Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and may break from a fall or, in serious cases, from sneezing or minor bumps. Osteoporosis means “porous bone.” Viewed under a microscope, healthy bone looks like a honeycomb. When osteoporosis occurs, the holes and spaces in the honeycomb are much larger than in healthy bone. Osteoporotic bones have lost density or mass and contain abnormal tissue structure. As bones become less dense, they weaken and are more likely to break. If you’re 50 or older and have broken a bone, ask your doctor or healthcare provider about a bone density test.
Breaking a bone is a serious complication of osteoporosis, especially with older patients. Osteoporotic bone breaks are most likely to occur in the hip, spine or wrist, but other bones can break too. In addition to causing permanent pain, osteoporosis causes some patients to lose height. When osteoporosis affects vertebrae, or the bones of the spine, it often leads to a stooped or hunched posture. Osteoporosis may limit mobility, which often leads to feelings of isolation or depression. Additionally, twenty percent of seniors who break a hip die within one year from either complications related to the broken bone itself or the surgery to repair it.
A bone density test is a measurement of how much mineral, such as calcium, you have in your bones. The most common and most versatile test is with dual-energy X-ray absorptiometry (DXA). This is used to diagnose osteoporosis BEFORE you break a bone, help to estimate your chances of breaking a bone in the future, and monitor the effectiveness of osteoporosis treatments. This is a very simple test that only takes a few minutes to do.
For patients at high risk, drug treatments are needed to effectively reduce the risk of broken bones due to osteoporosis. Today there is a wider variety of osteoporosis treatment options than ever before. The type of treatment you are prescribed will depend on your individual risk profile. This includes the risk for a specific type of fracture (spine versus hip), other medical conditions, or medications you may take. Finally, cost and cost-effectiveness considerations, insurance plans and reimbursement policies will undoubtedly also influence your doctor’s recommendations of therapeutic options.
Treatments have been shown to reduce the risk of hip fracture by up to 40%, vertebral fractures by 30-70% and, with some medications, reduce the risk for non-vertebral fractures by 15-20%. There are two main types of treatment: anti-resorptive agents reduce bone destruction and therefore preserve bone mineral density (BMD), while anabolic agents stimulate bone formation, thereby increasing BMD.
Medically approved drug therapies for the treatment of osteoporosis and prevention of fractures include:
Bisphosphonates (alendronate, risedronate, ibandronate, zoledronic acid)
Raloxifene and bazedoxifene
Teriparatide and abaloparatide
Menopausal Hormone Therapy (MHT)