Osteoporosis - Love Your Bones
Dr Sunil says that with proper treatment adherence and improved lifestyle, osteoporosis can be managed and in fact reversed. But, this is along with the fact that osteoporosis management is lifelong.
Osteoporosis makes the bones brittle and prone to fractures
World Osteoporosis Day is observed on October 20. The day is meant to raise awareness about osteoporosis, its causes, importance of early diagnosis and treatment adherence. Osteoporosis is essentially a condition in which the bones become brittle. It occurs when the body loses too much bone or bone density decreases. Osteoporosis weakens the bones to such an extent that there is risk of bone breakage from a fall or even a sneeze. To know all about it, we spoke to Dr Sunil Marwah, Orthopaedic Surgeon, about the causes of osteoporosis and tips for prevention. In India, osteoporosis is a condition which primarily affects women around the age of 45. The condition affects men around 50 to 55 years of age. “In our society, bone strength is low in people in their early teens and 20s. This is because our calcium intake is low and we are not as athletically oriented,” says Dr Sunil. According to him, this is the reason why the total bone mass is comparatively lesser in people in India.
This in turn, results in quick loss of bone around 40 to 45 years of age, especially in women (thanks to menopause and other hormonal changes).
Vitamin D deficiency can also increase risk of osteoporosis. Spending less time under the sun is main reason for Vitamin D deficiency. “Vitamin D fortified foods are available in other parts of the world, but not in India. Lack of Vitamin D results in low absorption of calcium, which leads to soft bones at an early age,” adds Dr Sunil.
This process, he says, is also known as slow loss or silent loss of bones. People are not likely to realise this loss of bones. One commonly caused symptom of osteoporosis is loss of height. There is also an increased risk of easy fractures of the hip. Ultimately, it leads to chronic back ache as well.
How is osteoporosis diagnosed?
Dr Sunil informs that osteoporosis diagnosis can be done by the DEXA bone density test. “It is like an x-ray which tells us how much bones a person has and the strength of bones,” he says. He recommends women crossing the age of 40 to get DEXA bone density scan to know their status and start osteoporosis treatment if required.
In our society, bone strength is low in people in their early teens and 20s. This is because our calcium intake is low and we are not as athletically oriented."
Dr. Sunil MarwahSenior Orthopedic Surgeon, Artemis Hospital and Narayana Hospital in Gurgaon
Apart from DEXA scan, an x-ray of the spine and hip can also diagnose if a person has osteoporosis.
Osteoporosis treatment and management
During the initial stages of osteoporosis, patients are recommended to get sufficient Vitamin D—either from exposure to sunlight or by eating food sources of Vitamin D like eggs, mushrooms, leafy green vegetables and fatty fish. Also, eating more of calcium-rich foods like milk and dairy products, beans, almonds, spinach and lentils can help in maintaining bone health and managing osteoporosis.
Being physically active is also important for people who have been diagnosed with osteoporosis. “It is only by being physically active that you are absorbing more calcium and losing less of it. It is very important to be physically active for osteoporosis management,” says Dr Sunil.
Medications for osteoporosis treatment
If your condition has surpassed the stage where modifications in diet can't help, medications are required for treating osteoporosis. “Medications are prescribed to osteoporosis patients to stop further loss of bones. Zoledronic acid is given once a year as an intravenous (IV) infusion to treat osteoporosis. Also, Denosumab or Prolia is a vaccine which is given to patients once in 6 months. This vaccine has been used for treatment of osteoporosis for almost 15 years across the world. It has been available in India since the past 2 years,” says Dr Sunil while adding that the vaccine is most effective in stopping loss of bone.
However, if the patient has already been fractured with soft bone or with poor bone quality, then doctors have to work towards building bone quality in osteoporosis patients.
“India is the biggest hub of osteoporosis patients worldwide,” Dr Sunil tells DoctorNDTV.
Ask him about the age at which people should start taking bone health seriously and he says that women should begin to take extra care of their bones by the age of 45 to 50, and men should do the same by the age of 55 to 60.
Can osteoporosis be controlled?
Dr Sunil says that with proper treatment adherence and improved lifestyle, osteoporosis can be managed and in fact reversed. But, this is along with the fact that osteoporosis management is lifelong. “Even after rebuilding bones, it is important to take care of bones to prevent bone loss again,” he asserts.
Just like is the case with rheumatoid arthritis, early diagnosis is also important for osteoporosis in order to be able to maintain it properly. Late diagnosis makes treatment more expensive and requires rebuilding of bones, which is a lengthy process.
(Dr Sunil Marwah is Orthopaedic Surgeon at Artemis Hospital and Narayana Hospital in Gurgaon)
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