More than 200 million people suffer from osteoporosis across the world. It is suggested that 1 in 3 women above the age of 50 and 1 in 5 men will experience osteoporosis fractures in their lifetimes. Osteoporosis can cause your bones to fracture easily, which can affect how you carry out your daily activities.
The prevalence of osteoporosis in Singapore has been quickly rising, similar to the global trend. As the population of Singapore continues to age, osteoporosis is likely to become more common. Spine fractures as a result of osteoporosis seem to be more common in males. Osteoporotic hip fractures are problematic, with 1 in 3 of those with hip fractures experiencing a significant loss of function, becoming reliant on others in their daily life. Furthermore, 1 in 5 of these hip fracture patients die within a year.
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Osteoporosis refers to a disease that weakens your bones to the point where they become brittle, breaking easily due to falls or mild stresses such as bending over or coughing. Fractures due to osteoporosis are most common in the hip, wrist or spine. Our bones are living tissues that constantly get broken down and replaced. Osteoporosis happens when the creation of new bone is no longer able to keep up with the rate of the old bones breaking down.
Osteoporosis can be broken down into two categories, primary and secondary. Primary osteoporosis includes postmenopausal osteoporosis (type I), and senile osteoporosis (type II).
Primary Osteoporosis
Type I
Postmenopausal osteoporosis (type I) develops due to the loss of oestrogen and androgen which causes increased bone turnover. Bone resorption is increased, outpacing bone formation. While it is commonly referred to as postmenopausal osteoporosis, it can occur in men as well due to a loss of testosterone. However, women who have gone through menopause are approximately 6 times more likely to develop this type of osteoporosis, thus the name. Wrist and spinal fractures tend to be common among patients with type I osteoporosis.
Type II
Senile osteoporosis (Type II) occurs due to long-term calcium deficiencies. This calcium deficiency can be due to a deficiency in dietary calcium and vitamin D as a result of ageing or due to the hyperactivity of the parathyroid glands. Women are two times more likely to develop type II osteoporosis in comparison to men. Hip fractures tend to be common among patients with type II osteoporosis.
Secondary Osteoporosis
Secondary osteoporosis develops due to certain medical conditions and medications that disrupt bone reformation. Bone mass is lost as a result of the lowered bone turnover rate. Hormonal imbalance is a common cause of secondary osteoporosis. Other potential causes of secondary osteoporosis include:
Medical conditions such as:
Medication such as:
Osteoporosis is dangerous because symptoms rarely show in its early stages and only surface when your bones have already been weakened. These may include:
If you experience these symptoms and suspect that you may have osteoporosis, seek a doctor’s opinion. If you are diagnosed with osteoporosis, your doctor will be able to advise you on a treatment plan that can help you manage the disease.
Common risk factors of Osteoporosis include:
While some of these risk factors are unavoidable, those associated with unhealthy lifestyle habits such as smoking and drinking can be changed in order to lower your risk of developing osteoporosis.
Osteoporosis mainly leads to bone fractures. Hip and spine fractures are especially dangerous. Hip fractures are typically the result of a fall and can cause disability and in severe cases, lead to an increased risk of death within the first year of the injury. Spinal fractures can happen even without falling. The bones are weakened to the point of collapse, leading to back pain, a loss of height and a hunched forward posture.
To diagnose osteoporosis, your doctor will need to measure your bone mineral density. This is done using a special x-ray of the hips and spine, known as a dual-energy x-ray absorptiometry (DXA). If your bone mineral density is abnormally low, you will be diagnosed with osteoporosis.
By adjusting your lifestyle and diet, you can decrease your risk of developing osteoporosis, or halt the disease’s progression.
Calcium
It is important that you consume enough calcium to keep your bones healthy. Calcium deficiency is one of the risk factors for osteoporosis. It is advised that men and women between the ages of 18 to 50 consume 1,000 milligrams of calcium daily. This amount increases to 1,200 milligrams when they turn 70. If you find it too difficult to consume the suggested amount of calcium through your diet, you may wish to consider taking calcium supplements. However, excessive consumption of calcium has been linked to kidney stones as well as heart diseases, so do ensure that you stick to the recommended dosages.
Healthy sources of calcium include:
Vitamin D
Ensuring that your body gets sufficient vitamin D can help prevent osteoporosis. Vitamin D improves bone health as it improves your body’s ability to absorb calcium. While most people can get their vitamin D from sunlight, some may require vitamin D supplements if they are not able to expose themselves to the sun for a prolonged period of time. Certain types of food can also be good sources of vitamin D, such as cod liver oil, trout and salmon.
Exercise
Exercise is good for your health overall, but also benefits your bone health. It is most beneficial if you start exercising regularly when you are young. Strength training, weight-bearing and balance exercises can all benefit your bones. Strength training strengthens your muscles and reduces the strain put on your bones. Weight-bearing exercises can strengthen your bones. Balance exercises are helpful in preventing falls, especially for those who are older in age.
Changes to your diet and lifestyle can be helpful in treating osteoporosis if you are diagnosed with it. Ensuring that your intake of calcium and vitamin D is sufficient by adjusting your diet accordingly can help improve your bone health. Lifestyle changes such as avoiding alcohol and smoking are also important to prevent osteoporosis from further progressing. Lastly, you will need to integrate physical exercise into your regular schedule. The types of physical exercises that will be suitable for you will depend on the severity of your osteoporosis. Talk to a doctor if you require advice on exercising with osteoporosis.
Osteoporosis will also require drug treatments depending on your condition. Osteoporosis medication include:
Physiotherapy is helpful for managing osteoporosis. Trained physiotherapists can design a treatment plan suitable for you after a physical assessment and examination of your range of motion, muscle strength, fitness level, fracture risk, gait, and balance. Under the supervision and guidance of a trained physiotherapist, the effectiveness of physical exercise can be guaranteed as well as ensuring that you carry them out in a safe manner.
Weight-bearing exercises
Simple exercises such as walking or hopping can help to maintain or improve bone density in patients with osteoporosis. Strength exercises can also be useful in achieving this objective.
Flexibility and balance exercises
Improving flexibility can be helpful in improving your overall range of movement, which can be affected by osteoporosis. Balance exercises are especially important for osteoporosis patients, who are prone to falls which can lead to serious fractures. Balance exercises can reduce the risk of falls significantly.
Postural exercises
Postural exercises are important as they help to prevent your bone structure from changing as a result of osteoporosis. Improved posture can also help to improve your balance, preventing future falls.
Education
Physiotherapists can give osteoporosis patients useful advice when it comes to managing their condition and avoiding falls. For example, wearing a well-fitting shoe can be helpful in preventing falls.
Our bones are vital in allowing us to move about and carry out daily activities. Osteoporosis can possibly affect your mobility which can result in a fall in quality of life. Furthermore, osteoporosis cannot be cured or completely reversed, meaning that you will need regular medications or treatment to manage the disease. This can cost you a hefty amount. In addition to this cost, fractures can be expensive as they will almost certainly require hospitalisation and can also affect your ability to work. In fact, a study revealed the 3-month cost of osteoporosis to be SGD 11,438.70 (acute) and SGD 1,015.40 (prevalent), inclusive of both direct and indirect costs. Like many other chronic diseases, it is better to prevent osteoporosis through preventive measures so as to avoid the high financial burden that it may cause you in the future.
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