Group 8
Diagnosis and Treatment
Osteoporosis is a "silent" condition, with many people not knowing they have it until a fracture occurs. Today, simple bone scans and risk assessments help detect it early, before serious damage happens. On the other hand, treatment focuses on keeping your bones strong and preventing fractures.
With early diagnosis and the right care, you can take control of your bone health and stay active, strong and independent.
Diagnosis
Osteoporosis was historically diagnosed after the occurrence of fragility fractures, most commonly is postmenopausal women and older men. With the introduction of bone mineral density (BMD), osteoporosis and other bone related diseases can be diagnosed before fractures occur. BMD is also used to confirm diagnosis in patients who already present with fragility fractures.
The main goal of diagnosis is to identify individuals at the highest risk of future fractures so treatment can reduce that risk. Although BMD is a major predictor, it is not enough on its own as many fractures can occur in individuals without markedly low BMD. Other risk factors include:
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Advanced Age
As you age, bone breakdown happens faster than bone formation, leading to weaker and more fragile bones over time.
Diseases
Glucocorticoid excess, Thyroid hormone excess
Low body weight
Less body weight means less stress on bones, which reduces bone strength and density. It is also linked to lower hormone levels that protect bone.
Medications
Medications treating chronic inflammatory disorders can lead to the promotion of bone loss.
Smoking
Smoking interferes with bone-building cells and reduces calcium absorption. It speeds up bone loss and increases fracture risk.
Bone Remodelling Rate
The rate of bone remodelling is another important consideration in diagnosis. Increased osteoclastic bone resorption and elevated bone formation markers are associated with accelerated bone loss and a higher risk of fragility fractures.
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Bisphosphonate
This is a medication that directly inhibits osteoclast function and stops bone turnover by increasing bone mass. By doing this, it also decreases pain.
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Side effects include: osteonecrosis of the jaw, and atypical femur fracture
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Examples include: alendronate, risedronate, obandronate, zoledronate
Vitamin D Intake
These promotes dietary calcium absorption from the intestinal tract, while controlling Ca 2+ metabolism and parathyroid hormone action.
Analgesics (Pain Killers)
These drugs relieve pain, and act as a symptomatic treatments. The choice of drug should be determined by the intensity and type of pain.
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Side effects include: raising the risk of thromboembolic events in patients with pre-existing cardiovascular disorders
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Examples include: Ibuprofen, selective COX-2 inhibitors, acetaminophen, + opioids
Adequate Physical Therapy
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Physical therapy plays a key role in the management of osteoporosis by improving bone strength, balance, and overall mobility, which helps reduce fracture risk. Weight-bearing and resistance exercises stimulate bone remodeling and slow bone loss, while balance and posture training decrease the likelihood of falls.
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Examples include:
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Massage physiotherapy
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Thermal stimulation
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Electrical stimulation (low-frequency electrical stimulation)
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Yoga/Pilates
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Acupuncture
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Diathermic ultrasound
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Cryotherapy stimuli and low-frequency electrical stimulation
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Reduces neuropathic pain via transcutaneous electrical nerve stimulation by reducing the neuro peptides secretion
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