Osteoporosis

A condition that weakens the structural integrity of bones and makes them prone to breakage

Osteoporosis

Osteoporosis is a condition that affects the entire skeletal system and is characterized by the thinning, depletion, and weakening of bones, making bones more prone the fractures. Bones become more brittle to the extent that the simple movements, like walking or even the simple stress, like bending or coughing, or any other simple stress, can lead to a breakage of the bone. Lack of vitamin D is one of the major cause behind osteoporosis, and to balance vitamin D, you need to plan osteoporosis treatment under the guidance of a spine doctor.

As the components of the bones gradually break down and become much smaller, bones experience a considerable high stress, including the spinal vertebrae, the femoral neck in the hip, and the distal radius in the wrist, which easily become fractured. 

Bone remodeling imbalance 

  • This is a state whereby osteoclasts are overactive, breaking down the bone tissue than the osteoblasts, which are charged with the formation of new tissues. 
  • The integrity of these minerals is normally conserved and managed in the body through bone formation and resorption is slightly higher than formation in osteoporosis, thereby lowering the bone mass.

Affected Joint 

  • The axial joint, including the spine, is most likely to be affected as it is a load-bearing skeleton. 
  • While the hip and wrist are also part of the appendicular skeleton, they also form a potential site for fractures.

Compression fractures of vertebral bodies result in height loss and Kyphosis, hip fracture leads to disabilities, which may be severe. Since bone loss is a gradual process that may not be accompanied by any symptoms in the early stages, the initial sign is often a minor fracture.

Early osteoporosis treatment focuses on reducing bone loss and strengthening existing bones. This typically involves osteoporosis bone density medication, such as bisphosphonates, alongside lifestyle measures like calcium supplements and weight-bearing exercise. When pain or functional impairment arises, targeted osteoporosis relief therapy, including physical rehabilitation and pain management, helps restore mobility and quality of life. 

Due to the slowing down of bone cell generation, bones become brittle and break easily with minimum impact. This condition is called osteoporosis and affects 29% of women between the ages of 30 and 60. However, it could be osteoporosis if you experience:

  • Sudden back pain, which gets worse when standing up.
  • Widespread pain in the back and joints
  • Back pain that gets relieved when lying down.
  • Pain while twisting and bending.
  • Tiredness and stiffness
  • Posture changes in the back and along the spine.

How Common is Osteoporosis?

The data regarding osteoporosis prevalence rate in India is approximately 20–40% in women above 50 years, while in men, osteoporosis prevalence is about 10–20% in the same age group. From the research, some of the causes are a lack of Vitamin D, low Calcium intake in the diet, lack of regular exercise, and others. Early osteoporosis management strategies, such as regular DEXA scans and calcium supplements, are essential to identify at-risk individuals and implement preventive measures before fractures occur.

  • Professional diagnosis required
  • Chronic, can last for years
  • Treatable with 12 weeks of QI Spine Therapy

Causes of Osteoporosis

Many causes lead to a gradual loss of bone density. These causes range from hormonal shifts to lifestyle choices, and understanding them is essential for timely intervention through proper osteoporosis therapy. Such therapy should be done early enough since early identification of these triggers results in improved prevention of long-term impairments in bones and decreased possibility of fractures. Don’t ignore the following causes:

  • Aging: Most patients are 30-60 years old.
  • Heredity: A person is prone to osteoporosis if the condition is present in their family history.
  • Gender: Women are more affected than men.
  • Race: Caucasian and Asian women are more prone to osteoporosis.
  • Low body weight/bone mass weight: Shorter people are at greater risk of osteoporosis.
  • Low sex hormones: Post-menopausal women are more affected.
  • Smoking and Excess Alcohol: Smoking accelerates the symptoms and decreases bone density. Alcohol damages bone formation and increases the risk of fracture.
  • Glucocorticoids: Long‑term use of glucocorticoids or certain anticonvulsants
  • Deficiency in Vitamin D or Calcium: The lack of essential minerals decreases bone mass, making it more susceptible to the condition.

Risk Factors of Osteoporosis

Understanding the factors that increase the likelihood of developing osteoporosis is crucial for early identification and osteoporosis prevention. Identifying the risk factors allows healthcare providers to recommend appropriate osteoporosis therapy. These risks are divided into four categories as follows:

1. Unchangeable Risks

  • Age: There is a gradual decrease in bone density starting from the age of 30, and so older persons are more vulnerable to conditions that affect bones.
  • Sex: Women are at a higher risk, especially postmenopausal women, because of the lower peak bone mass and decreased estrogen levels.
  • Family History: A genetic predisposition, such as a parent’s history of hip fracture, significantly raises one’s own risk.

2. Hormone Levels

  • Bone Degeneration: Women suffering from menopause are especially at risk of losing their bone density faster when estrogen levels drop.
  • Lower levels of testosterone in the same way influence the formation of new bone tissues in men.
  • Thyroid hormones: Hyperthyroidism or excessive dosage of the medication containing thyroid hormones tends to enhance bone resorption.

3. Dietary Factor

  • Low Calcium Intake: Insufficient calcium supplements or dietary calcium impairs bone mineralization.
  • Vitamin D Deficiency: Low amounts of vitamin D hinder the body’s ability to absorb calcium, thus worsening bone density.
  • High rate of salt and caffeine consumption: Caffeine and salt are known to cause the body to excrete more calcium.

4. Steroids and Other Medicines

  • Glucocorticoids (Steroids): Long-term use interferes with the returning mobility phase, which results in the accelerated rate of bone resorption.
  • Anticonvulsants & Thyroid Medications: Some antiepileptic drugs and levoxyl increase the bone remodelling rate.

5. Medical Problems

  • Autoimmune diseases: Conditions such as rheumatoid arthritis cause inflammation, which deforms the bone structure for a long period.
  • Gastrointestinal disorders such as celiac disease, crohn’s disease, and malabsorption can hinder the absorption of nutrients that are relevant in bone formation and maintenance.

6. Lifestyle Choices

  • Sedentary Lifestyle: Failure to engage in activities that place some pressure on our bones will make them progressively become weak.
  • Smoking and excessive consumption of alcohol: Both of these activities can hinder the deposition of bone mass and lead to fractures.
  • Low Body Mass: Maintaining bone health requires that there is a certain amount of mechanical load applied to the bones, and a BMI below 20 has been said to require low mechanical load, hence causing poor bone maintenance.

Recognizing heightened risk can also guide the timing of osteoporosis relief treatment for those who go on to develop low bone mass.

  • Professional diagnosis required
  • Chronic, can last for years
  • Treatable with 4 weeks of QI Spine Therapy

Osteoporosis Treatment

Active self-care, calcium supplements, vitamin D therapy, and lifestyle management can help improve a patient's condition. It can be controlled by:

  • Isolation Treatment: We work on strengthening the extensor muscles in the affected area, providing immediate pain relief and preventing further degeneration. This is a long-lasting solution.
  • Making lifestyle changes.
  • Eating healthy and consuming calcium supplements.
  • Managing your weight.
  • Increase exposure to the sun.
  • Medication to reduce inflammation.
  • Smoking and alcohol should be avoided. It reduces the blood supply to bones.
  • Exercise and physiotherapy.

Other Medical Osteoporosis Treatments

Effective osteoporosis treatment aims to reduce bone loss, relieve symptoms, and, in high‑risk cases, stimulate new bone formation. Here are the key medications:

1. Bisphosphonates

Bisphosphonates are a class of medications used to treat and prevent bone loss, primarily due to osteoporosis and other conditions affecting bone density and strength.

  • Mechanism: Effectively slows the processes of bone resorption through inhibition of the osteoclast, thus promoting bone density.
  • Examples: Alendronate sodium, Risedronate sodium, Ibandronate sodium, Zoledronic acid.
  • Indication: Oral weekly or monthly; intravenous annually.
  • Consideration: To be taken in a standing position with water; indicated for patients with certain types of esophageal diseases.

2. Denosumab

Denosumab injection is a medicine for the treatment of osteoporosis or thinning of bones in postmenopausal women and osteoporosis in men.

  • Mechanism: It is a monoclonal antibody that acts by binding to RANKL and thereby inactivating any possibility of the formation of osteoclasts or their activation.
  • Benefits: Reduces vertebral, hip, and non‑vertebral fractures similarly to bisphosphonates.
  • Indication: Subcutaneous injection every six months.
  • Special precaution: To minimize the risk of hypocalcemia, adequate calcium intake and vitamin D level should be maintained; bone density will drop if treatment is stopped.

3. Hormone‑Related Therapy

  • Estrogen Replacement: is effective in reducing bone resorption in post-menopausal women, yet its use comes with certain dangerous side effects like breast cancer and thromboembolism.
  • Selective Estrogen Receptor Modulators(SERM): SERMs – Raloxifene lowers the incidence of vertebral fracture without some estrogen-linked side effects.
  • Considerations: Best suited for women with concurrent menopausal symptoms; follow guidelines for osteoporosis management.

4. Bone‑Building Medicines

  • PTH Analogs (Teriparatide/Abaloparatide): The PTH has an intermittent dosing schedule as it directly act on the osteoblasts thus enhancing bone formation.
  • Romosozumab: Anti-sclerostin monoclonal antibody that promotes bone formation and decreases bone resorption.
  • Indication: For cases of osteoporosis, particularly high risk of fracture, it should be a second-line therapy, for up to 18 to 24 months at most.
  • Follow‑Up: Transition to antiresorptive therapy (e.g., bisphosphonates) to maintain gains.

Combining these therapies with lifestyle measures, such as osteoporosis relief therapy including weight‑bearing exercises like walking, jogging, running, stair climbing, skipping rope, skiing, and impact-producing sports, optimizes outcomes. These translate to a more effective long-term treatment of fractures since the treatment is customized depending on the patient’s risk factors and bone density. 

Following these treatments will help you to get rid of the pain, and it will lead you to recover, but proper guidance from a certified doctor is mandatory. At QI Spine you can consult about your pain by expert spine doctor’s with our free in-clinic or video consultation and that will allow you to expedite your recovery journey.

  • Professional diagnosis required
  • Chronic, can last for years
  • Treatable with 4 weeks of QI Spine Therapy

There is no cure for osteoporosis, only active self-care and lifestyle management can help improve a patients condition. It can be controlled by:

  • Isolation Treatment: We work on strengthening the extensor muscles in the affected area, providing immediate pain relief and preventing further degeneration. This is a long-lasting solution.
  • Making lifestyle changes.
  • Eating healthy and consuming calcium supplements.
  • Managing one’s weight.
  • Increased exposure to the sun.
  • Medication to reduce inflammation.
  • Exercise and physiotherapy.
  • Professional diagnosis required
  • Chronic, can last for years
  • Treatable with 4 weeks of QI Spine Therapy

Osteoporosis Diagnosis

Accurate diagnosis of osteoporosis is essential for preventing fractures and guiding appropriate osteoporosis treatment. A structured approach combines clinical evaluation, risk assessment tools, imaging studies, and laboratory tests to confirm low bone mass and stratify fracture risk.

1. Medical Assessment

  • Medical History & Physical Exam:

The patient aims to document whether the patient has had any low-impact fractures in the past or a close family member with osteoporosis, and the use of medications like glucocorticoids, which weaken bones.

Assess risks that involve smoking, alcohol consumption, and activity levels of the patient.

For this reason, you should make a physical examination to estimate height, posture, and or vertebral compression.

2. Risk Stratification

  • FRAX Tool:

That is valid for the analysis of the 10-year probability of hip and major osteoporotic fractures that depend on the age, sex, weight, and clinical risk factors.

Helps determine whether to initiate pharmacologic osteoporosis therapy or focus on lifestyle measures.

3. Bone Mineral Density (BMD) Testing

  • Dual‑Energy X‑Ray Absorptiometry (DEXA):

A gold standard for assessment of BMD at the hip and spine.

In particular, a T-score below -2,5 discriminates osteoporosis, and the score from -1 up to -2,5 points to osteopenia.

  • Peripheral DXA and Quantitative Ultrasound:

Useful for screening in settings without central DXA access.

This test should be accompanied by a DXA scan in the central region in case the results indicate a poor bone mass.

4. Laboratory Evaluation

  • Basic Blood Tests:

Exclude secondary causes by measuring serum calcium, 25-hydroxyvitamin D level, and parathyroid hormone level.

Evaluate renal and liver function before initiating certain bone density medications.

  • Additional Markers:

Bone turnover markers (e.g., osteocalcin, CTX) may help monitor response to osteoporosis treatment.

5. Follow‑Up and Monitoring

  • Repeat DEXA:

Usually it is done at the interval of 1–2 years to assess the efficacy of the treatment and disease status.

  • Therapeutic Adjustments:

From the alterations in BMD and fracture frequency, clinicians can boost the intervention and change or add agents accordingly in an attempt to prevent future fractures.

A comprehensive diagnostic protocol, integrating clinical, radiologic, and laboratory data, ensures the timely initiation of effective osteoporosis relief treatment and helps maintain long‑term skeletal health.

QI Spine’s Approach Towards Your Recovery Journey

After the thorough analysis doctor will develop a personalized osteoporosis therapy for you. The therapy follows the whole patient's journey, and our spine doctors will guide you from the first day of consultation to the post-care. Also, the doctor and you can both track the treatment details over QI Spine’s app. The app also allows you to map your exercise routine, schedule your video consultation or in-clinic appointment, and track your recovery progress. 

  • Professional diagnosis required
  • Chronic, can last for years
  • Treatable with 4 weeks of QI Spine Therapy

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