Osteoporosis is widely considered the most common bone disease in the world. Affecting more than 10.2 million Americans over the age of 50, it is characterized by weakening of the bones and can lead to an increased risk of bone fractures, especially vertebral compression fractures in the spine. Osteoporosis has few early symptoms, and it is not uncommon for a vertebral fracture to be the first indication a person has that they are living with the condition.
In this post, we’ve provided an overview of osteoporosis, including its causes, symptoms, risk factors, and treatment options. In addition, we’ve offered some tips on how to prevent the condition and reduce your risk of experiencing a compression fracture as you age.
At the New Jersey Spine Institute, osteoporosis is one of our areas of expertise. Our board-certified spine specialists possess the extensive training and experience necessary to accurately diagnose spinal compression fractures and develop personalized treatment plans tailored to the needs of each patient.
Living with back pain and suspect osteoporosis may be the underlying cause? Contact us today to schedule an initial consultation at the New Jersey Spine Institute and learn more!
What Is Osteoporosis?
Osteoporosis is a condition characterized by the weakening of the bones in the skeleton, including the vertebrae that make up the spinal column. It is normal for healthy human bone tissue to be continually broken down and replaced (a process known as bone remodeling), but in patients with osteoporosis, bone breakdown occurs more rapidly than bone regeneration. Over time, this trend leads to bone density loss and porous, brittle, fragile bones that are susceptible to damage, including fractures. Fractures associated with osteoporosis may occur anywhere in the skeleton, but are most common in the spine, hip, and wrist.
Vertebral Compression Fractures
Many patients are unaware that they have osteoporosis until a bone fracture occurs and they are diagnosed with the condition. Vertebral compression fractures are the type of fracture most commonly associated with osteoporosis, and an estimated 1.5 million occur in the U.S. every year, mostly in aging populations. Postmenopausal women are particularly at risk of experiencing one or more vertebral compression fractures as a result of osteoporosis.
Vertebral compression fractures occur when vertebral bone density decreases to such an extent that the vertebrae become too weak to support their normal load. One or more weakened vertebrae may develop tiny cracks in their front (anterior) portion, ultimately leading to a collapse that results in compression of the spine. Vertebral compression fractures can be extremely painful and may also be associated with postural shifts, neurological changes, and a variety of other symptoms (see below).
A fall or other high-impact event may cause a vertebral compression fracture to occur, but patients with osteoporosis may also experience this type of injury as the result of normal daily movements. If you are over the age of 50 and living with back pain triggered by sneezing, coughing, reaching, twisting, or bending, a vertebral fracture related to osteoporosis could be the underlying cause.
What Are The Symptoms Of Osteoporosis?
Early symptoms of osteoporosis are often overlooked, but one telltale sign that the condition is developing may be a noticeable loss of height as the vertebrae compress. Once the condition is more advanced, common symptoms include:
- Acute and/or persistent back pain
- Postural changes, especially rounding of the upper back, known as kyphosis
- Restricted mobility (limitations on flexibility of the spine)
- Nerve-related symptoms such as numbness, tingling, and/or muscle weakness in the extremities
- Bone fractures stemming from minor falls or impacts, especially in the spine, hip, or wrist
- Compression fractures in the spine, which are characterized by symptoms including:
- Pain that increases with motion and decreases when resting/lying down
- Pain that worsens with coughing or sneezing
- Nerve pain that radiates into the arms or legs
How Is Osteoporosis Diagnosed?
Patients who experience a spinal compression fracture, especially as the result of regular activity or a minor impact, are typically screened for osteoporosis. To begin with, a detailed medical history is taken and a thorough physical exam is conducted. This may include careful observation of the back’s alignment while standing and during movement, a hands-on examination of the spine, and/or neurological testing to check for indications of muscle weakness, loss of sensation, or changes in reflexes.
If osteoporosis is suspected, further diagnostic imaging tests may be ordered. X-rays can be helpful in identifying compression fractures and may also reveal areas of bone thinning or low bone mass (osteopenia), which is often a forerunner to osteoporosis. Depending on the circumstances, CT or MRI scans may also be recommended.
The most definitive diagnostic test for osteoporosis is a DEXA (Dual-Energy X-Ray Absorptiometry) scan, which measures bone density and compares it to the bone density of a healthy young adult (known as a T-score). DEXA results are interpreted as follows:
- Normal: T-score above -1.0
- Osteopenia (low bone mass): T-score -1.0 to -2.5
- Osteoporosis: T-score of -2.5 or lower
What Causes Osteoporosis?
Advancing age is generally considered to be the primary cause of osteoporosis. As the body gets older, the activity level of cells that break down bones (known as osteoclasts) surpasses the activity level of cells that build them up (known as osteoblasts). As a result, the skeleton becomes weaker, more brittle, and more fragile. Under a microscope, the bones of a person with osteoporosis appear to have a porous, honeycomb-like structure.
Other factors that can increase the likelihood of developing osteoporosis include:
- An unbalanced diet, especially an inadequate intake of calcium and Vitamin D (which is essential for calcium absorption)
- A sedentary lifestyle
- Tobacco usage
- Excessive alcohol and/or caffeine consumption
- A family history of osteoporosis
Who Is At Risk?
Osteoporosis can affect anyone, but you may be particularly at risk of developing the condition if:
- You are over the age of 50
- You are a postmenopausal female
- One or both of your parents were affected by osteoporosis
- You are a smoker
- You eat an unhealthy/imbalanced diet
- You regularly consume large quantities of alcohol, caffeine, or carbonated sodas
- You have limited exposure to the sun and/or don’t take Vitamin D supplements
- You live a sedentary lifestyle
- You take certain medications or live with certain medical conditions (see below)
Some Medications Can Increase The Risk Of Osteoporosis
Various medications have the potential to decrease bone density and increase the risk of osteoporosis. These can include:
- Corticosteroids
- Seizure medications
- Antidepressants
- Proton pump inhibitors
- Blood thinners
- Immunosuppressants
- Thyroid hormone replacement
- Chemotherapy
While it may be medically necessary for you to take one or more of the medications listed above, proactive engagement in bone-building strategies and techniques can help mitigate the associated risk of potential bone loss (see Tips For Osteoporosis Prevention below).
Certain Health Conditions Can Also Worsen Osteoporosis If Left Untreated
Medical conditions that may contribute to worsening bone loss and osteoporosis if left untreated can include:
- Hormonal disorders
- Gastrointestinal disorders
- Eating disorders
- Chronic kidney disease
- Chronic liver disease
Speak with your primary healthcare provider to learn more about how any existing medical conditions you have may impact your overall bone health and the development of osteoporosis.
Treating Osteoporosis
Once a spinal compression fracture or other bone fracture has occurred as the result of osteoporosis, the chance of experiencing one or more subsequent fractures increases substantially. While osteoporosis cannot be completely reversed, proactive treatment can help slow its progression, reduce the risk of future fractures, and even increase bone density over time.
Many cases of osteoporosis can be effectively treated using conservative methods. In more severe cases, surgical treatment options may also be explored.
Non-Surgical Osteoporosis Treatment
Non-surgical treatment options for osteoporosis can include a combination of lifestyle modifications, medications, and dietary supplements. At the New Jersey Spine Institute, our experienced doctors may recommend one or more of the following, based on your specific needs and goals:
- Lifestyle Modifications – These could include regularly engaging in weight-bearing exercises, such as walking or jogging, and strength/resistance training (as recommended by your doctor or physical therapist). Actively working to improve balance and mobility and taking proactive measures to reduce the likelihood of falls in your home and while on the go may also be highly beneficial for patients living with osteoporosis.
- Medications – Medications prescribed for osteoporosis may include antiresorptive drugs, which slow down the rate of bone breakdown and help preserve existing bone, and/or anabolic drugs, which stimulate the body to build new bone. Always follow the advice of your doctor carefully when starting new medications.
- Dietary Supplements – The most common dietary supplements prescribed for osteoporosis are calcium supplements and Vitamin D, which is essential for calcium absorption in the body. Depending on the circumstances, other supplements such as Vitamin K, magnesium, zinc, and/or probiotics may also be recommended.
Surgery For Osteoporosis
If symptoms associated with a spinal compression fracture are severe or unresponsive to a conservative treatment approach, surgery may be recommended. Three of the surgical procedures most commonly performed on patients with osteoporosis are kyphoplasty, vertebroplasty, and spinal fusion:
- Kyphoplasty – Minimally invasive surgery that involves inserting and inflating a balloon to restore the height and shape of one or more fractured vertebrae and then injecting cement to improve spinal stability and reduce pain and discomfort.
- Vertebroplasty – Minimally invasive surgery similar to kyphoplasty except that bone cement is injected directly into one or more fractured vertebrae without first inserting and inflating a balloon to create a cavity.
- Spinal Fusion – A spinal fusion procedure joins one or more vertebrae together with hardware to increase stability in the spine.
Every case of osteoporosis is unique, and our team of experienced, board-certified spine specialists is committed to tailoring treatment to the needs of each patient. To learn more about surgical treatment options for spinal compression fractures, contact our clinic today to book an appointment!
Tips For Osteoporosis Prevention
At one time, bone density loss and osteoporosis were considered to be an inevitable aspect of growing older, but today an extensive body of research has demonstrated that the condition can be effectively prevented in many cases and treated in many others. Building healthy bones and habits in the earlier decades of life can be key to maintaining good bone density as you age.
Below, we’ve listed our top four research-supported tips for osteoporosis prevention:
Stay Active
Staying physically active at every stage of life is crucial to many aspects of your health, not least the health of your bones. While inactivity can cause bones to become weak and thin, weight-bearing exercises and resistance/strength training exercises can contribute to the active building and maintenance of bone mass, particularly in postmenopausal women.
Exercise is vital for improved bone density and fall prevention (improved balance and mobility), but not all types of exercise are suitable for osteoporosis patients. Speak with your spine surgeon, primary healthcare provider, or physical therapist to explore how best to stay active without inadvertently increasing your risk of bone fractures.
Maintain A Healthy Diet
Eating a healthy, balanced diet rich in natural sources of calcium and Vitamin D can help support bone health and slow postmenopausal bone loss. Dietary sources of calcium include dairy products (milk, cheese, yogurt), dark leafy greens (kale, collard greens), and canned fish with bones (sardines, canned tuna). Dietary sources of Vitamin D, which is essential for calcium absorption, include egg yolks and fatty fish (salmon, tuna, mackerel). Many food products are also fortified with calcium and/or Vitamin D (fortified orange juice, fortified breads and cereals, fortified milk, etc.).
Working closely with a doctor or nutritionist ensures an appropriately balanced diet based on your individual needs and circumstances and can help you maintain a healthy body weight that reduces pressure on your bones and joints. Calcium and other supplements may also be recommended.
Eliminate Tobacco And Alcohol
Tobacco usage and alcohol consumption have both been widely linked to decreased bone density and increased risk of bone fractures, including spinal compression fractures. Quitting smoking/vaping and reducing or eliminating alcohol from your lifestyle can have a positive impact on bone mass. Some studies have also suggested a link between bone fragility and the consumption of caffeine and carbonated sodas/beverages, but further research is needed in these areas.
Visit Your Doctor Regularly
Because osteoporosis can develop silently (without noticeable symptoms), visiting your doctor regularly for wellness checks is essential. If you have a genetic predisposition to osteoporosis or your healthcare provider has noted early signs of bone loss, making osteoporosis prevention a priority is crucial. Book a consultation at the New Jersey Spine Institute to learn more about osteoporosis and compression fracture prevention based on the specifics of your case..
Don’t Ignore Back Pain, Call The New Jersey Spine Institute Today
Seeking spinal fracture treatment in New Jersey? At the New Jersey Spine Institute, we offer patients a wide range of non-surgical and minimally invasive solutions. Experience the many benefits of our unique, two-surgeon approach and begin your journey toward improved bone and spine health at our state-of-the-art clinic. Book an appointment today! We look forward to working with you.