Osteoporosis is a progressive bone disease that causes bones to become fragile and brittle. It is the most common type of bone disease, afflicting more than 44 million Americans. In many patients, osteoporosis may develop for years without exhibiting any signs or symptoms. Most patients are unaware that they have osteoporosis until a fracture occurs. This disease causes approximately two million of all bone fractures per year. Another common sign of far-progressed osteoporosis is loss of height and curvature of the upper spine.
Symptoms of Osteoporosis
Symptoms of osteoporosis may include:
- Fractured or collapsed vertebrae (causing back pain)
- Stooped posture / loss of height
- Being more susceptible to bone fractures
- Sudden and severe back pain when active
- Mild pain relief when lying down
If you are experiencing any of these symptoms, you may wish to schedule an appointment with an orthopaedic surgeon or rheumatologist in Phoenix, Mesa, or Tempe. Early diagnosis may improve long-term outcomes.
Causes of Osteoporosis
Healthy bone tissue goes through a constant cycle known as remodeling, which consists of resorption (breaking down) and formation (rebuilding). As the body ages, the “breaking down” phase of this cycle can be faster than the “rebuilding” phase. In patients with osteoporosis, the formation phase cannot keep up with the resorption phase. What exactly causes this imbalance in the remodeling process is unknown. Calcium and vitamin D deficiencies may contribute to the lack of bone formation. Still, in other patients, bone loss is idiopathic (without any ascertainable cause).
Osteoporosis Risk Factors
Osteoporosis can occur in both men and women, but the highest risk groups are post-menopausal white and Asian women. The following factors may put you at greater risk for developing osteoporosis:
- Being on bed rest for an extended period of time
- Estrogen loss (women) or testosterone loss (men)
- Using steroids and some medications for cancer, depression, seizure, gastric reflux, and transplant rejection.
- Glandular problems (thyroid, parathyroid, and adrenal)
- Amenorrhea (no menstrual periods for a long period of time)
- Having low body weight and/or slight build
- Having more than two alcoholic drinks per day
- Having had some types of bariatric surgery, which diminishes the body’s abilities to absorb calcium and other nutrients
Testing for & Diagnosing Osteoporosis
If you are experiencing some of the above symptoms (or have several risk factors), you may wish to talk to your doctor about osteoporosis. A rheumatologist is one type of physician that may examine and diagnose osteoporosis. In addition to performing a physical examination and inquiring into your medical history, a rheumatologist may:
- Arrange for a DEXA scan (dual energy x-ray absorptiometry), which measures bone mineral density. This scan is one of the most common diagnostic tools. It can reveal bone loss and be used to predict the risk of future bone fractures. Other similar tools include SPA (single photon absorptiometry), QCT (quantitative computed tomography), ultrasound, and radiographic absorptiometry.
- Your physician may also arrange for a spine or hip x-ray, which may reveal more details about the health of your bones.
Unfortunately, osteoporosis has no cure. Once bone tissue has been lost, it cannot be replaced. However, if you have been diagnosed with osteoporosis, your rheumatologist may be able to help prevent further bone loss through one of the following treatment options.
- Bisphosphonates, a class of osteoporosis medications, are one of the most common therapies for bone loss. These medications include alendronate, risedronate, ibandronate, and zoledronic acid. The medication may be taken orally (on a weekly or monthly basis) or administered via a quarterly or yearly injection.
- Hormone Replacement Therapy (HRT) is another treatment option, which many at-risk women start shortly after menopause. Estrogen Replacement Therapy (ERT) is a standard hormone therapy for women who are at high risk for bone loss and fracture.
- Selective Estrogen-Receptor Modulators (SERMs) are another treatment option. These drugs may be used as an alternative to HRT.
- Calcitonin is a nasal spray that increases bone mass, limits spinal fractures, and provides pain relief.
In addition to physician-supervised medical therapy, patients with osteoporosis may be able to improve their condition by eating a diet rich in calcium and vitamin D and participating in low-risk exercise activities that preserve bone density. Patients with severe osteoporosis and spinal fractures may have back fusion surgery to reduce pain.
Schedule Your Appointment With a Rheumatologist
If you’re suffering from back pain or any of the symptoms listed above, you may wish to schedule an appointment with a rheumatologist in Mesa. At Hedley Orthopaedic Institute, your rheumatologist can provide state-of-the-art treatment and therapy, all under the same roof as some of Arizona’s best-known orthopaedic surgeons. Osteoporosis may be treated most effectively when diagnosed early on. Contact us to schedule your appointment.