Osteoporosis
Osteoporosis is a condition in which the density of bones is reduced due to increased loss of material from them.
This results in impairments in the strength and function of these structures. Osteoporosis is often termed “brittle bones.”
This condition increases the risk of bone fractures due to their reduced ability to bear the load of muscles, other bones, or external forces.
In cases of severe osteoporosis, simple motions or gestures may result in a broken bone. This disorder may lead to damage to the bones of the wrists hips or spine, and may also be connected to a fall or injury.
Causes Of Osteoporosis
Osteoporosis may occur as a natural, age-related process over time. However, certain factors or variables may increase the risk of developing the condition. These may include:
- Family history of osteoporosis
- Female gender
- Certain medical conditions, such as hypothyroidism
- Calcium deficiency
- Vitamin D deficiency
- The use of steroid medications
- Regular or high-volume tobacco smoking
- Regular or high-volume alcohol consumption
An individual may develop a number of characteristic types of bone damage as a result of osteoporosis. These include vertebral compression fractures, in which the bones of the spine lose tissue, and thus their proper structure, until they collapse inward. One or more of these fractures may result in a loss of vertical height and mechanical disturbance or damage to the spinal cord. Vertebral compression fractures are also associated with pain, impaired motion, and other possible neurological symptoms resulting from spinal cord impingement.
The early stages of osteoporosis may be asymptomatic or not exhibit noticeable signs. This may hinder a diagnosis until bone density loss has progressed enough to cause an adverse event. Early detectable signs of osteoporosis may include pain and spinal deformity due to vertebral compression fracture.
Diagnostic procedures for the condition include tests for bone density. These may detect the presence of osteoporosis or a high risk for the condition. The degree of bone matter loss may contribute to a decision by the patient and physician concerning the next appropriate step in treatment for this condition.
Treatments For Osteoporosis
Treatment for osteoporosis typically includes the management of pain, if present, or procedures that address bone loss in important regions of the skeleton where such treatment may be acutely necessary, i.e. the spine.
Vertebroplasty is a minimally invasive surgical procedure in which the height and structure of a bone affected by vertebral compression fracture is restored. This begins with the administration of a local anesthetic to the skin above an affected spinal bone (or vertebra). A needle is then inserted through this into the collapsed bone. This is done with guidance from technology such as fluoroscopy or X-ray imaging to ensure accurate needle placement and insertion and avoid inadvertent nervous system damage. Next, acrylic medical cement is injected through the needle. This replaces the lost bone in the vertebra and returns it to its original height and orientation in the spine.
Kyphoplasty is a newer variant of vertebroplasty that includes the additional step of the insertion of small inflatable balloons into the bone before the cement. This is associated with reduced cement leakage from the vertebra after the procedure, shorter procedure duration, and reduced exposure from radiological equipment, if used.
Vertebroplasty is associated with increased long-term vertebral healing and reversal of the effects of osteoporosis in comparison with kyphoplasty. On the other hand, kyphoplasty is associated with reduced recovery times and latency to relief from chronic pain. Both procedures are associated with the alleviation of pain in as little as two days post-treatment.
Pharmacotherapy for chronic pain associated with osteoporosis may include opioids. These are associated with significant pain relief in cases resistant to more commonly-available over the counter pain medications. However, opioids are associated with adverse effects including respiratory depression, addiction, and abuse. Therefore, they are not recommended for cases of chronic pain unless an individual is assessed as being at a reduced risk for these adverse effects. If a patient is a suitable candidate for opioid treatment, they should be monitored closely for side effects and adverse events, and must be prepared to discontinue the therapy if it appears ineffective or potentially harmful.
Acupuncture is a complementary or alternative therapy derived from ancient Chinese medicine. This may be effective in mild to moderate cases of pain, or in combination with other treatments. Acupuncture typically involves the shallow placement of stainless steel sterile needles through the skin in the part of the body affected. Other regions that may be thought to be related to the pain may also be treated. Acupuncture is linked to improvements in symptoms such as inflammation, pain, and reduced mobility. It is thought to promote the release of endorphins that regulate pain in the body.
