What is Osteoporosis? Osteoporosis Diagnosis and Treatment

Bones support the body just like the beams used to make a building. The strong beams used in building skyscrapers are usually made of steel, while bones are made up of mostly calcium and protein. Calcium and other ingredients join together to make very strong minerals. These minerals are hard, but when they bind together with special proteins, the bone becomes more flexible, preventing it from breaking easily. Bones stay strong by a process that constantly removes old bone and replaces it with freshly made bone. This process is called “remodeling.” This remodeling naturally slows down as you get older. If the supporting beams of a building are weak, the building could collapse and break down. In a similar way, if the bone’s structure becomes weak, it is more likely to break. When your bone breaks, doctors call this a “fracture. So, what is osteoporosis?: when the bone is weak in its structure, doctors call this osteoporosis.

There are risks that can increase the chances of buildings breaking down. Rain, wind, snow and floods can do damage to the building. Similarly, there are also forces that can weaken the structure of bones. These forces include age, smoking and lack of important vitamins — like vitamin D — as well as drinking too much alcohol. Medications like the steroids used for allergic reactions and asthma can also weaken the bone. There are also rare causes of bone destruction related to excess hormones in the body. The doctor may recommend testing for some rare causes of bone problems, but usually, the other risk factors are more common. 

It can be hard for engineers to look at the steel beams inside a building to see if the building is weak, but doctors have a much easier time examining the bone. Doctors can use X-rays to see if the bone is weak. The weaker the bone, the easier it is for energy rays to pass through it. Doctors use this information when they order a specialized X-ray test for bones called a DXA scan (dexa scan). Doctors score the strength of your bone to that of young, healthy people to get an idea of how weak the bone is. This score is called the T-score. A bone density scan is recommended for females 65 years of age or older. Younger females can also be screened if their risk of breaking a bone is similar to that of a 65-year-old.

A doctor may offer treatment for osteoporosis. Nutrition and exercise are often recommended as a first-line treatment. Taking in adequate calcium and vitamin D is important. A Vitamin D pill is often recommended, as most Americans do not have enough dairy in their diet. Weight-training exercise will help because muscle pulls on the weaker bone and helps it remodel. Cutting back on smoking and alcohol intake is also a good idea.

For cases where the bone density is far less than normal (T-scores < -2.5), or if there has been a fragility fracture, the doctor usually recommends a medication to protect the bone from breaking down further. This class of medication is called bisphosphonates. For those patients that cannot take these oral pills, there are also injectable forms of medications that can help patients with osteoporosis.