What is osteoporosis?

Osteoporosis, or “porous bone”, is a bone disease that causes bones to be brittle, fragile, and weak. Our body creates new bone cells to replace old bones; however, in individuals with osteoporosis, either too much bone is lost, making it difficult for new bone to replace the old bone cells or not enough new bone cells are created. This may eventually cause bones to break when the individual coughs or has a minor fall. 

In Singapore, 1 in 3 Singaporean women over the age of 50 have osteoporosis. However, despite its commonity, many people do not test or get treated for osteoporosis after a bone fracture.

Osteoporosis results in brittle or porous bones prone to fracture.

There are four stages of osteoporosis depending on severity; these are:

  • Stage 1: this stage is characterised by equal formation and loss of bone. Usually, the human body makes more bone cells than it loses. Hence, osteoporosis begins when bone loss and formation occur at an equal rate.
  • Stage 2: individuals have low bone density or mass for their age. This is where bone loss occurs more frequently than bone formation and is called osteopenia
  • Stage 3: officially known as osteoporosis, individuals with stage 3 osteoporosis have significant bone loss and are more prone to fractures. 
  • Stage 4: known as severe osteoporosis; individuals with stage 4 osteoporosis are at an increased risk of bone fractures and curved or hunched posture.
osteoporosis stages
Loss of bone mass and density results in osteoporosis.

What causes osteoporosis?

Our body is in a constant state of renewal. This means that old bones, cells, and tissues are constantly being replaced by new ones. However, as we age, this replacement of old with new slows down, eventually resulting in an imbalance with more old than new bones, cells, and tissues. 

osteoporosis spine
Having a stooped posture or a hunched back is a common symptom of spinal osteoporosis.

What are the symptoms of osteoporosis?

Osteoporosis is often called a silent disease because symptoms do not show up until the condition is in stage 4 – severe osteoporosis.

Some warning symptoms to be aware of are:

  • Breaking a bone easily after a small or minor fall
  • Losing height due to a stooped posture
  • Lower back pain

Osteoporosis is also commonly characterised by fractures or breaks in the hip, wrist, or spine. The symptoms of osteoporosis may look like other bone disorders or health problems. Make an appointment with Chou Neuroscience Clinic if you are experiencing or have experienced any of the symptoms stated above.

Is osteoporosis painful?

Some people with osteoporosis may have bone and muscle pain, particularly in their back. Sometimes, a collapsed vertebra (bones in the spine) may cause severe pain, decreased height, or spinal deformity. 

Who is at risk of osteoporosis in Singapore?

Recognising risk factors empowers people to take control of their situation and make active decisions about their health. Some factors may increase a person’s risk for developing osteoporosis, including:

  • Genetics: a family history of osteoporosis increases an individual’s risk of developing the condition. 
  • Age: osteoporosis is more common in the elderly. This is due to increased bone loss and decreased bone replacement, a natural part of ageing.
  • Gender: women are more likely than men to develop osteoporosis. 
  • Hormonal changes: low levels of oestrogen in women (postmenopausal or women with missing periods) and testosterone in men increase the risk of osteoporosis. 
  • Sedentary lifestyle: exercise helps to increase bone density and mass. A sedentary lifestyle means your bone mass cannot increase, making you more prone to osteoporosis.
  • Low calcium and vitamin D intake: a diet low in minerals, calcium and vitamin D increases an individual’s risk of osteoporosis and fractures.
  • Slim or slender body types: the bones of slim or slender individuals have low mass and density compared to individuals with a heavier body weight. This is because bone mass will increase when it is tasked with carrying heavy weights.
  • Medications: some medications, such as those used to treat cancer, type 2 diabetes, rheumatoid arthritis, etc., increase an individual’s risk of osteoporosis. 
  • Other medical conditions: medical conditions such as epilepsy, multiple sclerosis, stroke, spinal cord injury, Parkinson’s disease, and muscular dystrophy increase the risk of osteoporosis.
  • Smoking: smoking increases the risk of osteoporosis and a host of other chronic and life-threatening diseases.
  • Alcohol: increased consumption of alcohol increases an individual’s risk of osteoporosis and bone fractures.  

spinal osteoporosis
Hormonal problems, smoking, and age all contribute to the development of osteoporosis.

How is osteoporosis diagnosed?

Osteoporosis is diagnosed in the following ways:

  • Physical examination: during the physical exam, your height will be measured, and your spine will be examined. 
  • Imaging tests: DEXA tests or bone density tests use low levels of X-rays to measure the density of your bones.
  • Blood and urine tests: these tests are used to identify if the cause of your osteoporosis is another medical condition.

A proper diagnosis will help determine the most appropriate treatment option for your needs and increase the chances of a successful treatment; make an appointment with Chou Neuroscience Clinic.

What are the treatment options for osteoporosis in Singapore?

Osteoporosis is a normal part of ageing; fortunately, it is preventable and manageable. Treatment options vary from one individual to another, depending on the severity of the symptoms. Treatment options for osteoporosis include:

  • Lifestyle changes: maintaining a healthy body weight through appropriate and adequate exercises and physical activities go a long way for prevention. As a bonus, it also helps prevent other conditions like heart disease and diabetes.
  • Medications: for both men and women at increased risk of fracture, the most widely prescribed osteoporosis medications are bisphosphonate pills.
  • Dietary changes: maintaining a healthy and balanced diet, increasing vitamin D and calcium levels, and limiting or stopping smoking and alcohol consumption.
  • Physiotherapy: a physical therapist will create custom exercise programmes to strengthen your bones and muscles over weeks and months. This helps improve your balance and decrease your chances of falling.
  • Injections: injections such as denosumab (Prolia) to strengthen your bones may be administered as treatment.
  • Surgery: only for severe cases when pain is persistent or if there is a risk of nerve damage.

Frequently asked questions  

Can osteoporosis heal by itself?

There is no cure for osteoporosis, but treatment can help to slow or stop the loss of bone density and reduce the risk of fractures. This may involve medications, diet changes, exercise, and steps to prevent bone fractures.

Can people with neurological disorders have osteoporosis? 

Osteoporosis is more prevalent in people with neurological conditions, such as multiple sclerosis (MS) and Parkinson's disease (PD). In contrast, sudden neurological events, such as strokes and spinal cord injury (SCI), can cause a rapid loss in bone mineral density.

Can osteoporosis cause neurological problems?

In severe cases of spinal osteoporosis, the nervous system is affected, and you may experience numbness, tingling, or weakness. Your doctor will likely want to see you if you have back pain or poor posture-even if you think it's just a natural part of ageing.

What are the red flags for osteoporosis?

Red flags to be aware of are low bone density, easy bone fractures, stooped stature, curved upper back, sudden back pain, gastrointestinal issues, and dental problems.

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Copyright © 2023 Chou Neuroscience Clinic. All Rights Reserved