Osteoporosis, or fragile bones, has been referred to as the “untreated epidemic.” This disease is a loss of bone density that leads to increasingly high risk for broken bones. Several treatment options exist for osteoporosis, but because there are no noticeable symptoms until after a bone has broken, many people are never tested.

The onset of osteoporosis can almost always be prevented or slowed.

Bones are living tissue, and they’re constantly being built up and absorbed by the body. Bone density begins to drop when the body absorbs the bones’ minerals faster than it replaces them. Bones can be thought of as a bank. By putting lots of minerals into the bones and “saving up,” there will be plenty of extra minerals for the body to draw on, making osteoporosis less likely.

Watch This Video and Learn About Osteoporosis

The best time to start “saving up” is during the first 20 years of life, but it’s never too late. The same recommendations for children and teens can be applied to adults, and they can still be beneficial.

The best ways to prevent or slow the loss of bone density are:

  • Get plenty of calcium
  • Get plenty of vitamin D
  • Eat a healthy diet rich in nutrients
  • Exercise
  • Don’t smoke
  • Drink alcohol in moderation

Calcium is what gives bones their strength, and vitamin D helps the body absorb calcium. Low-fat dairy products, fish, and dark green vegetables can provide these nutrients, and both calcium and vitamin D are also available in supplement form. Fresh fruits and vegetables are a rich source of other nutrients that benefit the bones.

Osteoporosis is relatively easy to diagnose and quite treatable.

If an individual is at risk for osteoporosis, a non-invasive X-ray called a dual energy X-ray absorptiometry (DXA) can measure his or her bone mineral density. If the person does, indeed, have lowered bone density, there are several potential treatments. Some of these treatments focus on pain management, while others are meant to disrupt further loss of bone density.

Additionally, if an individual is diagnosed with osteoporosis, there are steps that he or she can take at home to lower the risk of breaking a bone. Most notably, if someone is aware of his or her increased risk for broken bones, he or she can be extra careful not to fall. Moving electrical cords, attaching adhesive backing to rugs, and having sufficient lighting can all reduce the risk of falls.

Because osteoporosis has no obvious symptoms or warning signs, many people are never tested.

According to a Canadian study originally published in Circulation: Heart Failure, 12% of heart failure patients also had moderate to severe vertebral compression fractures, which are a sign of osteoporosis. Out of that 12% of patients, 55% had multiple fractures. These fractures were all significant enough to be easily detectable with an X-ray, but only 15% of those with spinal fractures were actively undergoing treatment for osteoporosis.

This might give an idea of how terribly undertreated osteoporosis is. The symptoms aren’t obvious until after an individual breaks a bone, but because so many of the broken bones are subtle, a disturbing number of people go without testing and, as a result, without treatment. Since many of the broken bones associated with osteoporosis can be mistaken for simple back pain, many people never go to a physician about the pain.

For example, if an older woman sneezes or coughs and suffers from a sore back afterwards, it’s unlikely she’ll go to the doctor about it. If an elderly man with a hunched back complains of aches and pains, it can easily be brushed off and ignored.

Neither of these individuals would be likely to speak to a physician or undergo a bone density test for such subtle symptoms, even though testing might reveal that they’d both suffered spinal fractures. They might not undergo testing until after tripping over a rug and breaking a hip. Even then, if nobody put together the pieces and suggested the test, it might not be performed.

A new automated system, however, could help identify and inform individuals who are at high risk of osteoporosis.

A program was recently implemented at the emergency department of Penn State Milton S. Hershey Medical Center. The program, which was devised by researchers at Penn State College of Medicine, analyzes treatment codes to identify potential osteoporosis patients.

To accomplish this, data from the hospital’s financial department was used to fill out a spreadsheet to screen for osteoporosis. The resulting database was screened further to narrow down the patients with potential fragility fractures, which are osteoporosis-related breaks. Computer-generated letters were sent to the final list of people, encouraging them to pursue testing for osteoporosis.

The letter was sent out 3 months after each individual’s visit to the emergency room. Another 3 months after that, the patients received a follow-up call to find out if they’d received any treatment for osteoporosis. 60% had either received treatment or were planning to pursue treatment. Among patients treated for fragility fractures who did not receive a computer-generated letter, only 14% had undergone or planned to undergo osteoporosis treatment. Obviously, the program made a significant difference.

Research has been conducted on osteoporosis prevention and treatment, but without a simple way to identify those at risk, individuals still go largely untreated. As stated by Edward Fox, professor of orthopedics:

“Our almost fully automated osteoporosis system identifies these patients, requires minimal resources–many of which are already currently in U.S. hospitals, but just need to be tapped–and delivers substantially improved osteoporosis intervention results.”

Past systems of osteoporosis identification have been largely lacking in automation or difficult to implement in average hospitals. In addition to its easier use, this new system also helps remove human error. For example, if an ER physician doesn’t put together the dots for some reason, an individual could go on with no idea that he or she is at a much higher risk for broken bones.

If more people can be diagnosed with osteoporosis, more people can receive treatment. Additionally, if more people can be diagnosed with lowered bone density, more people can take steps to stop or slow the onset of osteoporosis.

Do you think you or someone in your family might be at high risk for osteoporosis?

Image by Alyssa L. Miller via Flickr


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