Osteoporosis
Last updated Tuesday, May 15, 2007
Prognosis and impactsPrognosis This chronic condition is one of the leading causes of
disability in aging men and women. Hip
fractures can cause loss of independence.
Vertebral fractures (also called "compression fractures" in
the spine) cause discomfort and may interfere with breathing.
Lethality Osteoporosis is not usually listed as the cause of
death on a death certificate. But it contributes
to other medical problems. The one-year mortality following a hip fracture is
12 to 24%. It is estimated that 14% of
deaths following a hip or pelvic fracture in previously ambulatory women were
caused or hastened by the fracture.Many people die in the year after a hip
fracture, from problems such as bleeding, infection, and blood clots.Pain The most typcial fractures are of the spine, wrist and
hip. Osteoporosis is not painful until the bone actually breaks. Fractures in
hips and wrists are always painful, but about 2/3 of the spine fractures do not
cause pain. The spine (vertebral) fractures cause height loss, curvature of the
spine, disfiguring posture, and muscle aching.
When women and men do suffer painful compression fractures, the pain
usually lasts from one to two months, is localized to the back with
accompanying muscle spasms, then gradually subsides. In severe cases the ribs
can rub on the pelvic bones which is painful.Debilitation The "Dowager's hump" caused by vertebral
compression fractures is disfiguring. This is the feature of osteoporosis that
is identified by most patients. The hump causes difficulty in finding clothes
that will fit, let alone look attractive.
The protruding abdomen which is a result of the kyphosis
is an unrecognized aspect of osteoporosis. Women do not realize that the
curvature of the spine decreases the abdominal space, and thus the intestines
have nowhere to go except forwards. Many women think that they are getting fat,
and they go on a diet trying to regain their youthful waistline. If they do
successfully lose weight, it will only increase their risk for more
osteoporotic fractures.
Patients
with kyphosis may develop reflux esophagitis due to the changes in abdominal
space. Wearing tight clothing can exacerbate the problem.Curability Osteoporosis has many causes, and sometimes the
disease can be cured. The most common
form, however, is due to aging. Although
there are medicines and life-style changes that can help the osteoporosis of
aging, it is not possible to grow younger and really cure the disease.Fertility and pregnancy It is unusual for a woman to have osteoporosis when she is
young enough to have children. When this
does happen, the osteoporosis is often a complication of another disease, and
the ability to get pregnant would depend on that other disease.
Osteoporosis itself does not prevent a woman from becoming
pregnant, but in severe cases women get fractures in their spine during
pregnancy. These are painful but do not
harm the baby.
If
a woman has serious osteoporosis, her physicians might try to deliver the baby
by Cesarian section because her pelvic bones might not be able to allow safe
passage of the baby's head.Independence Osteoporosis is one of the leading causes of loss of
independence. After a hip fracture many
patients need nursing home care.Mobility After a hip fracture, some patients will not be able to
walk. Other patients will eventually
walk again, but they will need rehabilitation and physical therapy. This will depend on how healthy a person was
before the hip fracture, how severe the fracture was, and what kind of surgical
treatment was done. It is important to
work hard and follow exercise programs after a hip fracture.
Women
and men who walk regularly during middle-life can strengthen their muscles,
improve their balance, and reduce their chance of gettting a hip fracture when
they become older. One-half to one hour
daily is recommended.Daily activities The irreversible height loss associated with
osteoporosis is one of the aspects of the disease that is most distressing to
many women. They have trouble reaching high shelves, driving the car, and are
at greater risk for airbag injuries.Energy Osteoporosis does not cause changes in
metabolism. But changes in metabolism
can cause osteoporosis. The most
important cause of osteoporosis is decrease in estrogen, one of the sex
hormones that is made in the ovaries.
During menopause the ovaries don't make normal amounts of estrogen, and
this causes the bones to dissolve.
Another hormone is called "parathyroid hormone", made by
glands in the neck that are next to the thyroid gland. This hormone controls the calcium in the
blood and in the bones. Sometimes the
glands make too much hormone and this results in osteoporosis. The hormone made in the adrenal glands,
called cortisone, also can cause osteoporosis.Diet The Surgeon General released a report about osteoporosis
in 2004, and recommended that all people should eat adequate amounts of
calcium. The calcium can come from the
food (especially dairy products, tofu, some grean vegetables and bones of
fish), fortified foods such as orange juice or cereal, or from
supplements. Adults need 1200mg of
calcium each day to help promote strong bones.
Vitamin D is also important. This is not found in very many foods, but is
added to dairy products in the USA. Most people will also need to take vitamin
pills to get an adequate amount of vitamin D.
The current "official" recommendation is 400 units a day but
many doctors think that older men and women should get at least 800 units a
day.
Thin
persons are much more likely to get osteoporosis. In fact, obesity is good for the bones
(although it has other health problems).
The "body mass index" is a way of telling if a person is too
thin for his or her height. If the body
mass index is lower than 20, eating extra calories to gain weight would be
beneficial. The upper limit of normal
body mass index is 25. The body mass
index can be calculated using the on-line calculator from the National
Institutes of Health.Surgery for Osteoporosis at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 (outside the Seattle area: 800-440-3280) to make an appointment.
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