Osteoporosis is a condition that affects the inside of bones, even though on the outside a person can look perfectly fine. It causes bones to become fragile, so they break more easily. This guide will give you an overview of Osteoporosis.

 

Osteoporosis: Symptoms, Treatments Overview 

From symptoms of undiagnosed bone loss, diagnosis of bone loss,  treatment, diet and exercise, we provide easy-to-understand explanations. We also point you in the right direction for more detailed information on specific topics.

This handy resource is essential reading for anyone living with osteoporosis or who may be experiencing symptoms of undiagnosed Osteoporosis. It is also useful to those interested in maintaining good bone health and anyone supporting family members with osteoporosis.

We cover the following topics:

  • What osteoporosis means
  • What Osteopenia means
  • Causes of osteoporosis
  • Risk factors for osteoporosis
  • Symptoms of undiagnosed osteoporosis
  • How osteoporosis is diagnosed
  • Treatment for osteoporosis
  • How diet and appropriate exercise are important for bone health
  • Managing your osteoporosis

We aim to answer the most common queries and concerns. For further information, contact the National Osteoporosis experts on the national helpline (01) 637 5050.

normal bone vs. osteoporotic bone

What is osteoporosis? 

Osteoporosis is a condition that affects the inside of bones. It causes bones to become fragile, so they break more easily. It is called the silent disease because there are no signs or symptoms prior to a person breaking (fracturing) bones. The effects of undiagnosed/untreated osteoporosis can be devastating, and therefore the prevention and early detection of this disease is so important.

Bone is living tissue that the body continually renews and replaces. As we get older, the process slows down, and usually more bone is lost than formed. However, some people lose bone much faster than others. If new bone formation does not keep up with the loss of old bone, it will result in osteoporosis.

It is estimated that up to 300,000 people in Ireland have osteoporosis. Although more common in females who have gone through menopause, it can also affect men and even children.

Osteoporosis can occur in any bone in the body. However, some bones are more at risk of breaks than others. The most common bones to break are the bones in your wrist, hip bones and bones in your back. With osteoporosis, a fall or trip can easily result in a broken bone. However, a break can also happen while carrying out everyday tasks such as bending down, standing up from a chair, even when coughing. That is why anyone who has any unexplained broken bones should be assumed to have Osteoporosis, unless they are investigated, and it is ruled out.

Broken bones due to bone loss are also known as low trauma breaks (fractures), osteoporotic breaks, and fragility breaks, and can have devastating consequences, especially in senior citizens. After breaking bones you have trouble with dressing, bathing and even walking which can cause a person to lose their independence. Unless your causes of bone loss are investigated and addressed, you can continue to lose bone and can end up with more broken bones.

You can reduce your risk of experiencing a break, as most fractures or breaks are preventable, by taking our 3 minute risk test on this website free risk test. Osteoporosis is treatable, and there are plenty of steps you can take to maintain healthy bones. Medications are available to treat bone loss and can help to strengthen your bones, as well as nutrition and exercise.

What causes osteopenia?

Osteopenia is the early stages of bone loss, and it is very important that your causes of bone loss are investigated and addressed, to help reduce your risk of developing Osteoporosis. Research shows that most broken bones occur in the moderate to marked Osteopenia range.

 

What causes osteoporosis? 

As people age their sex hormone levels decline, this along with a person developing a condition that causes bone loss or being put on medication or treatment that causes bone loss places senior citizens more at risk of bone loss.  However, there are many other causes that can put you more at risk of developing osteoporosis.  Some relate to your lifestyle, such as over exercising or an eating disorder, while others are outside your control, such as being a female and over 65 years of age.

What are the risk factors for osteoporosis? 

Osteoporosis and Osteopenia risk factors outside your control include the following:

  • Gender: Women –are more likely than men to develop the condition. This is because women have smaller bones and changes in hormone levels following menopause cause bone loss, with some women losing excessive amounts of bone.
  • Age: The risk of developing osteoporosis increases as you get older.
  • Ethnic background: You are at greater risk if you are Caucasian or Asian.
  • Family history: If there is a history of osteoporosis in your family, then you have a much greater risk. This is especially so if your mother or father has suffered a broken hip.
  • Body frame: Having a small-boned body frame

 

The following osteoporosis risk factors relate to your lifestyle.

  • Physical activity: If you spend most of your day sitting, then you have a higher risk of developing osteoporosis than those who are physically active.
  • Smoking: Not only is smoking bad for your general health, but it’s also known to contribute to weaker bones.
  • Excess alcohol: Regularly consuming more than two alcoholic drinks a day increases your chances of developing osteoporosis.
  • Diet: Calcium and vitamin D are essential for bone health. If you are not getting enough, then you may be at increased risk of breaking bones.

Furthermore, certain medical conditions and medications affect your bone health.

  • Long-term use of steroids (commonly used in conditions such as arthritis and asthma).
  • Having an overactive thyroid or overactive parathyroid gland.
  • Early menopause (before 45) or irregular periods not as a result of pregnancy.
  • Conditions such as Coeliac disease or Crohn’s disease which affect the absorption of nutrients.
  • Some medicines used in the treatment of breast cancer, prostate cancer, and epilepsy.

If you are concerned about your risk of developing osteoporosis, then check out our free risk test.

Who typically gets osteoporosis? 

Women are at the highest risk of developing osteoporosis. However, men and children can also be affected. Furthermore, athletes who overtrain, those who develop eating disorders, or a combination of both can be at greater risk.

What are the symptoms of Undiagnosed osteoporosis? 

While no one experiences signs or symptoms before breaking a bone, there are signs and symptoms of possible undiagnosed osteoporosis.

  • Back pain: Many people with osteoporosis suffer broken vertebrae (broken bones in their back) without even realising it. Make sure you do not ignore back pain, get assessed to find out why you have the pain, as 75% of broken bones in their back have intermittent back pain.
  • Loss of height or change in body shape: Broken bones in your back can lead to loss of height and fractures (broken bones) in your mid and upper back, over time this can lead to a stooped posture, followed by a hump developing.
  • Unexplained broken bones: People with undiagnosed osteoporosis can break bones very easily, such as while rolling over in bed or coughing and sneezing. If you break a bone, make sure to check to see if you have any risk factors for bone loss because if you do, you should speak to your GP about a DXA scan. These signs and symptoms do not automatically mean you have osteoporosis. However, if you have one or more of them, especially if you are over 50, osteoporosis should be ruled out by having a DXA scan.

How is osteoporosis diagnosed? 

If you take the risk factor test on the Irish Osteoporosis Society website and if the results say you are at risk of bone loss, please make an appointment with your GP to further discuss your bone health.

If you are at risk of bone loss, a DXA scan, similar to an X-ray, is the only test the Irish Osteoporosis Society who are the leading experts in bone loss recommend. A DXA scan measures your bone density, which is the quality of your bone and will show if you are at risk of breaking bones.

DXA scan: The test is not claustrophobic and is painless and takes about 20 minutes to complete. A scan is taken of your spine and hips. DXA scan results are explained in numbers called T-scores. Your doctor will be sent a copy of your DXA results, and it is essential to discuss what the results mean for you, as most breaks are preventable.

We recommend DXA re-scanning a maximum of every two years so that your response to osteoporosis treatment is monitored. This is very important in case your results are declining instead of improving.

Osteopenia: Your doctor may tell you that you have osteopenia, which is the early stages of osteoporosis. The causes of your bone loss must be investigated and addressed to prevent you from losing more bone and developing osteoporosis.

Your doctor will advise you on what you need to do. We have developed a checklist of questions to ask your doctor to help you improve your bone health.

What treatments are available for osteoporosis? 

The Irish Osteoporosis Society only recommend taking medications and treatments that have had extensive research done on them to prove they work. Osteoporosis treatments either help to prevent bone loss or increase bone formation, ultimately reducing your risk of breaking bones.

The best choice for you depends on your DXA scan results, the causes of your bone loss, your risk of a break, your age, gender, and medical history. Possible treatments include the following:

Bisphosphonates: These non-hormonal medications work by increasing bone density and reducing the rate of bone loss. Brand names include Boniva®, Fosamax® and Fosavance®.

Hormone Replacement Therapy (HRT) or contraceptive pill: Oestrogen and progesterone can be prescribed for females with low oestrogen either as HRT for postmenopausal women if they do not have contraindications or the contraceptive pill for premenopausal women. HRT prevents bone loss.

Selective oestrogen receptor modulators (SERMs): Also used as a breast cancer treatment, these drugs work similarly to oestrogen. They are often prescribed for women who experience side effects from MHT or HRT. The most well-known brand is Evista®.

Monoclonal antibodies: This drug (brand name Prolia®) works by reducing bone loss, so more bone is maintained.

Parathyroid hormone (PTH): This is a daily injection for severe osteoporosis. PTH is a bone-forming agent that stimulates new bone growth.

Testosterone: One of the main causes of bone loss in men is low testosterone levels, which is why it is essential levels are checked as testosterone therapy may be necessary.

Vertebroplasty: This is a non-surgical procedure involving inserting a needle containing a special ‘bone cement’ into a broken vertebra. This procedure is not suitable for everyone and should only be done for pain relief.

Kyphoplasty: During surgery, a balloon filled with ‘bone cement’ is placed within the broken vertebra. This procedure is not suitable for everyone and should only be done for pain relief.

Like all medications, some of those listed here have side effects such as nausea and indigestion. And with hormonal therapies such as HRT, there is an increased risk of breast cancer and blood clots in the lungs. However, for most people with osteoporosis, the high risk of breaking bones far outweighs the low risk of any possible side effect. Your doctor will identify the best treatment for you.

How can diet and exercise help your osteoporosis?

The good news is that diet, and appropriate exercise can help strengthen your bones, combined with an Osteoporosis prescribed medication. We do not recommend that people attempt to treat bone loss with just diet and exercise, as bone loss is a disease.

Osteoporosis diet: Calcium and vitamin D are essential to healthy bones. Eating foods with calcium and vitamin D can make a difference.

Calcium-rich foods include all dairy products – milk, cheese, and yoghurt. If you are vegan (you are at higher risk of bone loss) or are dairy intolerant, green vegetables are an excellent source, especially spinach, kale, Collards, and okra. Fish such as tinned salmon and sardines are also excellent choices, as well as fortified breakfast cereals.

Sunlight is an excellent source of vitamin D, but it is essential to put sunblock on after 15 minutes. Those who burn easily should not try to get their vitamin D from the sun. Great sources are fortified milk, fatty fishes – salmon, tuna, and mackerel plus egg yolks.

Osteoporosis and exercise: Appropriate regular exercise is good for your bones, overall health and mental wellbeing. Certain exercises can also help to improve your balance and coordination, which can help to reduce your risk of falls, which can lead to breaks.

If you have bone loss or want to prevent it, weight-bearing exercises are the best type to do. If at all possible, be assessed by a chartered physiotherapist before undertaking any exercise. Go for a light walk, use the stairs rather than the lift or escalator. Dancing provided you have good balance, and low-impact exercises are also excellent options. Swimming and cycling, although good for your health and fitness, are not weight-bearing exercises. Contact the Irish Osteoporosis Society for guidance in this area.

Managing your osteoporosis 

It is possible to enjoy life while managing your osteoporosis.

Alongside taking your medications, exercising regularly and eating a healthy diet, it is essential to prevent falls and tripping hazards. For people living with osteoporosis, falls often cause broken bones. There are several things you can do to reduce the risks in your home.

  • Install handrails on stairs and grab bars in bathrooms.
  • Get rid of throw rugs and electrical cords lying across floors, which you can easily trip over.
  • Make sure halls, stairways, walkways, and porches are well lit.
  • Wear comfortable shoes with flat heels and non-slip soles.
  • Have non-slip mats in the bathroom in front of the sinks.

 

Expert help and advice 

The Irish Osteoporosis Society are the national experts on osteoporosis.

Support and advice are just a phone call away. You can ring the national helpline on (01) 637 5050. The helpline is open from 9.30 am to 4.45 pm Monday to Friday. Or email us at info@irishosteoporosis.ie.

We are here to help.