Osteoporosis causes bones to become weak and brittle, so brittle that even minor stresses like bending over or coughing can result in a fracture. Most osteoporosis-related fractures occur in the hip, wrist, or spine.
Bone is a living tissue that is constantly breaking down and being replaced. Osteoporosis develops when the formation of new bone does not keep up with the loss of old bone.
Men and women of all races are affected by osteoporosis. However, white and Asian women, particularly older women who have passed menopause, are most vulnerable. Medications, a healthy diet, and weight-bearing exercise can help prevent bone loss or strengthen bones that are already weak.
In the early stages of bone loss, there are usually no symptoms. However, once your bones have been weakened by osteoporosis, you may experience the following signs and symptoms:
Back pain as a result of a fractured or collapsed vertebra
Height loss over time
A hunched posture
A bone that fractures far more quickly than expected
Your bones are constantly being renewed — new bone is formed, and old bone is broken down. When you’re young, your body creates new bone faster than degrades old bone, so your bone mass grows. This process slows after the early twenties, and most people reach their peak bone mass by thirty. Bone mass is lost faster than it is created as people age.
The amount of bone mass you had when you were younger influences your risk of developing osteoporosis. Peak bone mass is inherited in part and varies by ethnic group. The more bone you have “in the bank” and the less likely you are to develop osteoporosis as you age, the higher your peak bone mass.
Various factors, including age, race, lifestyle choices, and medical conditions and treatments, can increase your risk of osteoporosis.
Some osteoporosis risk factors are beyond your control, such as:
Women are far more likely than men to develop osteoporosis.
The older you get, the more likely you are to develop osteoporosis.
You are most likely to develop osteoporosis if you are white or of Asian descent.
A family tree.
An osteoporotic parent or sibling would increase your risk, especially if your mother or father fractured a hip.
Size of the body frame.
Men and women with small body frames are more vulnerable because they may have less bone mass to draw from as they age.
People who have too much or too little of certain hormones in their bodies are more likely to develop osteoporosis. Here are some examples:
Hormones of sex.
Low sex hormone levels are known to weaken bones. Women’s estrogen level decline during menopause is one of the most significant risk factors for osteoporosis. Prostate cancer treatments that lower testosterone levels in men and breast cancer treatments that lower estrogen levels in women are likely to hasten bone loss.
Thyroid hormone excess can result in bone loss. This can happen if your thyroid is overactive or if you take too much thyroid hormone medication to treat an underactive thyroid.
Overactive parathyroid and adrenal glands have also been linked to osteoporosis.
Osteoporosis is more common in people who have the following:
Inadequate calcium intake.
A lifelong calcium deficiency contributes to the development of osteoporosis. Low calcium intake leads to decreased bone density, early bone loss, and an increased risk of fractures.
Food restriction and being underweight both weaken bones in men and women.
Surgery on the intestines.
Surgery to reduce the size of your stomach or remove a portion of your intestine minimizes the surface area available to absorb nutrients, including calcium. These procedures include those used to help you lose weight and treat gastrointestinal disorders.
Steroids and other pharmaceuticals
Long-term use of corticosteroid medications, such as prednisone and cortisone, either orally or intravenously, disrupts the bone-rebuilding process. Medication used to treat or prevent osteoporosis has also been linked to the disease.
- Reflux of the stomach
- Rejection of a transplant
- Medical problems
People with certain medical conditions are more likely to develop osteoporosis, including:
- Gluten intolerance
- IBD (Irritable Bowel Disease)
- Kidney or liver failure
- Myeloma multiplex
- Arthritis rheumatoid
- Lifestyle options
Some bad habits can put you at risk for osteoporosis. Here are some examples:
Sedentary way of life.
People who spend a lot of time sitting are more likely to develop osteoporosis than those who are more active. Any weight-bearing activities that promote balance and good posture are suitable for your bones, but walking, running, jumping, dancing, and weightlifting appear to be incredibly beneficial.
I was drinking too much alcohol.
Drinking more than two alcoholic beverages per day raises the risk of osteoporosis.
The precise role of tobacco in osteoporosis is unknown, but it has been demonstrated that tobacco use contributes to weak bones.
The most severe osteoporosis complication is bone fractures, particularly in the spine or hip. Hip fractures are frequently caused by falls and can result in disability and even an increased risk of death within the first year.
Even if you haven’t fallen, you can sustain a spinal fracture. The vertebrae (the bones that make up your spine) can weaken to the point of collapsing, resulting in back pain, loss of height, and a hunched forward posture.
Good nutrition and regular exercise are critical to maintaining bone health.
Men and women aged 18 to 50 require 1,000 milligrams of calcium daily. When women reach the age of 50 and men reach the age of 70, the daily amount increases to 1,200 milligrams.
Calcium-rich foods include:
- Dairy products with low fat
- Vegetables with dark green leaves
- Salmon or sardines in cans with bones
- Calcium-fortified cereals and orange juice made from soy
Consider taking calcium supplements if you have trouble getting enough calcium from your diet. However, excessive calcium consumption has been linked to kidney stones. Although the exact cause is unknown, some experts believe that too much calcium may increase the risk of heart disease, particularly in supplements.
The National Academies of Sciences, Engineering, and Medicine’s Health and Medicine Division recommend that people over 50 consume no more than 2,000 milligrams of calcium per day from supplements and diet.
Vitamin D improves bone health by increasing the body’s ability to absorb calcium. Sunlight can provide some vitamin D, but it may not be a good source if you live in a high latitude, are housebound, or regularly use sunscreen or avoid the sun due to the risk of skin cancer.
Cod liver oil, trout, and salmon are all excellent sources of vitamin D. Many types of milk and cereal are vitamin D fortified.
Most people require at least 600 international units (IU) of vitamin D per day. After the age of 70, the recommendation increases to 800 IU daily.
People who do not have access to other sources of vitamin D, particularly those with limited sun exposure, may require a supplement. Most multivitamins contain 600 to 800 IU of vitamin D. Most people can tolerate up to 4,000 IU of vitamin D daily.
Exercise can help you strengthen your bones and slow bone loss. Exercise benefits your bones regardless of when you begin. Still, you will reap the most significant benefits if you start exercising regularly when you are young and continue to exercise throughout your life.
Combine strength training, weight-bearing, and balance exercises. Arm and upper spine muscles and bones are strengthened by strength training. Walking, jogging, running, stair climbing, skipping rope, skiing, and impact-producing sports primarily affect the bones in your legs, hips, and lower spine. Tai chi and other balance exercises can help reduce your risk of falling, especially as you get older.
Explain the modifiable and nonmodifiable risk factors for osteoporosis. How can a nurse support the patient to manage the health condition and restore the patient to optimal health?