Osteoporosis: Risk factors, symptoms and management

Abstract

Osteoporosis is a systemic, debilitating disease of the skeleton, characterized by significantly decreased bone mass in combination with the deterioration of bone microarchitecture. This process results in weakened bone with a great propensity for fracture with low-energy stress. As the average life expectancy and median age of the population rises, fractures secondary to underlying osteoporosis are becoming increasingly commonplace. Several risk factors for osteoporosis have been identified including low body weight, a history of premature menopause, cigarette or excessive alcohol use, an eating disorder, a sedentary lifestyle, use of anticonvulsants and lifelong low calcium intake. Once a patient has been diagnosed with osteoporosis, a complete evaluation should be obtained. This includes a thorough medical history with particular attention to the risk of osteoporosis, a physical examination, and essential laboratory investigations. If secondary osteoporosis is suspected based on the clinical findings, further investigations are required directed at the secondary cause. Calcium and vitamin D supplement is the cornerstone of all treatment modalities for osteoporosis. All patients with osteoporosis should take adequate calcium intake of 1000-1500 mg/day and vitamin D of 1000 - 2000 IU/day. Bisphosphonates are strong anti-resorptive agents which have been shown to reduce both the vertebral and nonvertebral fracture risk. Therefore, they are the first-line drugs for the treatment of postmenopausal osteoporosis, unless contraindicated. An anabolic agent such as teriparatide should be considered in patients with fracture despite bisphosphonate treatment. © 2012 by Nova Science Publishers, Inc. All rights reserved.