About 54 million Americans have osteoporosis or low bone mass, which puts them at increased risk to develop osteoporosis.
Osteoporosis, a musculoskeletal disease, happens when bones become brittle and porous. Healthy bone looks like honeycomb under a microscope; in a person with osteoporosis, the holes in the honeycomb get bigger, like Swiss cheese. With this, bones have lost density or mass; when this happens, they become weaker and are more likely to break.
Osteoporosis is associated with aging and is most common in women.
“The bones are less strong than they should be because of, in most cases, a loss of bone, which occurs as we get older,” says Ethel S. Siris, MD, a member of the National Osteoporosis Foundation Board of Trustees.
Signs and Symptoms of Osteoporosis
Osteoporosis is generally a silent disease, which means it can be seen only after it begins. These signs can include back pain, which is caused by a fractured or collapsed vertebra; loss of height (about an inch or two) over time; a stooped posture; and bones that break or fracture easily, according to Mayo Clinic.
Experts believe that approximately 1 in 2 women and up to 1 in 4 men over the age of 50 will break a bone because of osteoporosis.
Fractures, especially at an older age, can affect your mobility, independence, and quality of life, which is why appropriate screening is important, explains Lisa Brandt, ACNP-BC, a member of Trinity Health’s Rheumatology department, which treats patients with diseases of the joints, muscles, bones, and tendons.
Preventing Damage from Osteoporosis
Screening, which is recommended starting at age 65 from women and 70 for men, is done through a DEXA scan, which measures bone density. The test is similar to an X-ray, but it uses less radiation, Brandt says. “A DEXA scan result will show either normal bone mineral density, meaning no treatment is indicated; osteopenia; or osteoporosis.
“Osteopenia is bone mineral density that is less than normal, but not to the extent of osteoporosis,” Brandt explains. A special calculation using patient risk factors for osteoporosis, called a FRAX score, will be used to determine the probability of fracture and if treatment is needed for those with osteopenia. “If the DEXA scan shows osteoporosis, treatment is strongly recommended.”
Treating Osteoporosis
Management options for osteoporosis include calcium and vitamin D supplementation, as well as regular physical activity with weight-being exercises.
“Medications are generally well-tolerated and can be prescribed as a pill, injection, or IV infusion,” Brandt says. “The goal of treatment is generally to help slow bone loss in order to decrease fracture risk. The best choice of medication will be discussed and decided on at your appointment.”
Common medications to treat osteoporosis include bisphosphonate medciations, such as alendronate, which is generally given as a once-a-week pill; zoledronic acid infusion, given once a year by IV in the Rheumatology clinic; antiresorptive medication, such as Prolia, an injection given in the clinic every six months; or teriparatide, which is an injection given at home daily.
Bone Health Concerns?
Trinity Health’s Rheumatology department can help treat osteoporosis. For more information or to make an appointment, call 701-857-7495. Depending on insurance, a patient may need a referral from their healthcare provider.