Sadly, Osteoporosis has for too long been ignored by the medical community and population at large, possibly due to the fact that the condition is silent, not causing any symptoms, prior to the occurrence of a fracture. Furthermore, even when considered, only few patients (about 30%) receive optimal treatment. This is a sad fact given that osteoporosis is the most common disease of bone, whereby 50% of females and 20% of males over the age of 50 will sustain a minimal trauma fracture at some time in their lives.
The most common bone to be fractured is the vertebra (spinal bone), which frequently (70% of the time) is not recognized since back pain is common and often not investigated. However, in some, the pain can be severe requiring hospitalization in about 10%. These fractures can cause a curvature of the spine, termed a kyphosis, which if severe enough can cause difficulty with respiration and is known to shorten life expectancy. Another common fracture affects the forearm/wrist and is known as the Colles fracture.
However, perhaps the most devastating fracture involves the neck of the thigh bone, called the femur, which is associated with a 10-20% risk of death in the 1st year (highest in the 1st 6 months). The risk of this type of fracture, which is most common in females, increases with age and likely relates to the reduction in bone mass and an increase in the chance of falling. Should the person survive then there is often residual impairment in mobility, requiring some to use walking aids and worse still move into residential care (such as a nursing home). They are often preceded by previous fractures, which signify a missed opportunity for treatment that may have prevented the fracture from occurring.
We must treat this group most at risk of recurrent fractures (read about BJC Health’s Refracture Prevention Program).
The following sections on osteoporosis will focus on risk factors for the disease, how is the diagnosis made, and what is the approach to treatment.