Brittle bone disease or osteoporosis

Osteoporosis, which means "porous bones", causes bones to become weak and brittle – so brittle that even mild stresses like bending over, lifting a vacuum cleaner or coughing can cause a fracture. In most cases, bones weaken when you have low levels of calcium, phosphorus and other minerals in your bones.

A common result of osteoporosis is fractures – most of them in the spine, hip or wrist. Although it's often thought of as a women's disease, osteoporosis also affects many men. And aside from people who have osteoporosis, many more have low bone density.

It's never too late – or too early – to do something about osteoporosis. You can take steps to keep bones strong and healthy throughout life.

Symptoms

The osteoporosis can be present for decades without any symptoms, because osteoporosis doesn't cause symptoms unless the bone fractures. Some osteoporosis fractures may escape detection until years later. Therefore, sufferers may not be aware of their osteoporosis until they have a painful fracture. Only then will the symptoms be felt at the location of the fracture.

Fractures of the spine (vertebra) can cause severe "band-like" pain that radiates around from the back to the side of the body. Over the years, repeated spine fractures can cause chronic lower back pain as well as loss of height or curving of the spine, which gives the individual a hunched-back appearance of the upper back, often called a "dowager hump".

A fracture that occurs during the course of normal activity is called a minimal trauma fracture or stress fracture. For example, some patients with osteoporosis develop stress fractures of the feet while walking or stepping off a curb.

Hip fractures typically occur as a result of a fall. With osteoporosis, hip fractures can occur as a result of trivial accidents. Hip fractures may also be difficult to heal after surgical repair because of poor bone quality.

Causes

What factors determine bone strength?

• Bone mass (bone density) is the amount of bone present in the skeletal structure. Generally, the higher the bone density is, the stronger are the bones. Bone density is greatly influenced by genetic factors, which in turn are sometimes modified by environmental factors and medications. For example, men have a higher bone density than women. African Americans have a higher bone density than Caucasian or Asian Americans.
• Normally, bone density accumulates during childhood and reaches a peak by around age 25. Bone density is then maintained for about 10 years. After the age of 35, both men and women will normally lose 0.3% to 0.5% of their bone density per year as part of the aging process.
• Oestrogen is important in maintaining bone density in women. When oestrogen levels drop after menopause, bone loss accelerates. During the first five to 10 years after menopause, women can suffer between 2% and 4% loss of bone density per year! This can result in the loss of between 25% and 30% of their bone density during that time period. Accelerated bone loss after menopause is a major cause of osteoporosis in women.

Risk factors for developing osteoporosis

Factors that will increase the risk of developing osteoporosis are:

• Female gender
• Caucasian or Asian race
• Thin and small body frames
• Family history of osteoporosis
• Personal history of fracture as an adult
• Cigarette smoking
• Excessive alcohol consumption
• Lack of exercise
• Diet low in calcium
• Poor nutrition and poor general health.

Prevention

Certain risk factors which predispose to the developing of osteoporosis cannot be altered – you cannot change your gender, race or age. You can however do much to prevent further bone loss. There are four main areas in which you can help maintain healthy bones:

• Eat a balanced diet rich in calcium or take calcium supplements
• Do regular weight-bearing exercise
• Stop smoking
• Decrease alcohol intake.

Our Employee Wellbeing Programme (EWP) is available 24 hours a day if you want to know more about brittle bone disease. Call us on our EWP number or email us at This e-mail address is being protected from spambots. You need JavaScript enabled to view it. .