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 SYMTOMS AND DIAGNOSIS
 
OSTEOPOROSIS
 
Symptoms
 

Initially, you may have no symptoms. You may experience dull pain in the bones or muscles, particularly low back pain or neck pain. Later in the course of the disease, you may feel sharp pain that comes on suddenly. It may not radiate, is made worse by activity that puts weight on the area, may be tender, and generally begins to subside in a week. But constant pain may last for more than 3 months.

Some of the common Symptoms are:

  • Hunched Back
  • Loss of Height
  • Back Pain
 
Risk Factors
 

Strong risk factors for osteoporosis include:

  • Estrogen deficiency
  • Absence or cessation of menstrual periods
  • Primary or secondary hypogonadism in both genders
  • Prolonged corticosteroid therapy
  • Maternal family history of hip fracture
  • Low body mass index
  • Previous fragility fracture, particularly of the hip, spine or wrist
  • Loss of height, thoracic kyphosis (widows hump)
  • Poor diet low in calcium
  • Men with low levels of the male hormone - testosterone

Diagnoses
 

A diagnosis is usually done using a combination of a complete medical history and physical examination, skeletal X-rays, bone densitometry and specialized laboratory tests. If you have low bone mass, your doctor will perform additional tests to rule out the possibility of other diseases that can cause bone loss, including osteomalacia (a vitamin D deficiency) or hyperparathyroidism (overactivity of the parathyroid glands).

Bone densitometry is a safe, painless X-ray technique that compares your bone density to the peak bone density that of someone of your same sex.

The most common diagnostic tool is a bone mineral density (BMD) test. This is a painless and noninvasive scan which, depending on the technology, measures bone density in the hip, spine, wrist, heel or hand.

Several types of bone densitometry are used today to detect bone loss in different areas of the body. Dual Beam X-ray Absorptiometry (DXA) is one of the most accurate methods, but other techniques may also identify osteoporosis, including Single Photon Absorptiometry (SPA), Quantitative Computed Tomography (QCT), Peripheral Dual Energy X-ray Absorptiometry, Single-Energy X-Ray Absorptiometry, Radiographic Absorptometry and Quantitative Ultrasound (QUS).

Treatment
 

Through early detection, people with osteopenia (low bone mass) or osteoporosis, can take action to stop the progressive loss of bone mass. By making positive lifestyle changes and following appropriate treatment strategies in consultation with a doctor, osteoporosis can be prevented and treated.

Wockhardt Hospital offers you a number of effective treatments that can help prevent fractures and increase bone density. Some of them include:

 
Hormone replacement therapy (HRT)
This prescription aims to restore estrogen to a pre-menopausal level. In the short term, it is taken to relieve menopausal symptoms such as hot flushes, night sweats and vaginal dryness. Small doses over several years also reduce osteoporosis. HRT also helps reduce the risk of heart disease. There are over 30 forms of HRT available in pills, patches, under-the-skin implants or gels.
 
Bisphosphonates
Bisphosphonates are non-hormonal medicines, which work by blocking the break down of bone. As of now, they are the first choice of treatment in a variety of bone metabolism disorders characterized by high bone resorption. There are different types of bisphosphonates, which differ widely in their efficacy, side effects and possible routes of administration, thus offering a flexible range of therapeutic options. They are Alendronate (Fosamax), Etidronate (Didronel) and Risedronate (Actonel).
 
Selective Estrogen - Receptor Modulator (SERM)
SERM is a synthetic hormone replacement medicine. It mimics estrogens in some tissues and anti-estrogens in others, and ideally provides the bone-retaining effects of estrogen without its unwanted side effects. This type of drug reduces the risk of osteoporosis and heart disease, but appears to not increase the risk of breast or endometrial cancers.
 
Vitamin, Protein and Calcium Supplements
Supplements are an effective treatment to reduce bone loss in the elderly. Calcium supplements and low doses of vitamin D has been shown to reduce the risk of hip fracture in elderly women living in nursing homes.
 
Calcitriol
Calcitriol is an active form of vitamin D given to post-menopausal women who have osteoporosis in the spine. Calcitriol improves the absorption of calcium from the gut.
 
Tibolone
Tibolone is a synthetic analog of the gonadal steroids with combined estrogenic, progestogenic and androgenic properties. Its effects on bone density are comparable to those of hormone replacement therapy. Its efficacy on fracture risk has not yet been assessed.
 
Non-pharmacological Interventions

Nutrition and lifestyle play an important role in osteoporosis prevention and treatment. Other factors like fall prevention techniques, or hip protectors to reduce the impact in case of a fall, are also very important. Smoking and alcohol can have a harmful effect on bone. Regular weight-bearing exercise has been shown to help maintain and build up bone mass. A varied, well-balanced diet is important to build and maintain healthy bones.

 
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