What is Osteoporosis?
Osteoporosis means “soft bones”. Osteoporosis is the loss of calcium and collagen (elastic tissue) from bones which results from ageing. The process can sometimes start earlier if the family is prone to osteoporosis.
Causes of Osteoporosis
There has been prolonged use of steroids, smoking, or underweight. This condition is often confused with Osteoarthritis, pain in joints like knees and hips with mobility restriction because of wear and tear of joints.
The most alarming thing about osteoporosis is that it can have no osteoporosis symptoms whatsoever until someone develops a fracture after which it is diagnosed. So, the only way to be sure whether someone has osteoporosis is to proactively screen for it. Current scientific data supports Osteoporosis screening (by a BONE MINERAL DENSITY scan or DEXA scan) for all women who have attained Menopause and Men greater than 60 years of age. People with risk factors may be screened even earlier.
My approach:
- This condition is where I insist on the osteoporosis treatment as fractures in older people can profoundly impact their quality of life (pain at the fracture site, need for hospitalisation, restriction of mobility, loss of independence, and an increased risk of dying).
Several treatment modalities (weekly or monthly tablets, daily, injectable for osteoporosis -bi-annual or annual injections) can be used, and more are in the pipeline. What treatment option is best for a particular patient is best decided after a detailed discussion with your Endocrinologist depending on-site, the severity of osteoporosis and associated medical conditions. - The biggest challenges are getting people to start the treatment (especially if injectable for osteoporosis are the best choice) and staying on the treatment. There is no visible evidence that the treatment is working. People usually need proof of effect. Unfortunately, the scans may take up to a year or more to show effects. The simple fact that you haven’t had a fracture and the scans do not show further bone loss, means the treatment is working!
- The approach I take is to empower the patient with enough information to decide together about the best course of action. When the person is a partner in their care, I find it greatly increases people’s chances of staying on the treatment.
- I encourage people to refrain from repeating scans very frequently. There are often no changes on the scans (absence of evidence does not equal absence of benefit). I explain all potential treatment effects that the person may experience so that they are not taken unawares and know when to come back to me in case of an issue related to the treatment.
