What is osteoporosis?
Osteoporosis is a condition that
weakens bones, making them fragile and more likely to break. People with axial
SpA (axial spondyloarthritis)
are at higher risk of osteoporosis.
Recent research shows that axial SpA
patients have a higher prevalence of both osteoporosis and osteopenia. High
disease activity and hip involvement are risk factors for bone loss in axial
SpA.
During childhood, bones grow and
repair very quickly, but this process slows, as you get older. Bones stop
growing in length between the ages of 16 and 18 but continue to increase in
density until you are in your late 20s. You gradually start to lose bone
density from about 35 years of age. Women lose bone rapidly in the first few
years after menopause.
Losing bone is a normal part of the
aging process, but for some people, it can lead to osteoporosis and an
increased risk of fractures. People with inflammatory conditions such as axial
SpA are at higher risk of developing osteoporosis.
Osteoporosis is often referred to as
the ‘silent disease’ because, although almost 3 million people in the UK are
estimated to have osteoporosis, few know they have it until they break a bone.
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| Orthopedic Institute of New Jersey |
Diagnosing osteoporosis
Your GP can use an online program
such as the Fracture Risk Assessment Tool to help assess your risk of fracture.
They may also refer you for a bone mineral density scan, known as a DXA scan.
A DXA scan is a quick, safe and
painless procedure that usually takes about five minutes, depending on the part
of the body being scanned. The scan measures your bone mineral density and
compares it to the bone mineral density of a healthy young adult and someone who
is the same age and sex as you.
The difference between the density
of your bones and that of a healthy young adult is calculated as a standard
deviation (SD) and is called a T score. A T score of:
- above -1 SD is normal
- between -1 and -2.5 SD is defined as
decreased bone mineral density compared with peak bone mass - below -2.5 is defined as
osteoporosis
Treating osteoporosis
There are medications that can help
strengthen bones.
- Calcium and vitamin D supplements
- Bisphosphonates slow the rate bone
is broken down in your body. This maintains bone density and reduces the risk
of fracture. There are several different bisphosphonates, including
alendronate, ibandronate, risedronate, and zoledronic acid. They are given as a
tablet or injection - Selective estrogen receptor
modulators (SERMs) are medications that have a similar effect on bone as the
hormone estrogen. They help to maintain bone density and reduce the risk of
fracture, particularly of the spine. Raloxifene is the only type of SERM
available for treating osteoporosis. It’s taken as a daily tablet - Parathyroid hormone (teriparatide) is
used to stimulate cells that create new bone (osteoblasts). They’re given by
injection. They can increase bone
density but are only used where bone density is very low and when other
treatments aren’t working - Hormone replacement therapy (HRT)
has been shown to maintain bone density and reduce the risk of fracture during
treatment.
How can I help myself?
There are steps you can take to
lower your risk of osteoporosis and improve your bone health.
Exercise
Your bones will be stronger if you
do regular weight-bearing exercise. This is any kind of physical activity where
your feet and legs bear the weight of your own body. Brisk walking is ideal.
For most benefit you should exercise regularly, aiming for 30 minutes at least
5 times a week. Muscle strengthening exercises are also important as they will
help give strength to the supporting muscles around bones
Food and diet
Calcium is important for maintaining
strong bones. Adults need 700mg a day, which you should be able to get from
your daily diet. Calcium-rich foods include leafy green vegetables, dried fruit,
and yogurt. Vitamin D is also important for good bone health. Your body needs a
good supply of vitamin D to absorb the calcium you are eating and drinking.
Vitamin D can be found in eggs, milk, and oily fish. Vitamin D is also made by
your body after exposure to the sun
Smoking and drinking
Smoking
is associated with an increased risk of osteoporosis. It is another good reason
to try to give up. Enjoying the odd drink is fine but drinking too much alcohol
can damage your bones and increases your risk of fracture.
For more details visit NASS.CO.UK
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