The Silent Disease
Although more than 10 million Americans are affected by osteoporosis, the
majority of patients are not even aware they have it. Osteoporosis is
a disease that results in weakened bones, and often does not produce symptoms
until a fracture occurs. A fracture has the potential to be painful and
could affect you and your lifestyle. People are often surprised to learn
that 40% of women over age 50 will experience an osteoporosis-related
fracture in their lifetime. However that osteoporosis is not a natural
part of aging.
What is Osteoporosis?
Osteoporosis is a loss in bone mass and bone strength. Bones become weak
and easier to break. Any bone can be affected. The wrists, spine and hips,
are the most common areas that are affected. Osteoporosis can occur without
any pain and you may not see or feel any changes occurring with your bones.
The first sign is a fracture of the hip, wrist, or spine.
Risk Associated with Osteoporosis
- Gradual loss of height
- Rounding of the shoulders
- Sudden back pain
- Stooped posture
- Dowager's hump
Breaking a bone is serious, especially at an older age. Broken bones and
fractures as a result of osteoporosis are most likely to occur in the
hip, spine and wrist, but other bones can break too. This can cause severe
pain. Some people lose height and become shorter. It can also affect your
posture, causing you to become stooped or hunched. This happens when the
bones of the spine, called vertebrae, begin to break or collapse.
Osteoporosis may even keep you from getting around easily and doing the
things you enjoy. This can make you feel isolated and depressed. It can
also lead to other health problems. Twenty percent of seniors who break
a hip die within one year from problems related to the broken bone itself
or surgery to repair it. Many of those who survive need long-term nursing
While many patients can be at risk for osteoporosis, certain people are
more likely to develop the disease. The following factors increase your risk:
- Women, especially past menopause
- Women with early menopause (before age 45)
- Caucasian or Asian
- Small, thin frame
- Family history of osteoporosis
- Certain medications such as steroids (like prednisone), thyroid hormones,
anti-seizure medications, antacids that contain aluminum, heparin, and
some cancer treatment mediations
- Inactive lifestyle
- Diet low in calcium
- Heavy alcohol use
Postmenopausal Osteoporosis, The Women's Bone Disease
There are more than 10 million people in the United States who have osteoporosis,
80% are women. Postmenopausal osteoporosis is a form of osteoporosis,
which occurs in women after menopause. Normally, old bone breaks down
and is replaced with new bone. Osteoporosis creates an imbalance in this
rebuilding cycle when bone breaks down but no new bone forms. This process
speeds up after menopause.
People develop postmenopausal osteoporosis because estrogen rates decline
after menopause. Low estrogen levels can potentially cause osteoporosis.
As women grow older, they can lose a significant percentage of their bone
mass to osteoporosis.
How We Can Help
Bone Density Exam
The good news is that your physician can help you treat osteoporosis so
that a fracture is less likely to affect your life. You can change dietary
and lifestyle behaviors to help improve your bone health, including taking
calcium and vitamin D and exercising. Your physician can discuss these
options with you. In addition, prescription medications are now available
that can help prevent and treat osteoporosis and related fractures. Your
physician can use the results of your bone density evaluation to help
develop a treatment plan that best meets your needs.
How Does My Physician Know That I Have Osteoporosis?
One of the best ways for a physician to know whether a patient has osteoporosis
is through a bone mineral density (BMD) exam. BMD is measured by a quick,
easy procedure known as a DEXA (dual energy X-ray absorptiometry) evaluation.
The DEXA evaluation is one of the most recommended ways for a physician
to measure bone density because it gives precise measurements at clinically
relevant skeletal sites (i.e. those with major clinical consequences when
a fracture occurs.) The exam is easy, painless, and only takes about 20
minutes. While there are a variety of technologies to measure BMD, DEXA
of the hip, spine and forearm is the only method for diagnosis of osteoporosis,
prediction of fracture risk and monitoring changes in BMD over time. This
statement is supported by extensive clinical research. The World Health
Organization defines osteoporosis using DEXA, and all medication research
trials use this technology. Accuracy and precision are excellent while
radiation exposure is very low.
Is The DEXA Exam Safe?
The DEXA exam uses a very weak form of X-ray (a small fraction of the radiation
of a standard chest x-ray) to rapidly scan your bones. A computer then
converts this information to numbers indicating your bone density.
We participate with most insurance carriers in the area. Patients are responsible
for any deductibles, co-payments or uncovered services. For qualified
individuals, Medicare routinely covers DEXA exams every two year. Medicare
allows for a follow-up DEXA exam sooner than every two years under certain
circumstances. However, there are insurances plans that may not cover
the DEXA exam. Our Diagnostic Scheduling Desk will contact your plan before
making an exam appointment and advise you if it is not covered and what
the patient financial responsibility would be for the exam.
How Do I Schedule a Bone Density Exam
Please make an appointment with your physician to discuss whether a bone
density exam is medically indicated for you. At the office appointment,
the doctor will evaluate your medical history and other pertinent indicators
of possible osteoporosis and make a medical determination if a bone density
study is appropriate in your case.
Treatment For Postmenopausal Osteoporosis
Torrance Memorial Physician Network offers intravenous Boniva injections
for individuals unable to tolerate oral bisphosphonate medications for
Boniva injection is given intravenously over 15 - 30 seconds every three
months by a Torrance Memorial Physician Network provider. Boniva injection,
along with a healthy lifestyle and a diet rich in calcium and vitamin
D, can help build bone strength.
Please ask your physician if this option is appropriate for you, since
insurance reimbursement is limited.
All procedures and treatments are directed by the guidance of your Torrance
Memorial Physician Network primary care physician.