Kraus Back & Neck Institute: 281.446.3876(281.44.Neuro)

Conditions

Osteoporosis

Osteoporosis is characterized by loss of bone mineral density (BMD). Reduced BMD causes bones to become weak and increases the risk for fracture. Any bone in the body may fracture, although the hips, vertebral bodies, and wrists are common fracture sites related to osteoporosis. Left unchecked and untreated, osteoporosis can progress to cause physical deformity and loss of stature.

Osteoporosis affects more than 44 million Americans. Women are four times more likely than men to develop this metabolic bone disease. The National Osteoporosis Foundation estimates that by the year 2025, the costs associated with osteoporosis will exceed $25 billion.1

Are you at risk?

Many people do not know they have osteoporosis. Why? Because osteoporosis is a silent—symptom free disease—at least until a fracture occurs. Osteoporosis is different from osteopenia. Osteopenia is low bone density, but not low enough to be diagnosed as osteoporosis. However, if you know you are osteopenic talk with your doctor about your personal osteoporosis risk factors.

Many risk factors you cannot control while, others can be.

Risks that can't be controlled How to help control your risks
  • Female gender
  • Aging
  • Family history
  • Endocrine disorder*
  • Small-boned
  • Thin
  • Caucasian, Asian, Hispanic
  • Eat well
  • Take enough Calcium/Vitamin D**
  • Hormone replacement therapy
  • Don't smoke
  • Regular weight-bearing exercise
  • Be active
  • Moderate use of alcohol

*Endocrine disorders can disrupt your body's metabolism, which may include your body's ability to normally rebuild bone.

**Talk with your doctor about Calcium and Vitamin D supplementation to ensure you are taking the right amount.

Other risk factors

  • Corticosteroid therapy (oral or injection)
  • Certain anti-convulsant drugs
  • Excessive thyroid hormone replacement therapy
  • Eating disorders
  • Rheumatoid arthritis
  • Gastrointestinal problems

Accurate diagnosis

If you develop sudden back pain, acute back pain, and/or have osteopenia or osteoporosis, we urge you to visit your doctor. An accurate diagnosis is essential to help prevent a vertebral compression fracture, manage your risk factors, and maintain healthy bone.

Your medical and family history is very important and discussed in detail. Your consultation includes a physical and neurological examination. The doctor tests your reflexes and evaluates you for muscle weakness, loss of feeling, and signs of neurological injury. Why is this important? Because certain medications—even some over the counter drugs—or physical disorders can cause dizziness, imbalance, or confusion increases your risk for fracture from a fall.

If you have back pain, a simple x-ray can help to rule out compression fracture. Further, an x-ray may show fractures by revealing loss of calcium that causes bones to have a washed out appearance.

Depending on your risk factors, your doctor may recommend you undergo a bone densitometry scan called dual energy x-ray absorptiometry (DEXA). It is a fast and painless way to measure bone density—the strength of your bones. Not only can the test diagnose osteoporosis, but is used to detect early stage bone loss (osteopenia).

Your T-score is the result of DEXA; a score comparing your bone density to that of a young Caucasian woman.

  • T-score of +1 to -1 is considered normal bone density
  • A score of -1 to -2.5 is considered osteopenia or low bone density
  • A score of lower than -2.5 is considered osteoporosis

Non-operative treatment

The doctor may prescribe medication to prevent or treat osteoporosis. The type of medication depends on many things, including your age, gender, risk of fracture, and the status of your osteoporosis. Lifestyle factors, including calcium and Vitamin D supplementation and weight-bearing exercises, are an important component of treatment.

Osteoporosis treatment is aimed at prevention

  • Calcium
  • Vitamin D
  • Estrogen if post-menopausal (female)
  • Testosterone (male)
  • Anti-resorptive biphosphonates alendronate, risedronate
  • Human parathyroid hormone
  • Smoking cessation
  • Regular weight-bearing exercise
  • Eat well

Treatment of back pain

  • Spinal bracing support the spine
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Pain medication

Outlook

Osteoporosis is a serious disease, but highly preventable or controlled if diagnosed early. However, even if your osteoporosis is advanced, it is not too late to begin treatment to save and rebuild your bone density.

We hope this information about osteoporosis has answered your immediate questions. Remember, your doctor is your most valuable source to answer your questions about symptoms and your healthcare.

Reference:

  1. Fast Facts. National Osteoporosis Foundation. Available at www.nof.org/node/4
Gary Kraus, MD,
Neurosurgeon, is Board Certified
Meet Gary Kraus, MD
Masaki Oishi, MD,
Spine Fellowship at the University
Meet Gary Kraus, MD
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