Osteoporosis means that our bones are more porous than normal and have lost some of their strength to resist the forces we put on them in normal life. The outer shell of a bone is known as the cortex and is denser to provide strength and resistance to bending. The inner, honeycomb-like mesh is called cancellous bone and has its holes filled with collagen tissue, blood vessels and bone marrow. When osteoporosis occurs the holes inside the bone become larger, with fewer cross-connecting support struts, reducing the strength of the bone. The effects are usually widespread but fractures typically occur in the spine, hip and wrist.
Bone looks static but is living and so in a constant state of change, with older bone being broken down and replaced, a process that in an adult takes about seven to ten years to replace the whole skeleton. Bone turnover is the name given to this natural and important process. Children have an altogether faster rate of bone turnover and can replace their skeleton in two years. Our bones finish growing in length from around sixteen to eighteen years of age by which time we have achieved our final size, but our bone density continues to increase for a bit longer, into our mid-twenties.
The balance of bone turnover then enters a phase where there is equilibrium between the rate of bone breakdown and the rate of bone formation. From middle age this balance shifts in favour of bone breakdown and we begin to lose bone as we age, with osteoporosis occurring in some cases, especially in women after the menopause due to hormonal changes. Factors which may increase the likelihood of a man getting osteoporosis are low levels of male hormones, low body weight, smoking, high alcohol intake, being very immobile, diet absorption problems from conditions such as ulcerative colitis and long term steroid use for asthma.
One in three women is affected by osteoporosis in their lifetime so it is often thought to be a disease affecting women. However men are affected as well, with one in twelve having this at some time, even though only 20% of spinal fractures and 30% of hip fractures occur in men. Men may suffer from osteoporosis less for several reasons: they attain a higher bone mass to start with so have a higher level to start from and men suffer a much less dramatic bone loss in the middle years of life. Men in particular lose smaller amounts of the structural cortical bone than women.
Osteoporosis is a silent disease and the first indication many people get that they have the disease is the acute pain of fracture such as in the spine or wrist, often because of a trivial fall or blow. Spinal fractures cause wedging of the thoracic spine in particular, with acute pain which can be very disabling, and in some cases becomes chronic. The process of crushing and wedging can also occur quietly without dramatic pain, showing itself by the development of a spinal curvature called a kyphosis or a significant loss of height. A severe kyphosis can restrict the space in the ribcage, causing breathing and digestive problems.
Genetic factors may be responsible, at least partly, for the fact that no diagnostic cause can be found for 45 percent of men with osteoporosis. If someone in the close family has a history of osteoporosis then a man has a higher likelihood of developing lowered bone density and an elevated risk of spinal fractures developing. The maintenance of bone density is partly under the control of the testosterone levels in the body and osteoporosis is a risk if the levels of the hormone are low. Seventy year olds produce only fifty percent of the testosterone levels of men of thirty years of age. Testosterone replacement therapy can be prescribed if appropriate.
Various conditions such as asthma and ulcerative conditions of the bowel have significant degrees of inflammation which is treated by corticosteroid drugs. Bone loss can be produced by prednisolone treatment for six months so they are used only when essential. Patients should not alter their steroid medication doses without medical consultation as this can produce unpleasant side effects. - 14130
Bone looks static but is living and so in a constant state of change, with older bone being broken down and replaced, a process that in an adult takes about seven to ten years to replace the whole skeleton. Bone turnover is the name given to this natural and important process. Children have an altogether faster rate of bone turnover and can replace their skeleton in two years. Our bones finish growing in length from around sixteen to eighteen years of age by which time we have achieved our final size, but our bone density continues to increase for a bit longer, into our mid-twenties.
The balance of bone turnover then enters a phase where there is equilibrium between the rate of bone breakdown and the rate of bone formation. From middle age this balance shifts in favour of bone breakdown and we begin to lose bone as we age, with osteoporosis occurring in some cases, especially in women after the menopause due to hormonal changes. Factors which may increase the likelihood of a man getting osteoporosis are low levels of male hormones, low body weight, smoking, high alcohol intake, being very immobile, diet absorption problems from conditions such as ulcerative colitis and long term steroid use for asthma.
One in three women is affected by osteoporosis in their lifetime so it is often thought to be a disease affecting women. However men are affected as well, with one in twelve having this at some time, even though only 20% of spinal fractures and 30% of hip fractures occur in men. Men may suffer from osteoporosis less for several reasons: they attain a higher bone mass to start with so have a higher level to start from and men suffer a much less dramatic bone loss in the middle years of life. Men in particular lose smaller amounts of the structural cortical bone than women.
Osteoporosis is a silent disease and the first indication many people get that they have the disease is the acute pain of fracture such as in the spine or wrist, often because of a trivial fall or blow. Spinal fractures cause wedging of the thoracic spine in particular, with acute pain which can be very disabling, and in some cases becomes chronic. The process of crushing and wedging can also occur quietly without dramatic pain, showing itself by the development of a spinal curvature called a kyphosis or a significant loss of height. A severe kyphosis can restrict the space in the ribcage, causing breathing and digestive problems.
Genetic factors may be responsible, at least partly, for the fact that no diagnostic cause can be found for 45 percent of men with osteoporosis. If someone in the close family has a history of osteoporosis then a man has a higher likelihood of developing lowered bone density and an elevated risk of spinal fractures developing. The maintenance of bone density is partly under the control of the testosterone levels in the body and osteoporosis is a risk if the levels of the hormone are low. Seventy year olds produce only fifty percent of the testosterone levels of men of thirty years of age. Testosterone replacement therapy can be prescribed if appropriate.
Various conditions such as asthma and ulcerative conditions of the bowel have significant degrees of inflammation which is treated by corticosteroid drugs. Bone loss can be produced by prednisolone treatment for six months so they are used only when essential. Patients should not alter their steroid medication doses without medical consultation as this can produce unpleasant side effects. - 14130
About the Author:
Jonathan Blood Smyth is the Superintendent of Physiotherapists at an NHS hospital in the South-West of the UK. He writes articles about back pain, neck pain, and injury management. If you are looking for Physiotherapists in Bournemouth visit his website.
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