Osteoporosis and Dexa Scan

Osteoporosis a Greek/Latin word meaning porous bones, discovered by the French pathologist Jean Georges Chretien Frederic Martin Lobstein in the 1830’s.

The inside of a healthy bone has small spaces, like a honeycomb. Osteoporosis increases the size of these spaces, causing the bone to lose strength and density or in other words, Osteoporosis is a health condition that causes bone fracture, making the bones so brittle and weak so that a fall or mild stresses such as bending over, coughing can cause a bone fracture.

Osteoporosis has no visible symptoms, so that the patient may not know about it until he/she suffers a fracture. Osteoporosis can occur in people of any age, however, it’s more common in older adults, especially women and more common in females who have gone through the menopause. According to the Irish osteoporosis society, it is estimated that up to 300,000 people in Ireland have Osteoporosis.

People with osteoporosis are at a high risk of fractures, or bone breaks, while doing routine activities such as standing or walking. It can occur to any bone in the body; however, some bones are more at risk than others, the most affected bones are the ribs, hips, and the bones in the wrists and spine. With osteoporosis, a trip and fall can result in broken bones. A fracture can also happen while carrying out everyday tasks such as bending down, standing up from a chair, even when coughing or sneezing.

Like most of the diseases, Osteoporosis is also treatable and there are lot of steps you can take to maintain good bone health. Medications for bone loss combined with healthy eating proper exercise can help to significantly reduce the risk of fractures.

Osteoporosis

 

The Risk Factors of Osteoporosis

 

·      Gender

Although it can happen to adults of any gender, or in some rare cases even among the children, Osteoporosis is much more common in women because of the small bones than a men and changes in hormone levels as they grow.

·      Age

Another biggest risk factor of Osteoporosis is age. It is common for human body to breakdown bones throughout the lifetime of an individual because the breakdown ones will be replaced by new ones. But after the 30, your body starts breaking down bone’s way faster than its able to replace it, causing an unbalance and leading to Osteoporosis.

·      Menopause

Menopause is another primary risk factor. Usually occurred in the age between 45 to 55. Due to the hormone changes associated with the menopause the human body loss the bone more quickly.

·      Family Background

Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father has suffered a fractured a hip

·      Ethnic Background

Osteoporosis can occur in persons of all races and ethnicities. In general, however, whites (especially of northern European descent) and Asians are at increased risk. Non-Hispanic white women and Asian women are at higher risk for osteoporosis

·      Body Frame

Men and women having small or thin body frames tend to have a higher risk because they might have less bone mass to draw from as they age.

 

Other risk factors include poor nutrition, physical inactivity, low body weight, Excessive alcohol consumption eating disorders, Gastrointestinal surgery, Long-term use of oral or injected corticosteroid medications, and medical conditions such as Kidney or liver disease, Cancer, Inflammatory bowel disease, Multiple myeloma, Rheumatoid arthritis etc.

 

How to Diagnose Osteoporosis?

 

To diagnose osteoporosis and assess your risk of fracture and determine your need for treatment, your doctor will most likely order a bone density scan. X-ray, Body CT, Spine CT can also be used for the diagnosis, but most preferred diagnosis method is DEXA Scan.

What is a DEXA Scan?

 

Dual energy x ray absorptiometry (DXA) scans to measure bone mineral density (BMD) at the spine and hip have an important role in the evaluation of individuals at risk of osteoporosis, and in helping clinicians advise patients about the appropriate use of antifracture treatment. Traditional X-rays used to identify broken bones (for example spine fractures) cannot measure BMD.  BMD must be measured by more specialised techniques for that we use DEXA scan. Simply, this scan uses X-rays to determine how much calcium is present in your bone. As we all know Bones with more calcium are less likely to break.

DEXA Scan is a safe, fast, and painless method to measure whether you have osteoporosis or how likely you are to develop it in the future. After your first DEXA scan, a doctor may schedule another in a few years to look for any changes. These scans can help indicate how effective osteoporosis treatments are because they can show whether the condition is staying the same, worsening, or improving.

The Bone Health and Osteoporosis Foundation recommends that females aged over 65 and males aged over 70 have at least one DEXA scan. The ideal frequency may vary, depending on the results. People receiving treatment for osteoporosis may require a scan every 1 or 2 years

You do not have to change your daily routine before this scan. Eat, drink, and take any medications as you normally would. However, do not take calcium supplements or drugs that contain calcium, such as Tums, for 24 hours before your scan.

 

Results

 

The Results of the DEXA Scan is based on T-score. It is basically comparing your bone mass with healthy young adult of your same sex. According to the World health organization,

  • A BMD T-Score (SD) of -1 and above is normal,
  • A BMD T-Score (SD) between -1 and 2.5 is Osteopenia (Low bone mass),
  • A BMD T-Score (SD) of -2.5 or lower is Osteoporosis,
  • A BMD T-Score (SD) of -2.5 or lower and presence of at least one fragility fracture is Severe Osteoporosis.

If the results of your BMD test show osteopenia or osteoporosis, it does not automatically mean that you will have a fracture. There are lifestyle changes and several available therapies that your doctor might prescribe to slow down bone loss and help prevent fractures.

A DEXA scan may also report results using a Z-Score, which shows the amount of bone that a person has, compared with others of the same size, age, and sex. It can help determine whether something uncommon is leading to bone loss.

According to the International Society for Clinical Densitometry, a Z-score of over -2.0 is considered normal. Doctors consider a score below -2.0 as being below the normal range for the person’s age.

There are several other methods for diagnosing osteoporosis, however, these are most often used in clinical trials and research as opposed to routine diagnosis. These include radiological assessments and Bone Turnover Markers (BTM)

 

Treatment for Osteoporosis

 

According to the Irish Osteoporosis society the recommended medications are as follows,

  • Bisphosphonates
  • Hormone Replacement Therapy (HRT) or Contraceptive Pill.
  • Selective Oestrogen receptor modulators
  • Monoclonal antibodies
  • Parathyroid Hormone
  • Testosterone
  • Vertebroplasty
  • Kyphoplasty

 

Like most of the medication there are possible risk of side effects too with these too. So consult with your doctor before proceeding to any medication, diet, or exercise program.

 

Diet and Exercises to help fight Osteoporosis

 

Diet and appropriate exercises combined with the prescribed medication can greatly help to strengthen your bones. Since it is a disease don’t just rely on diet and exercise, always follow the medication.

To maintain your bones strong and healthy you need to ensure you’re getting enough nutrients from your food. The essential ones are Calcium and Vitamin D. Human body needs calcium to maintain strong bones and need Vitamin D to absorb that Calcium.

Dietary sources include:

  • dairy foods, such as milk, cheese, and yogurt
  • green leafy vegetables, such as kale and broccoli
  • fish with soft bones, such as tinned salmon and tuna
  • fortified breakfast cereals

Dietary sources for Vitamin D include fortified foods, Saltwater fish, and liver. As you know most of the vitamin D comes from the sun so a moderate – regular exposure to sunlight is recommended.

Other important nutrients include Protein, Magnesium, Vitamin K, Zinc.

If a person’s nutrition intake is inadequate, supplements like Joint Essential are an excellent option.

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Osteoporosis exercise includes the following,

Muscular strength relates to your ability to move and lift objects. It’s measured by how much force you can exert and how much weight you can lift for a short period of time. Examples of exercises that develop muscular strength and power includes, weightlifting, Push ups, Leg lift, resistance band exercises.

Individuals with osteoporosis should start with light weights and gradually increase the difficulty

  • Postural Exercises

Doing postural exercises reduces the back pain, improving a person’s posture and energy level. These movements strengthen and stretch the muscles in the back and chest, lowering the risk of spinal fractures. It includes, Stretching, different yoga poses etc.

  • Weight bearing exercise

Jogging, Jumping, Step aerobics, playing tennis or other racquet sports, Yard work, like pushing a lawnmower or heavy gardening, Hiking, and dancing

  • Non-Weight bearing exercises

Swimming, water exercise or rowing, Bicycle riding, Isometric exercises that tighten and relax muscles several times in a row

However, there are certain exercises that should avoid if the person has Osteoporosis. The patients should avoid activities that twist, flex, or bend the spine. The most common examples of such exercises that you should avoid are, sit-ups, crunches, toe-touches, spinal twist etc.

Catherine Fox