1. Muscle & Bone Problems

Osteoporosis

Osteoporosis is a loss in bone mass and bone strength. Bones become weak and brittle. This makes them more prone to fractures. Any bone can be affected. The hips, wrists, and spine are the most common sites.

Signs & Symptoms

Osteoporosis is a “silent disease.” It can occur without seeing changes taking place inside the body. Often the first sign is a fracture of the hip, wrist, or spine. When signs and symptoms occur, they include:

1. •Gradual loss of height.
   

2. •Rounding of the shoulders.
   

3. •Sudden back pain.
   

4. •Stooped posture.
   

5. •Dowager’s hump.

After a fall, are you not able to get up or do you have wrist, hip, or back pain?

Are you a female between ages 60 and 65, do you have risk factors for osteoporosis listed on page 199, and have you not had a bone mineral density test?

Are you an elderly male and have you used corticosteroid medicine long-term; are you physically inactive and of a low body weight and/or have you had a bone facture possibly due to osteoporosis?

Do you have signs of osteoporosis listed above? Do you want to find out about medicines to prevent and/or treat osteoporosis?

Are you a female age 65 or older and have you not had a bone mineral density test?

Self-Care / Prevention

To Treat, Slow, and Prevent Osteoporosis

1. •Take medicines, as prescribed.
   

2. •Eat a balanced diet. Get your recommended Adequate Intake (AI) for calcium every day.
   

3. *Check for updates on calcium and vitamin D needs from www.iom.edu.
   

1. •Choose high-calcium foods daily:
   

2. -Skim and low-fat milks, yogurts, and cheeses. {Note: If you are lactose intolerant, see information for Lactose Intolerance.}
   

3. -Soy milks and yogurts with added calcium. •Soft-boned fish and shellfish, such as salmon, sardines, and shrimp.
   

4. -Broccoli, kale, and collard greens.
   

5. -Beans and bean sprouts, as well as, tofu (soybean curd), if processed with calcium.
   

6. -Calcium-fortified foods, such as some juices and ready-to-eat cereals.
   

7. •Take calcium and vitamin D supplements, as advised by your doctor.
   

8. •Get vitamin D from sunshine (15 minutes of midday sunshine may meet daily needs) and from foods (fortified milks and cereals, egg yolks, saltwater fish, liver, and cod liver oil).
   

9. •Do regular, weight-bearing exercise, such as walking, at least 3 or 4 times a week. A person with osteoporosis should exercise as advised by his or her doctor. Practice good posture.
   

10. •Don’t smoke. Limit alcohol.
    

11. •Use fall prevention measures:
    

12. -Ask your doctor how to deal with any medications you take that could cause you to fall.
    

13. -Use grab bars and safety mats in your tub and shower. Use handrails on stairways.
    

14. -Pick things up by bending your knees and keeping your back straight. Don’t stoop.
    

15. -Wear flat, sturdy, nonskid shoes.
    

16. -If you use throw rugs, use ones with nonskid backs.
    

17. -Use a cane or walker, if necessary.
    

18. -Keep halls, stairways, and entrances well lit. Use night lights in hallways and rooms.

Causes

The actual causes are not known. Risk factors include:

1. •Being female. Women are 4 times more likely to develop osteoporosis than men.
   

2. •Low estrogen level. This occurs with menopause or with surgery that removes a women’s ovaries.
   

3. •Low testosterone level in men.
   

4. •Aging.
   

5. •Family history of osteoporosis or broken bones in adulthood.
   

6. •Having a thin, small- framed body.
   

7. •Lack of physical activity, especially weight-bearing exercises, such as walking and dancing.
   

8. •Long-term bed rest.
   

9. •Low calcium and vitamin D intake or absorption.
   

10. •Smoking cigarettes.
    

11. •Drinking too much alcohol. Heavy drinkers often eat poorly, too. They are also more prone to fractures from falls.

1. •Long-term use of certain medicines, such as oral corticosteroids and antacids with aluminum.
   

2. •Having certain health problems, such as anorexia nervosa, kidney disease, an over active thyroid gland, and rheumatoid arthritis. People with Crohn’s disease, ulcerative colitis, and celiac disease are at an increased risk, too.
   

3. •Exercising too much to the point where menstrual periods cease.
   

Treatment

There is no cure. The focus of treatment is to:

1. •Prevent the disease.
   

2. •Prevent further bone loss.
   

3. •Build new bone.

Special X-rays, such as one known as a DXA or DEXA scan, can measure bone mass in the hip, spine, or wrist. These tests are safe and painless. They help doctors decide if and what kind of treatment is needed. This includes:

1. •Treating medical problems that increase the risk for osteoporosis.
   

2. •Medications. There are different kinds. Your doctor will prescribe one(s) best suited for your needs.
   

3. •Exercises, as advised by your doctor.
   

4. •Proper posture.
   

5. •A balanced diet with enough calcium and vitamin D.
   

6. •Calcium and vitamin D supplements.
   

7. •Fall prevention measures. (Examples are listed below.)
   

Questions to Ask