“Say no to frail bones”

Arush Rasyotra
World Osteoporosis Day, observed annually on October 20, is a campaign dedicated to raise global awareness of prevention, diagnosis, and treatment of osteoporosis and related musculoskeletal diseases .
The theme for World Osteoporosis Day 2024 is ‘Say no to fragile bones’.
This year’s World Osteoporosis Day campaign aims to end the inertia surrounding bone health by encouraging individuals of all ages to value and protect their bones. Its goal is to elevate bone health and fracture prevention to the top of the global health agenda, and it targets health-care professionals, the media, policymakers, patients, and the general public alike. Currently, osteoporosis is significantly underdiagnosed and undertreated. Millions of people worldwide are at high risk of fractures yet are ignorant of the silent disease. Fractures have a significant influence on patients’ independence and come at a high cost for both individuals and society.
The Annual World Osteoporosis Campaign brings together individuals and organizations globally to raise awareness about the illness and its impact.
What is Osteoporosis
Osteoporosis literally means ‘porous bone’. This disorder causes bones to shrink, lose strength, and have lower quality due to diminished density. This might result in broken bones, causing pain and incapacity. Osteoporosis-related bone fractures can significantly affect quality of life, mobility, and independence. Osteoporosis is commonly referred to as the’silent illness’ since most individuals are unaware of the condition until they experience a fragility fracture, which occurs after a minor fall or bump.
Some facts about osteoporosis
* Osteoporosis affects one in every three women and one in every five men over the age of 50 years .
* Hip fractures are expected to increase 310% in males and 240% in women globally by 2050, compared to 1990.
* Osteoporosis accounts for about 8.9 million fractures worldwide, with one occurring every 3 seconds.
* According to the WHO definition of osteoporosis, around 500 million men and women globally may be affected.
Maintain a bone-healthy lifestyle.
* Peak bone mass typically occurs between the ages of 25-30. While genetics account for 60-80% of maximal bone mass, young people who exercise and eat well can maximize their genetic potential.
* To maintain good bone health throughout life, it’s important to engage in regular weight-bearing activity, consume nutritious bone-healthy foods, obtain enough vitamin D, maintain a healthy weight, and avoid smoking and excessive alcohol consumption.
Identify risk factors early on.
* If you’re at risk, have a bone health assessment and complete the IOF Osteoporosis Risk Check. Aside from age, risk factors include height loss, low BMI, specific disorders (e.g., rheumatoid arthritis), family history, and long-term use of glucocorticoids and other drugs.
* Breaking a bone, such as the wrist, after a modest fall from standing height may indicate osteoporosis. Consult your doctor for testing and treatment, as a single broken bone can indicate future fractures.
* Back pain, height loss, and a crooked back (kyphosis) may indicate vertebral fractures and should not be ignored.
Investigations conducted for osteoporosis
DEXA (Dual Energy X-ray Absorptiometry) is used to diagnose Osteoporosis. DEXA measures an individual’s bone mineral density. The measurements are taken at the lumbar spine, femoral neck, or hip. Quantitative CT is less widely used to detect osteoporosis because of its high cost and increased risk of radiation exposure compared to DEXA. However, the laboratory parameters i.e . serum calcium , PTH ,serum phosphate and ALP are in normal range
Screening
According to National Osteoporosis foundation the screening should be started at age of 65 in women and at age of 70 in men. But in case of fracture after 50 years of age the screening is advisable. The screening is also advised in women of menopausal age with risk factors, post menopausal women under age 65 with risk factors and in men age 50-69 years of age with risk factors.
Treatment
Maintaining a healthy lifestyle, including proper eating and exercise is crucial for managing osteoporosis. Pharmacological treatments can lower the risk of hip fractures by up to 40%, vertebral fractures by 30-70%, and non-vertebral fractures by 30-40%.
Message for the public and patients:
Move your bones.
* Bones and muscles, strengthen with use. Exercise promotes bone growth and maintenance in children and teenagers, as well as adults.
* Weight-bearing and muscle-strengthening workouts are optimal for bone health, regardless of age. Lift, push, run, leap, and’step’ your way towards stronger bones.
* Most people should exercise for 30-40 minutes three to four times per week, incorporating both weight-bearing and resistance activities.
* Osteoporosis patients benefit from specific exercise plans that include balance and posture improvement exercises. Exercise should be adjusted to individual needs and ability.
* Targeted exercise is essential for post-fracture rehabilitation, reducing pain, improving physical function, and improving quality of life. Physiotherapists can provide individualized exercise regimens based on individual needs and skills.
Follow a bone-healthy diet.
Eat well! A bone-healthy diet includes proper amounts of calcium, protein, vitamin D, vitamin K, and other nutrients. Nutritional requirements vary with age. Calcium intake is particularly important for young people and women following menopause. A well-balanced diet meets all of the nutritional requirements for the majority of people. Supplements may be necessary for individuals who do not consume enough calcium or vitamin D through food or sun exposure to maintain good bone health.
Prevent bone-damaging practices.
Smoking and excessive alcohol consumption are also risk factors for osteoporosis.
Maintaining a healthy weight is crucial, and being underweight (BMI < 19) is a significant risk factor.
Prevent recurring fractures
If you’ve broken a bone after 50 from a minor fall, consult your doctor for assessment and treatment to prevent future fractures.
(The author is MBBS student at GMC Jammu)