What are the features that suggest you might have osteoporosis?
Fractures
If you fracture your hip, wrist or spine after a minor fall e.g. tripping over something in the house, you may have osteoporosis, especially if you are over 40. It is usually not suspected or diagnosed in the early stages. By the time you have a fracture, you may have lost 1/3 of your bone mass.
Backache
If you have constant severe backache this may be due to a spinal fracture. Many tiny fractures of the bone cause them to collapse. This causes pressure on the nerves and leads to pain. This is also the cause of “Dowager’s hump” which is common in post-menopausal women. Collapse of the bones of the spine causes the curvature of the upper spine which gives the appearance of hunching over and causes loss of height.
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Tests used to detect Osteoporosis
- bone density test – This is a simple test similar to an x-ray that can be carried out in a hospital x-ray department or a clinic and assessed by a radiologist. It measures the thickness and strength of the bones. Usually the spine and femur (thigh bone) are measured. This test can be used:
- to detect osteoporosis for the first time and
- to measure if the condition is worsening or improving, especially if you are receiving treatment.
Bone density scans should be done around the time of menopause to help predict the likelihood of developing osteoporosis. This is important because up to 1/3 of your bone may have been lost by the time you develop symptoms. Bone loss is fastest immediately after menopause and gradually slows sown over the years, by which time the bones have undergone a lot of damage.
- ultrasound - Ultrasound of the heel can give an idea of the health of other bones in the body.
Osteoporosis Treatment
Hormone replacement therapy (HRT)
This is the most potent medical treatment to stop bone loss and encourage new bone deposits. Estrogen with progesterone acts to slow calcium loss from the bones and increase it’s absorption from the intestines. In low doses, estrogen slows down bone loss but at higher doses can actually help increase bone mass.
Selective estrogen receptor modulators
These have the same benefits as estrogen by slowing down bone loss.
Complementary therapies
These include acupuncture and TENS ( transcutaneous electrical nerve stimulation).
Pain management
- Physiotherapy in the form of exercises to increase muscle strength and tone also help to relieve pain. Exercising in a water pool is very helpful as it allows an increased range of bodymovement because the water supports your body and bears your weight. Physiotherapy may also involve the use of ultrasound and electrotherapy.
- Medication used for pain relief ranges from paracetamol and codeine to the more potent morphine. It is recommended that you take the lowest dose of the least potent painkiller that gives you relief from pain. Paracetamol is safe at recommended doses and non-addictive (unlike codeine and morphine).
