Osteoporosis - Crozer-Keystone Health System - PA

Osteoporosis

Osteoporosis is a condition characterized by weak, brittle bones, which dramatically increases a person’s risk for broken bones—mainly in the hips, wrists and spine. Approximately 52 million Americans have osteoporosis and low bone density (osteopenia). In fact, one in two women and one in four men will break a bone due to osteoporosis during their lifetime.

People who suffer a fracture are at greater risk of having another. The only way to prevent future fractures is to aggressively treat osteoporosis as soon as possible. Our clinicians are knowledgeable on the most up-to-date bone agents that ensure the best possible outcomes for our patients.

Because it has very few, if any, symptoms, Osteoporosis is considered a “silent disease.” Those who do exhibit symptoms may have noticed a loss of height or severe back pain. In addition, people with bone loss can easily fracture bones from a low-impact fall (from a standing position or less). If you have disease in your spine, even simple movements can cause a fracture.

Who is most at risk?

Osteoporosis is the most common condition experienced by women over the age of 50. While most cases of osteoporosis are seen in women, men are also at risk. Men who are affected usually begin to see signs in their seventies. Post-menopausal women, those who are thin, and people of Caucasian and Asian ethnicity are at greatest risk of developing osteoporosis.

People who smoke, eat a poor diet, drink excessive amounts of alcohol and do not exercise increase their risk of developing osteoporosis and sustaining bone fractures. In addition, those who have low bone mass (or osteopenia) are at an increased risk of having a fracture.

How to Lower Your Risk

Taking some simple steps early on in life can go a long way in preventing osteoporosis down the road. You should:

  • Get a baseline DEXA scan (dual energy X-ray absorptiometry) to help determine if you have osteoporosis (or if not, your risk).
  • Get enough calcium and Vitamin D. The daily recommended amount for calcium is:
  • 1,300 mg from onset of menses to age 23
  • 1,000 mg from age 23 to menopause
  • 1,200 mg from menopause through the rest of life
  • Regarding Vitamin D, the Institute of Medicine (IOM) recommends at least 600 international units (IU) every day for most healthy adults under age 71, and at least 800 IU for healthy people age 71 and older.
  • Exercise regularly
  • Take preventive measures to prevent a fall in your home or work environment by removing clutter and tacking down or removing rugs.

Diagnosing Osteoporosis

Early diagnosis and treatment helps patients and physicians to best manage the effects of osteoporosis. In addition to a complete medical history and physical examination, diagnostic procedures for osteoporosis may include family medical history, x-rays, blood tests and DEXA scans or bone density tests.

A bone density test, also known as bone mass measurement or bone mineral density test, measures the strength and density of your bones as you approach menopause and, when the test is repeated sometime later, can help determine how quickly you are losing bone mass and density. These tests are painless, noninvasive, and safe. They compare your bone density with standards for what is expected in someone of your age, gender, and size and to the optimal peak bone density of a healthy young adult of the same gender.

Bone density testing can help to:

  • Detect low bone density before a fracture occurs
  • Confirm a diagnosis of osteoporosis if you have already fractured
  • Predict your chances of fracturing in the future
  • Determine your rate of bone loss and/or monitor the effects of treatment if the test is conducted at intervals of a year or more.

If you have one or more of the following risk factors for osteoporosis, you may want to consider having a bone density test:

  • You have already experienced a bone fracture that may be the result of thinning bones
  • Your mother, grandmother, or another close relative had osteoporosis or bone fractures
  • Over a long period of time, you have taken medication that accelerates bone loss, such as corticosteroids for treating rheumatoid arthritis or other conditions, or some anti-seizure medications
  • You have low body weight, a slight build, or a light complexion
  • You have a history of cigarette smoking or heavy drinking

Treating Osteoporosis

Specific treatment for osteoporosis will be determined by your physician based on:

  • Your age, overall health, and medical history
  • Extent of the disease
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

The goals of managing osteoporosis are to decrease pain, prevent fractures, and minimize further bone loss. Some of the methods used to treat osteoporosis are also the methods to help prevent it from developing, including the following:

  • Maintain an appropriate body weight
  • Increase walking and other weight-bearing exercises
  • Minimize caffeine and alcohol consumption
  • Stop smoking
  • Maintain an adequate intake of calcium through diet and supplements, and Vitamin D is also necessary because it facilitates the absorption of calcium
  • Prevent falls in the elderly to prevent fractures (i.e., install hand railings, or assistive devices in the bathroom, shower, etc.)
  • Consult your physician regarding a medication regimen

For postmenopausal osteoporosis in women, the US Food and Drug Administration (FDA) has approved the following medications to maintain bone health:

Estrogen Replacement Therapy (ERT) and Hormone Replacement Therapy (HRT)

ERT has proven to reduce bone loss, increase bone density, and reduce the risk of hip and spinal fractures in postmenopausal women. However, a woman considering ERT should consult her physician, as the recent study conducted by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) found health risks associated with this therapy.

Alendronate

This medication, from a group of medications called bisphosphonates, reduces bone loss, increases bone density, and reduces the risk of fractures.

Risedronate sodium (Actonel®)

This medication is also from the bisphosphonate family and has similar effects as alendronate.

Raloxifene (Evista®)

This medication is from a new group of medications called selective estrogen receptor modulators (SERMs) that help to prevent bone loss.

Fracture Intervention Service

Crozer-Keystone's Fracture Intervention Service is available to men and women over the age of 50 who have sustained a low-impact fracture in the wrist, hip, ankle, ribs, spine or upper arm. Low-impact fractures can occur from a slip or fall (and do not include traumatic fractures). Our medical team consults fracture patients during their hospital stay as well as after emergency room visits and outpatient operations to repair a fracture.

Contact Us

Hours are by appointment only and most insurances are accepted. For an appointment at the Osteoporosis Center of Delaware County, please call 610-541-7927.