Health Break | Published December 20, 2010

Fragility, Fractures and Osteoporosis

All of our lives our bones are being built up and torn down at the same time from natural body processes. Into our late 20s, creating bones takes precedence, but around 30 years old breakdown of the bones gradually comes to dominate. If enough destruction takes place, a person has osteoporosis, which means “porous bone.”

Bones naturally have an open honeycomb structure, but in osteoporosis the density of the bone is so diminished that breaks and fractures become more likely. According to the National Osteoporosis Foundation, about 10 million Americans have osteoporosis, and another 34 million are at risk, both women and men.

One of the dangers of osteoporosis is that there are no symptoms until a bone breaks. The most serious consequence of osteoporosis is broken bones, and with broken hips, the break may directly or indirectly cause death.

The most common bones to break from osteoporosis are the hip, spine, wrist and humerus (upper arm bone). Up to one half of all women over 50 will break a bone due to osteoporosis, and 25% of men will do so, according to the National Osteoporosis Foundation. Most broken bones are due to falls from a standing height.

Bones can fracture without breaking entirely, and the seriousness of a break depends on where it occurs. A broken wrist can probably be treated just with a cast, but in the hip, even a small crack in the bone may require surgery.

A common test for osteoporosis is a dexascan which checks for bone density; other tests include a physical exam, and possibly blood tests. Osteoporosis is usually not curable, but it is treatable once it is recognized. The two most common treatments for osteoporosis are exercise and medicine. Exercises must be weight-bearing so that the bones are placed under stress. Working the bones helps them get stronger.

There is nothing that will guarantee prevention of osteoporosis and many people who get it have a genetic predisposition to the disease. Young girls can help prevent bone problems later in life by building stronger bones while young. When people get into their 60s, doctors usually monitor the condition of the bones.

It is important for everyone to consume enough calcium, and since vitamin D is needed to metabolize calcium, the intake of vitamin D is essential. Calcium can be found in the diet mostly in dairy products, as well as in salmon, sardines and green leafy vegetables. Under the right conditions, the skin produces vitamin D when exposed to sunlight, but this can be affected by a number of factors. Other foods also have vitamin D, but a supplement of vitamin D alone or with calcium, is recommended since it is difficult to get enough vitamin D just from food.

While osteoporosis can be serious, it can also be managed, and the severity can be diminished through a combination of diet, exercise, supplements, and medicine when necessary.

Paul Sherbondy, M.D. is an orthopedic surgeon with Penn State Hershey Orthopaedics, State College, Pa. He is a member of the medical staff at Mount Nittany Medical Center. For more information go to www.mountnittany.org.

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