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Osteoporosis literally means ‘bones with holes’. It occurs when bones lose minerals such as calcium more quickly than the body can replace them. They become less dense, lose strength and break more easily. Most people don’t realise they have osteoporosis until a fracture happens, as there are usually no signs or symptoms. This is why osteoporosis is often called the ‘silent disease’. Osteoporosis particularly affects women in their middle and later years, although some men are also affected. If you have osteoporosis, lifestyle changes and medical treatment can prevent further bone loss and reduce your risk of bone fractures. Osteoporosis and bone growthBone is formed by specialised cells. Like the rest of the body, bone is constantly being broken down and renewed. It is living tissue that needs exercise to gain strength, just like muscle. In the early years of life, more bone is made than is broken down, resulting in bone growth. By the end of your teens, bone growth has been completed and by about 25 to 30 years of age, peak bone mass is achieved. Sex hormones, such as oestrogen and testosterone, have a fundamental role in maintaining bone strength in men and women. The fall in oestrogen that occurs during menopause results in accelerated bone loss. During the first five years after menopause, the average woman loses up to 10 per cent of her total body bone mass. Fractures of the spine caused by osteoporosis can lead to pain, loss of height and changes in posture, such as the ‘dowager’s hump’. This hump is caused when spinal fractures are compressed due to the force of gravity, resulting in an abnormal bending forward of the spine called kyphosis. Symptoms of osteoporosisOsteoporosis causes no specific pain or symptoms. However, it does increase the risk of serious or debilitating fractures. If you think you may be at risk of developing osteoporosis, see your doctor. Diagnosis of osteoporosisCurrently, the most reliable way to diagnose osteoporosis is to measure bone density with a dual-energy absorptiometry scan or DXA. A DXA scan is a short, painless scan that measures the density of your bones, usually at the hip and spine and, in some cases, the forearm. You can qualify for a Medicare rebate for a DXA scan if you:
Your doctor will be able to tell you whether you fit the criteria to receive a Medicare rebate. It is possible to have a DXA scan performed if you do not fit the criteria for the Medicare rebate, however, there will usually be an out-of-pocket cost associated with the scan. Risk factors for osteoporosisThere are many risk factors for osteoporosis, some of which you cannot change, such as being female, and having a direct relative who has had an osteoporotic fracture. Other risk factors include:
Some conditions place people at a higher risk of osteoporosis. These conditions include:
Prevention of osteoporosisFrom a young age, both men and women can take steps to prevent osteoporosis by making sure that they:
Calcium-rich diet and osteoporosisEnjoying a healthy, balanced diet with a variety of foods and an adequate intake of calcium is a vital step to building and maintaining strong, healthy bones. If there is not enough calcium in the blood, your body will take calcium from your bones. Making sure you have enough calcium in your diet is an important way to preserve your bone density. It is recommended that the average Australian adult consumes 1,000 mg of calcium per day. Postmenopausal women and men aged over 70 years are recommended to have 1,300 mg of calcium per day. Children, depending on their age, will need up to 1,300 mg of calcium per day. Dairy foods have the highest levels of calcium, but there are many other sources of calcium, including sardines, spinach and almonds. If you are unable to get enough calcium from your diet alone, you may need to talk to a health professional about calcium supplements. Vitamin D and osteoporosisVitamin D and calcium promote bone density. Vitamin D is important because it helps your body absorb the calcium in your diet. We obtain most of our vitamin D from the sun, and there are recommendations for the amount of safe sun exposure for sufficient vitamin D production, depending on your skin type, geographical location in Australia and the season. Vitamin D can also be found in small quantities in foods such as:
For most people, it is unlikely that adequate quantities of vitamin D will be obtained through diet alone. Talk with your health professional about vitamin D supplements if you are concerned that you are not getting enough vitamin D. Exercise to prevent osteoporosisWeight-bearing exercise encourages bone density and improves balance so falls are reduced. It does not treat established osteoporosis. Consult your doctor before starting a new exercise program, especially if you have been sedentary, are over 75 years of age or have a medical condition. General recommendations include:
Lifestyle changes to protect against osteoporosisBe guided by your doctor, but general recommendations for lifestyle changes may include:
Management of osteoporosisIf you have osteoporosis, the strategies listed to prevent osteoporosis will help to manage the condition, but you may also need to consider:
Safer exercise options with osteoporosisIf you have osteoporosis, the risk of a fracture (break) with high-intensity exercise and poorly performed strength training can outweigh the bone-building benefits of these exercises. The best approach is to have an exercise program put together specifically for you by a physiotherapist or exercise physiologist. The program may include:
Falls prevention and osteoporosisA third of people aged over 65 years fall every year and six per cent of those falls lead to a fracture. Reducing the risk of falls is important. Be guided by your doctor, but general recommendations include:
Treatment for osteoporosisThere is no standard treatment for osteoporosis. Your treatment will depend on your specific needs. Generally, your overall risk of fracture will help your doctor to decide on the best course of treatment for you. Osteoporosis medicationAs well as diet and lifestyle changes, your doctor may recommend medication. The options may include:
It is important to note that all medications have potential side effects. If you are prescribed medication for osteoporosis, discuss the benefits and risks of treatment with your doctor. When to treat osteoporosisIf you have osteoporosis, it is never too late to seek treatment, as age is one of the main risk factors for osteoporosis and breaks. Treatment can halt bone loss and significantly reduce the risk of fractures. It is important that your doctor excludes other medical conditions that can cause osteoporosis, including vitamin D deficiency. Where to get help
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This page has been produced in consultation with and approved by:
This page has been produced in consultation with and approved by:
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