As you age, so do your bones. This natural occurrence can make your bones thinner and weaker without you even knowing it. Just how much your bones will be affected over time may depend on whether you develop osteoporosis.
Osteoporosis is a disease that causes bones to become very weak and brittle. It can develop without symptoms or discomfort over many years so you may not realize you have osteoporosis until you experience a broken bone.
“Bone is living tissue that is constantly in a state of being broken down and replaced,” explains Sabatino Bianco, M.D., FAANS, FACGS, a spine and neurosurgeon on the medical staff and medical director of neurosciences at Texas Health Arlington Memorial Hospital. “When you’re young, your body makes new bone faster than it breaks down old bone, so your bone mass increases. As you get older, bone mass is lost faster than created. Because osteoporosis happens when the creation of new bone can’t keep up with the loss of old bone, how likely you are to develop the disease partially depends on how much bone you are able to store in your younger years.”
Fractures from osteoporosis most often occur in the small bones (vertebrae) that make up the spine as the result of a fall. But Dr. Bianco says even doing everyday things like bending over, twisting, reaching, or simply coughing can be enough to cause a break in very weak bone.
The American Academy of Orthopaedic Surgeons estimates spinal fractures, also called vertebral compression fractures, happen about 1.5 million times each year in the United States. They are almost twice as common as other fractures linked to osteoporosis, such as broken hips and wrists.
In a vertebral compression fracture, too much pressure is placed on a weakened vertebra in the spine. The pressure causes the front of the vertebra to crack and lose height. That’s why people with osteoporosis may become shorter over time or develop a stooped posture.
Are You at Risk for Osteoporosis?
A number of risk factors can increase your chance of developing osteoporosis, according to the Mayo Clinic. Some are out of your control, including:
- Your sex. Women are more likely to develop osteoporosis than men.
- Age. The older you get, the greater your risk.
- Race. You’re at greatest risk if you are white or of Asian descent.
- Family history. Having a parent or sibling with osteoporosis increases your risk.
- Body frame. Men and women with small body frames tend to be at higher risk because they may have less bone mass to draw from as they age.
- Hormone levels. Osteoporosis is more common in people who have too much or too little of certain hormones in their bodies.
- Certain medical conditions. People with celiac disease, irritable bowel disease, cancer, kidney/liver disease, multiple myeloma or rheumatoid arthritis are at greater risk.
- Vitamin D deficiency. Vitamin D is necessary to build strong bones.
Dr. Bianco notes that there are some lifestyle choices and bad habits that also can promote the development of osteoporosis, including.
- Low calcium intake. Low calcium intake contributes to diminished bone density, early bone loss and an increased risk of fractures.
- Eating disorders and obesity. Being severely underweight or overweight weakens bones.
- Steroid use. Long-term use of oral or injected corticosteroids interferes with the bone-rebuilding process.
- Sedentary lifestyle. If you spend a lot of time sitting, you have a higher risk of osteoporosis than if you are more active.
- Excessive alcohol consumption. Regular consumption of more than two alcoholic drinks a day increases the risk.
- Tobacco use. Tobacco use is also a contributor to weak bones.
“There are medications, diet choices and weight-bearing exercises that can help prevent bone loss or strengthen already weak bones,” Dr. Bianco says. “Activities that promote balance and good posture, like walking, dancing and weightlifting, are particularly good for your bones, as is a diet that includes zinc and vitamins C and D.”
When to See a Spine Specialist
Because osteoporosis has the reputation of being a silent disease, it can be difficult to know when to seek medical help. But if the disease runs in your family or you have other risk factors for it, Dr. Bianco recommends a proactive approach that includes getting a bone density test every two years.
A bone density test measures how much mineral, such as calcium, is in your bones. This non-invasive test can help gauge your chances of breaking a bone — hopefully before one occurs — and monitor the effectiveness of any osteoporosis treatment.
“If you are experiencing height loss or you notice your upper back is beginning to curve, it’s time to consult your doctor or other health care provider. Should a spinal fracture occur, you’ll likely experience back pain near the site of the break. This is often near the waistline or slightly above or below it. If the fracture is severe enough, it may cause nerve pain that radiates into the legs as well. Any of these symptoms should prompt a visit with a doctor,” Dr. Bianco adds.
While osteoporosis has historically been largely a disease found in post-menopausal women, Dr. Bianco says that cases are on the rise among older men. Early detection can help lead to early treatment that promotes better bone density and better overall bone health. Newer treatment options, including prescription injectable medications and kyphoplasty surgical care, are improving outcomes for women and men living with osteoporosis.
Ready to schedule an appointment? Find a back and spine specialist on the medical staff near you.