Prepared By: Sami Hizmetli, Prof, MD; Ece Kaptanoğlu, Prof, MD

What is osteoporosis? 

Osteoporosis is a skeletal disease which is characterized by decreased bone mass and weakening of bone structure. The first symptoms in AS may be waist, hip and heel pain. If the disease is not treated properly, spinal deformities and kyphoses occur in later periods.

The term ‘osteoporosis’refers to a decrease in the density of the bones, not the melting of the bones. The upper picture shows a normal bone tissue. The lower picture shows osteoporosis, a weaker bone tissue with weaker filling material and larger pores. 

What are the symptoms of osteoporosis?

Osteoporosis is in fact an insidious disease and may not cause symptoms until a fracture occurs.

However, one of the most common complaints is back pain, which is due to the small fractures of the back vertebrae caused by osteoporosis. With the increase in the number of these fractures, there is a collapse in the vertebrae, kyphoses is formed and the height decreases. There is a narrowing in the chest and abdominal cavity with the increase of the hump on the back. The abdomen may move forward and the patient may think that he / she gains weight. Shortness of breath can occur in heavy activities. In osteoporosis, risk of fractures in the hip and forearm are high, as well as in the vertebrae.

Who is at risk of osteoporosis?

Osteoporosis is more common in people whose relatives have osteoporosis, who have low body mass index, light skin, who live in sedentary life and who experience early menopause. Other risk factors for the development of osteoporosis are low calcium intake, smoking, excessive alcohol and caffeine consumption and use of medications such cortisone and thyroid hormones.

How is osteoporosis diagnosed?

For the diagnosis of osteoporosis, bone density should be measured. Although there are different methods for this purpose, DEXA is the most commonly and widely used method of measurement. DEXA measurement is not a painful or discomforting method and the patient is not exposed to significant radiation. Lumbar vertebrae, hip and wrist are measured.

Osteoporosis can be present without any symptoms, especially in the early stages. Therefore, people who have high risk of developing osteoporosis, menopausal women and gentlemen over 50 years of age should apply to the physician, even if there is no complaint.

What should we do to prevent osteoporosis?

A diet rich in calcium, starting from childhood, consuming enough vitamins, preserving the spine in everyday life, regular exercise and sunbathing provide significant protection.

In addition, smoking, alcohol, caffeine, sugar, salt and excessive protein intake should be reduced, ideal body weight should be maintained and osteoporosis-causing drugs should be avoided.

What is the treatment of osteoporosis?

1. Patient education should be done.
2. In osteoporosis, analgesics can be used during painful period. Drugs that reduce bone destruction and increase the bone formation are also used. Calcium and vitamin D are the most widely used among these drugs.
3. Bed rest in the painful period is appropriate.
4. Physical therapy is done for pain relief. 
5. Posture training and strengthening exercises (avoiding leaning forward) is important. Activities such as walking, weight training, aerobic exercises, tennis, climbing stairs are very good for osteoporosis.
6. The use of corsets can be recommended.
7. In addition, patients who have developed osteoporosis should avoid the use of somniferous drugs to prevent fractures. If there is a vision defect, its treatment and a good illumination are required. There should be no rugs or child's play on the floor, which may cause the foot to slide. Handrails can be made built for stairs and corridors.