Osteoporosis Compression Fractures in the Am I at Risk? Osteoporotic Lumbar Spine (Lower Back)
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Hughston Health 6262 Veterans Parkway P.O. Box 9517 ColumbusAler GA 31908-9517 t VOLUME 11, NUMBER 4 www.hughston.com FALL, 1999 Osteoporosis Compression fractures in the Am I at Risk? osteoporotic lumbar spine (lower back) Vertebral (bone) body What is osteoporosis? Central expansion of the Osteoporosis, or “thin” bones, is a intervertebral disk disease that gradually weakens bones, making them more fragile and likely Vertebral body to break. It is not a form of arthritis. Osteoporosis leads to an increase in certain types of fractures (broken bones), such as hip fractures, wrist Restricted fractures, and compression fractures intervertebral of the spinal vertebrae (back bones) foramen (space through (Figure). Although it can occur in men which nerves exit spine) or women at any age, this condition most commonly affects women after Normal intervertebral foramen menopause. Our bones are dynamic tissues; new Spinous process bone is constantly growing to replace old bone. The rate of new bone Intervertebral disk Normal adjacent lumbar vertebrae and intervertebral disk growth changes as we age. Bones The Hughston Foundation, Inc. ©1999 grow quickly during childhood and (Cross-sectional views) adolescence and thicken during early bone mass while they are growing and Inside This Issue: adulthood. Between ages 25 and do not experience the accelerated Screening Tests for 35, our bones reach their maximum phase of bone loss that women have Osteoporosis thickness, which is considered “peak in their early menopausal years. bone mass.” After early adulthood, Therefore, osteoporosis generally Prevention and Treatment of bones begin to lose mass faster than occurs less frequently in men. Osteoporosis they can replace it. In women, the Cardio Kickboxing rate of bone loss increases as estrogen Risk factors levels decrease after menopause. Left Several factors increase the risk of Spinal Injuries in Adolescent unchecked, this bone loss can lead to developing osteoporosis. They include Athletes osteoporosis. hormonal status, heredity, lifestyle General Exercise Guidelines Age-related bone loss in men choices, use of certain medications, from the American College of occurs almost as rapidly as in women. physical activity level, and associated Sports Medicine However, men develop a greater disease states. Page 1 FOR A HEALTHIER LIFESTYLE In women, menopause, which strength of bone and rate of bone Screening Tests for can occur naturally or as a result of loss. For example, alcohol is toxic to surgery (removal of ovaries), is the bones. Heavy drinking (i.e., more Osteoporosis most common risk factor. The chance than two alcoholic drinks each of developing osteoporosis can be day) can cause osteoporosis even if Osteoporosis describes a decrease more problematic for women who you do not have other risk factors. in bone mass. It causes dense bones have an early menopause because Smoking reduces bone mass and can to become thin and porous. Having they prematurely lose estrogen. Men interfere with estrogen function. You thin bones increases your risk for with a low testosterone level are also are at increased risk of developing developing a fracture (broken bone). at risk for osteoporosis. osteoporosis if your diet has always Approximately 10 million people in You are at increased risk if you have been low in vitamin D and calcium, the United States have osteoporosis, older relatives who have sustained which are the substances that help the and 18 million more have early certain fractures (e.g., hip, wrist, and body build bone. When eaten in large thinning of bones that puts them spine), are hunched over, or have amounts, protein-rich or salty foods at increased risk of developing lost height because of osteoporosis. may cause your body to lose calcium. osteoporosis. However, only 23% of Women of all ethnic backgrounds are Caffeine and certain medications, people who have osteoporosis know at risk for developing osteoporosis; such as cortisone or excess thyroid that they have it or have talked with however, white and Asian women are hormone, increase calcium loss. their doctor about their condition. at a higher risk than other women are. (However, do not stop taking any Special bone density tests are Thin, petite, small-muscled women prescribed medication without your available to help your doctor find out are at higher risk than other women doctor’s approval.) Inactivity weakens if you have osteoporosis and to what are. bones. Over time, these weakened degree osteoporosis has affected your Beginning in your late teenage bones can become thinner and can bones. Using the information from years, lifestyle choices affect the break. the test, your doctor can prescribe Bone loss is associated a treatment plan to help strengthen with a variety of diseases and your bones. conditions, such as Paget disease, Who needs a bone density test? multiple myeloma, anorexia All women who are 65 years of age nervosa, diseases treated with or older should have a bone density steroids, and malabsorption of screening test. Women should have a calcium or vitamin D. Advanced screening test at an earlier age if they kidney and liver disease can have a family history of osteoporosis, contribute to an acceleration have an increased incidence of in osteoporosis. Osteoporosis fracture after the age of 45, currently is a characteristic of several are smoking, are underweight, or endocrine (glandular) diseases, have other risk factors discussed in such as overactivity of the “Osteoporosis: Am I at Risk?” (p. 1). thyroid or parathyroid glands, In addition, women or men who are excess production of growth considering therapy for osteoporosis hormone, Cushing syndrome, should be screened. If a person has and hyperprolactinemia. a disease or is taking any medication Osteoporosis can affect the that can cause bone loss, he or quality of your life. Talk with your she should have a screening test. doctor about the factors that may Women who have been on hormone put you at risk for this condition replacement therapy for a prolonged and about what you can do to time also need to be screened. prevent or treat it. For more information, contact the Types of screening tests National Osteoporosis Foundation, Clark H. Cobb, M.D. Several tests are available to screen 1232 22nd St, NW, Washington DC Columbus, Georgia bones for osteoporosis. The most 20037-1292, (202) 223-2226 (telephone), widely used and most accurate test or http://www.nof.org. The Hughston Foundation, Inc. ©1999 is called a DEXA (dual-energy x-ray absorptiometry) scan. The DEXA Page 2 FOR A HEALTHIER LIFESTYLE Prevention and Treat- ment of Osteoporosis Osteoporosis is a common cause of fractures (broken bones), especially in women who are beyond menopause. However, by strengthening your bones, slowing bone loss, and avoiding falls, you can help prevent or treat the condition and avoid fractures. Diet Prevention and treatment of The Hughston Foundation, Inc. ©1999 osteoporosis begin with proper diet. Ensuring that you get enough calcium scan can measure the bone density 7.5 mg or more of prednisone each and vitamin D each day is a great in your spine (back bone), hip, or day for more than three months. start (Table). Calcium helps your body whole body. It is painless and takes (Steroids are medications given to build bone, and vitamin D helps about 15 minutes to complete. Some treat various diseases, such as arthritis, your body absorb calcium. Calcium blood tests also are available, but they asthma, Crohn disease, and lupus.) can be found in dairy products (e.g., mainly are used to determine how 4. You have primary milk, cheese, yogurt, and ice cream); effective treatment is. hyperparathyroidism (overactive in salmon and sardines with bones; parathyroid). in dark green, leafy vegetables (e.g., What do the results mean? 5. You are being monitored to assess kale and broccoli); and in foods with The DEXA scan can give three how well your bones are responding added calcium (e.g., orange juice). basic results: 1) a normal scan, 2) to a United States Food and Drug For example, a one-cup serving osteopenia (early thinning of bones), Administration-approved osteoporosis of milk contains about 300 mg of or 3) osteoporosis. Your need for drug therapy, such as estrogen, calcium, and a one-cup serving of further evaluation and treatment is alendronate (Fosamax), or calcitonin. broccoli contains about 135 mg. based on the amount of bone loss In certain cases, Medicare will Supplements also provide needed that this scan shows. cover the cost of having a DEXA scan calcium. If you need to take a Will Medicare cover the cost? more often than every two years. supplement, choose it carefully. Avoid Currently, Medicare covers the cost Your doctor can tell you if Medicare bone meal and dolomite supplements of one DEXA scan every two years for considers you eligible for more because they may contain lead. specific diagnoses, which include the frequent testing. You need at least 400 IU of following: Osteoporosis can be a debilitating vitamin D each day. You can get 1. Your doctor or other qualified problem for women and men. By your daily requirement by taking medical professional determines using special tests, such as the DEXA a multivitamin; getting 30 to 60 that you are estrogen deficient scan, your doctor can diagnose the minutes of sun exposure (wear (i.e., postmenopausal) and at risk degree of bone loss and can formulate sunscreen and protective clothing); for developing osteoporosis based a treatment program to strengthen or consuming foods, such as fortified on your medical history and other your bones and help you remain milk (a one-cup serving contains 100 findings. active. IU) or salmon (a three-ounce serving 2. X-rays show abnormalities of your contains 425 IU). Although vitamin D vertebrae (spine bones) that indicate Kristyn Fagerberg, M.D.