Osteoporosis

Osteoporosis

What is Osteoporosis?

The bones that make up our skeleton are made of a thick outer shell and a strong inner mesh-like honeycomb comprised of tiny struts of bone.

In osteoporosis some of these struts become thin, and this in turn makes the bone more fragile and liable to break after even a minor knock or fall. The wrist, the hips and the spine are the most commonly affected sites.

A bit about your bones 

The bones that make up our skeletons stop lengthwise growth as we reach between16 and 18 years of age, but the actual bone density continues to increase gradually until we are in our mid 20s. 

At this point the balance between bone demolition and subsequent bone construction stays stable. After the age of 35, bone loss increases very gradually over the subsequent years as a normal part of the natural ageing process. This bone loss does become more rapid in women for several years after they have gone through the menopause and this can lead to osteoporosis and an increased risk of broken bones, not immediately but more commonly in later life.

What are the effects of osteoporosis?

Having osteoporosis does not automatically mean that your bones will break easily or regularly; it simply means that you are at a ‘greater risk of fracture’. Thin, fragile bones are not painful in themselves, but the broken bones that can result, can obviously cause pain and other problem. Osteoporosis does not generally slow or stop the healing process if there is a break. Bones that have broken because of osteoporosis will still heal in the same way as they do in people who do not have the condition, and this healing will usually take about six to eight weeks.

So which parts of the body are most commonly affected?

Wrists

Broken wrists can often be the first indication that a patient has osteoporosis.  Where healthy bones should normally be able to withstand a fall from standing height, bones affected by osteoporosis will break and in these circumstances this will be categorised as a fragility fracture.

Hips

Hips broken because of osteoporosis occur most commonly in the late 70s or 80s age group.  Again they happen as a result of a fall and can have a big impact on all aspects of life. Making a full recovery is always possible but may be more problematic depending on how well someone was before the broken hip occurred.

Spinal bones 

Fractures due to osteoporosis of the bones in the spine usually occur in the lower back or upper area of the spine. In this type of fracture the bones become squashed together or compressed because of their reduced strength.  A ‘compression fracture’ is a good way of describing what happens in this type of injury.

These fractures do not interfere with the spinal cord.  They rarely result in paralysis or loss of sensation. Although the bones in the back may heal they will not return to their previous shape and that can mean loss of height or curvature of the spine.

Can osteoporosis be prevented? 

Our genes decide the potential height and strength of our skeleton but our lifestyle can also play a part in the amount of bone we invest in our bone ‘bank’ during our early years and how much we have ‘saved’ in later life.

From childhood, through to early adulthood, when the skeleton is still growing, it is vitally important to maximise our bone strength by ‘banking’ plenty of bone over these years.  The skeleton will then be in a better position to hold out against the natural bone loss later in life.  The best way to do this is by taking plenty of weight bearing exercise and eating a well balanced, calcium-rich diet.

Can we prevent  ‘fragility fractures’?

The fact is that the older we get, the greater our risk of breaking a bone.  Falling is much more common in older people because of poor balance and co-ordination and that in turn leads to a higher risk of breaking a hip. Lifestyle changes and keeping active can help to improve balance and prevent falling and there are drug treatments for those at highest risk of fracture.

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Amanda Thomas

UK Health Radio