- Use of corticosteroid therapy
- Use of Oral Contraception
What is Osteopenia?
Osteopenia is the stage before Osteoporosis, when the bone density scan indicates that your bone density is lower than what it should be for your age but not low enough to be classed as Osteoporosis. Osteopenia does not always lead to Osteoporosis, as this depend on many factors.
Should you have osteopenia, there are certain steps that you can take to keep your bones healthy and reduce your risk of developing Osteoporosis. You could also be prescribed bone-strengthening treatments by your Doctor, depending on the weakness of your bones and your fracture risk. Losing bone density is a normal part of ageing. This happens at different rates in different people.
Diagnosing Osteoporosis & Osteopenia
Bone density scans are an enhanced form of x-ray technology that is used to measure bone loss. This scan is often referred to as a DEXA scan or a BMD scan and is used to indicate the strength of your bones and the likelihood you may have in having a fragility fracture (break).
The most common used method is a type of X ray called dual energy x-ray absorptiometry and this scans the bones in the lower spine and hip, two of the main areas where fragility fractures mainly occur.
This is called an ‘axial’ or ‘central’ scan and uses a low radiation dose, which is similar to natural background radiation – less than one tenth of the dosage of a chest x-ray and equivalent to a transatlantic flight.
The importance of a BMD Scan
Like breast cancer, osteoporosis can be treated and prevented if detected early. As there are no symptoms, it is vital that you know the density of your bones especially if you fall into the category of high-risk.
Treatment can then be adequate, preventing a painful and debilitating condition later in life when the treatments are not as effective.
Bone Densitometry scanning (BMD) is used to diagnose osteoporosis in both men and women. It is a safe, painless, and cost- effective method to measure the bone mass or bone density.
You may be referred for a bone density scan if:
- You have easily broken a bone
- You have symptoms of spinal fractures
- You have risk factors for osteoporosis and broken bones
- Your doctor needs to reassess your bone health and risk of breaking a bone, such as at a medication review
Vertebral Fracture Assessment (VFA)
This type of scan helps to identify broken bones in the spine without needing an additional x-ray.
It is sometimes carried out at the same time as your bone density scan, using the same machine, although you may be referred for a VFA scan separately.
A VFA scan is similar to a bone density scan, although you may need to lie on your side for part of the procedure.
What to expect at your scan
The scan takes approximately 20 minutes and is carried out by a Radiographer. You may have to change into a hospital gown, but the procedure is painless and safe.
In most cases, you will be asked to lie on your back on a firm couch. A scanning arm passes over your body and takes a low dose x ray image of your spine and hips – two of the most common places that bones break. While the spine is being scanned, you will be asked to rest your legs on a large cushion and, for the hip part of the scan, your leg will be supported to keep it in the correct position.
What is the scan measuring?
The scan calculates how much calcium and other minerals are in the area being measured. Research has shown that your bone density measurement especially in later life, is linked to your bone strength.
How does the scan work?
It does this by counting the x rays going in and out of the body – the difference is the amount absorbed by the bone and other tissues. This is called your ‘bone density’ and gives you your BMD results.
Understanding Your BMD Results
The results of your scan tell your doctor how much bone tissue you have in the areas tested, also known as bone density.
T-Score
Results are given as a ‘standard deviation’, which is the number of units above or below the average bone density of a young and healthy person. This is known as your ‘T score’.
Whatever score you receive, your risk of breaking a bone increases the older you get. By the age of 75, 50% of the population has a bone density in the osteoporosis range. If your T-score is in the osteoporosis range, it does not always need to be a cause for concern and that you will fracture a bone or need treatment.
Your results from this test are usually used alongside a fracture risk assessment, which takes these other risk factors into account.
Z-Score
Sometimes you will be given a Z-score alongside the T-score and this compares your bone density to other people of your age. Having a low Z- score can be an indication of another condition or medication that is affecting your bone density levels. Further tests would then be advised by your Doctor. Your results from this test are usually used alongside a fracture risk assessment, which takes these other risk factors into account.
After Your Scan
Preventing & Treating Osteoporosis
Preventing Osteoprosis
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Get enough calcium and vitamin D: These nutrients are essential for strong bones. Aim for at least 1000-1200 mg of calcium per day, and get adequate vitamin D from sunlight or supplements.
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Exercise regularly: Weight-bearing exercises, such as walking, jogging, and weightlifting, can help maintain bone density and reduce the risk of osteoporosis.
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Avoid smoking and excessive alcohol consumption: Smoking weakens bones and interferes with the body’s ability to absorb calcium. Excessive alcohol consumption can also lead to bone loss.
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Eat a healthy diet: A diet rich in fruits, vegetables, and protein can provide the nutrients necessary for strong bones.
Osteoporosis Treatment
– Take care to prevent broken bones
– Your doctor will recommend medication to strengthen your bones
