I have osteoporosis. Now what?

I have osteoporosis. Now what?

Harry D. Fischer, MD, Chief, Division of Rheumatology, Department of Medicine, Beth Israel Medical Center

Since your risk for bone fractures increases with osteoporosis, be aware of the signs and learn to manage the disease. Like a house with crumbling walls, osteoporosis weakens the micro-architecture of our bones. When bones become thin and brittle, fractures can easily occur. Fractures of the spine (vertabrae) are the most common. If you have osteoporosis of the spine, talk with your doctor about how to modify everyday movements, such as twisting or rolling over in bed, to protect yourself from fractures.

Q: What are the signs of a spinal fracture?
A: Two-thirds of all people with a fracture in the spine don’t have any symptoms, but there could be clues. A height loss of more than two inches, back pain or a curvature of the back are all indicators. If you or someone you know has any of these signs, we recommend an X-ray. Women should get a height measurement at their annual check-up so we have a baseline for measuring loss of height when they’re older.

Q: How is a spine fracture treated?
A: Prescription medication can help heal the fracture, manage the pain and prevent another fracture from occurring. If osteoporosis is causing the vertebra to collapse, vertebroplasty is a minimally invasive spine surgery procedure that injects medical-grade bone cement into the spine. This can reduce pain and stop height loss or further curvature of the spine.

Q: What can I do to slow bone loss?
A: You can actually do a lot on your own to improve bone strength. Try getting at least 500 mg of calcium per meal and 600 IUs of vitamin D each day; do weight-bearing exercises like step aerobics or jogging; and don’t smoke. Depending on the severity of the disease, you may also need to take daily osteoporosis medication to slow bone loss.

Q: What tests do I need to monitor bone health?
A: A bone density test can measure bone loss. A DEXA scan, considered the gold standard for bone screening, can quickly diagnose osteoporosis with minimal radiation. Start talking to your physician about scheduling a bone density test around menopause (typically over age 50). Women can lose up to 3 percent of bone mass each year for the first five years after the onset of menopause.

Q: What kind of doctor can help me manage osteoporosis?
A: You have a lot of options when it comes to who can diagnose and treat osteoporosis. Your primary care doctor is the best place to start. After conducting an evaluation, he or she can refer you to a specialist, such as a rheumatologist, for treatment.

Q: I have two daughters in their 30s. Are they at increased risk for osteoporosis?
A: Yes, and for two reasons. Bone mass peaks around age 30 in women. After that, you have to support your body’s process of replacing old bone with new bone. Second, family history can play a role in bone density. Encourage both of them to start building bone strength now through diet and exercise.

Find a physician who can help assess your risk for osteoporosis by calling 1-855-411-LWNY (5969) or visiting chpnyc.org or bethisraelortho.com

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