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Osteoporosis ( Bone Weakness)
What is osteoporosis? Osteoporosis is a condition in which bones become weak due to decrease in the amount of mineral & bony material in a particular bone characterized by low bone mineral density (BMD). It is one of the most common bone diseases in human being and, while traditionally thought of as a problem primarily of post-menopausal women, it is also significant problem for men. In osteoporosis bone becomes porous from inside & it has less calcium & other minerals, less strength & thus more prone to fracture & deformity .Thus osteoporotic bones are weak bones. Normally bones are made up of inner honeycomb like lamellar bone surrounded by a thick outer shell called cortical bone. In osteoporosis there is decrease density of bone and bone becomes fragile. The osteoporosis of bone weakens the bone leading to an increase in the risk of bone fracture. Bones that are affected by osteoporosis can fracture with only a minor fall or injury that normally would not cause a bone fracture.
From childhood till the age of 35 years, more bone is laid down than is removed thus bone density keeps on increasing and an individual’s peak bone mass is typically achieved by around age 35. After peak bone mass is reached, the remodeling process (the process of laying down new bone and removing old bone) takes away more bone than is replaced. Hence making the bones more prone to osteoporosis (and consequently to fracture). Thus, the process of bone loss typically begins after 35 years. Starting from about that age to the onset of menopause, women lose a certain amount of bone steadily every year. Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, your body uses these minerals to produce bones. If you do not get enough calcium, or if your body does not absorb enough calcium from the diet, bone production may suffer. As you age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bone tissue weaker. This can result in brittle, fragile bones that are more prone to fractures, even without injury. Usually, the loss occurs gradually over years. Many times, a person will have a fracture before becoming aware that the disease is present. Osteoporosis occurs when the body fails to form enough new bone or too much old bone is reabsorbed by the body, or both. Fractures may occur as a result of osteoporosis. For your knowledge we’ll like to explain you that there are two types of cells which are constantly at work in our bones. One set builds up new bone (called osteoblastic i.e. bone forming activity) whereas another set break down old bone (called osteoclastic i.e. bone resorption activity). Up to our 35 year the construction cells work harder building strength into our skeleton. Thus in initial years of life there is more construction of bone than breakdown of old bone so that bone density as well as bone strength keeps on increasing. Our bones achieve maximum strength by the age of 35 years. From the age of 35 onwards, the demolition cells overtake and our bones gradually lose their density as a natural part of ageing. After the age of 35 year bone resorption i.e. destruction supercedes the new bone formation so bone strength & bone mineral content including amount of bone material in a particular bone starts gradually decreasing. This gradual decline in bone content occurs in every body. But in some people the bone loss is very fast compared to other people so that in few years there bone becomes very weak & becomes prone to easy fracture even on minor trauma. The osteoporosis which occurs due to aging or not due to well defined cause is called primary osteoporosis. There are many diseases which lead too rapid degradation of bone leading to significant osteoporosis more than what is expected at that age due to aging. Osteoporosis due to these diseases is called secondary osteoporosis.
What are the symptoms of osteoporosis? There are no symptoms in the early stages of the disease & the patient with osteoporosis may remain silent for decades. Many people have decreased bone mineral i.e. osteoporosis from lone time but they are not aware of it because it does not causes any symptoms in the beginning. Symptoms occurring late in the disease are Bone pain, back pain or pain on compression of the bone, Fracture with little or no trauma as fall on ground, Loss of height of spine due to forward bending because of vertebral fractures over time leading to decrease in height of vertebra, Low back pain due to fractures of the spinal bones, Neck pain due to fractures of the spinal bones or forward bending Stooped posture In many osteoporsis doesn't cause symptoms unless some acute bone fracture occurs. Once fracture occurs this causes severe acute pain in the affected areas. In most cases it often remains undetected until the time of this first broken bone. The most common fractures are of wrists, hips and spinal bones in people with osteoporosis. In
some patient may even have fracture of spine but because it is
gradual onset patient may not have any symptom thus may escape
detection until years later which is then detected during a routine
x-ray of spine. Therefore, patients may not be aware of their
osteoporosis until they suffer a painful fracture. Then the symptoms
are related to the location of the fractures as back pain when crush
fracture of vertebra occurs. Sometimes fractures of the spinal
vertebrae can cause severe "band-like" pain that radiates around
from the back to the side of the body. Over the years, repeated
spine fractures can cause chronic back pain as well as loss of
height or curving of the spine leading to stooping forward posture
which is typically seen in many older women, which gives the
individual a hunched-back appearance. A fracture that occurs during
the course of normal activity is called a minimal trauma fracture.
For example, some patients with osteoporosis develop stress
fractures of the feet while walking or stepping off a curb. Some persons with osteoporosis become severely disabled as a result of weakened bones. Hip fractures leave about half of patients unable to walk independently. This is one of the major reasons people are admitted to nursing homes. Although osteoporosis is debilitating, it does not affect life expectancy. Common complications of osteoporosis are: Fracture of various bones: The fracture can be either in the form of hip or wrist fracture or collapse of the vertebra of the spine. The spine, hips, and wrists are common areas of osteoporosis-related bone fractures, although osteoporosis-related fractures can also occur in almost any skeletal bone area. · compression fractures of the spine · Disability caused by severely weakened bones · Hip and wrist fractures · Loss of ability to walk due to hip fractures
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