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OSTEOPOROSIS
Osteoporosis is defined as a slow and steady
loss of calcium from bones, thereby weakening them. If this
loss is severe enough, some of the structural integrity of
the skeletal system can actually be lost and weakness of
this important supporting structure may be compromised.
This can result in early or easy fractures and loss of
height. Osteoporosis itself can be painful even without
obvious fractures. Although some bone loss is inevitable
with age, when this bone loss reaches the point where the
above problems occur it is defined as the abnormal condition
of osteoporosis.
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In its full blown form,
usually in
older women, but sometimes in younger women and even in men,
as much as 6 to 8 inches of height can be lost. The spine
becomes bent forward to some degree creating the so called
Dowager's hump. The entire chest area is forced downward
toward the pelvis and painful rubbing of ribs upon the
pelvis rim can occur. Compression of chest
structures makes
breathing difficult and makes the abdomen protrude and
causes difficulty with digestion. One of the most tragic
features of this condition is the fact that because women in
America today are living longer, they are experiencing more
and more osteoporosis fractures. This can lead to other
health problems because prolonged immobilization or
inactivity which is required for these fractures to heal can
lead to other health related complications. |
THE BENT BACK OF OSTEOPOROSIS, KNOWN AS KYPHOSIS |
X-RAY OF KYPHOTIC SPINE |
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In the United States Today, our diets are
woefully inadequate regarding calcium content. Young girls
from the age of 9 until they finish growing experience the
most intense buildup of calcium in their bodies they can
possibly undergo. Unfortunately, in this country today,
junk foods do not contain adequate calcium. All children
should take at least 600mg of calcium every day and
preferably closer to 1000mg or even more.
It certainly helps to begin the proper
calcium intake at any time. In general, between 1000 and
1500mg of calcium per day should be taken either by diet or
by calcium tablets. Keep in mind that a single dairy
serving (an 8oz. can of skim milk or a cup of yogurt)
contains about 300mg of calcium.
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Another important means of prevention is the
use of female hormones called estrogens.
Because
some women should not be taking estrogens because of
personal or family histories of uterine, endometrial or
breast cancer, each case must be evaluated on its own merit.
Studies at the University of Connecticut and Yale have shown
that the sooner the estrogen is started the better.
Besides calcium and estrogen, vitamin D and
weight-bearing exercise are essential. Newer treatments
that are very effective include "designer" estrogens
(SERM's),
bis-phosphonates (Fosamax™, Actonel™),
and nasal calcitonin. These are available by prescription
only and should be discussed with an expert on an individual
basis.
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QUALITY CALCIUM TABLETS SHOULD DISSOLVE QUICKLY IN A 50/50 MIXTURE OF VINEGAR AND WATER |
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The
newest treatment, which became available in 2003, is a
recombinant DNA form of parathyroid hormone, teriparatide (Forteo™).
Therapy with this agent requires training, since it is
administered by injection. The Arthritis Center has a
patient education program to make this task easy.
Any
physician can make the diagnosis of osteoporosis in a woman
who has lost significant height and who has a bent back, but
this is too late. Likewise, when osteoporosis has become so
severe that it shows itself on an x-ray, which is a
relatively crude tool, the problem has already gone
unnoticed for far too long. To make the diagnosis early
enough to administer the appropriate preventative or
therapeutic treatment, experts must be consulted.
Currently, the state of the art diagnostic technique for
osteoporosis is
dual x-ray absorptiometry (DEXA).
These are space age technologies on the very cutting edge of
modern discovery.
This technology delivers
miniscule doses of radiation, much less than that received
from a standard chest x-ray for example, and
provides
fast, accurate,
painless,
and completely reproducible results.
Even more important than making the
diagnosis, however, is the ability to follow the progress of
treatment using these devices. If a patient is under
treatment for osteoporosis and bone densitometry is
performed every 6 to 24 months, we can actually graphically
chart changes in bone density. This is useful in terms of
recognizing whether therapeutic maneuvers are helpful or in
terms of deciding when to move on to other therapeutic
measures, such as vitamins and hormones.
The important thing to remember is that osteoporosis can be
prevented, treated and in some cases, reversed.
Contact the Arthritis Center for
additional information. |
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Copyright © 2006
Brian Peck. All Rights Reserved. |
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