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World Osteoporosis Day 2022: Osteoporosis can catch you by surprise with a sudden or unexpected fracture sometimes even with the mildest of stresses such as bending over or coughing. The silent bone disease shows hardly any symptoms as it gradually makes the bones porous and susceptible to damage. Osteoporosis mostly happens with age and is quite a common condition in women who are close to menopause because of their receding levels of estrogen hormone. Apart from this, smoking, alcohol, lack of essential nutrients like calcium or vitamin D, inactive lifestyle, can all play their role in raising chances of developing the disease that would only get worse with time if the symptoms are not controlled. Around 50 million people in India have some form of osteoporosis with a higher prevalence in women undergoing menopause. World Osteoporosis Day is observed every year on October 20, to raise awareness around the prevention, diagnosis and treatment of osteoporosis and metabolic bone disease. Let's understand from experts the symptoms, risk factors, treatment and early management of osteoporosis to prevent it from worsening. (Also read: Osteoporosis: Foods to eat and avoid for preventing the condition)

"A common skeletal disease that affects bone mass and density in the human body, osteoporosis causes bones to become porous and prone to damage. Our bones comprise two layers of tissues: compact and cancellous. Compact tissues cover our bones in a hard and protective layer whereas cancellous tissues resemble sponges with holes in them. Like every other tissue, bone tissue breaks down and is rebuilt again, which strengthens our bones. However, as age catches up, bone building slows down, which causes a loss in bone strength. Early management of the condition can help prevent Osteopenia, the reduction in bone mass that eventually leads to osteoporosis," says Dr. Subhash Dhiware, Consultant, Orthopedics, Kokilaben Dhirubhai Ambani Hospital, Navi Mumbai.

"Due to the reduction in estrogen levels that women undergo during menopause, they are more likely to develop this disease and will also experience bone loss at an accelerated speed as compared to their male counterparts. Various risk factors worsen the condition," says Dr Dhiware.

Other risk factors apart from menopause as per Dr Dhiware are lack of calcium or vitamin D, sedentary lifestyle, alcohol consumption, old age, and anorexia nervosa.

Dr Sneha Kothari, Consultant Endocrinologist at Global Hospital, Parel Mumbai says while osteoporosis most often occurs in older women, but men are also at risk. One in three women and one in five men over age 65 will break a bone because of osteoporosis. Apart from age and sex, following are the risk factors for osteoporosis according to Dr Kothari:

• Being underweight (body mass index below 19)

• Medical conditions associated with osteoporosis, such as rheumatoid arthritis, diabetes, breast or prostate cancer, or certain digestive diseases

• Medications causing osteoporosis, such as longer-term daily use of glucocorticoids (steroids)

• Parental history of hip fracture or osteoporosis

• Poor dietary intake of calcium and vitamin D

• Ethnicity: Caucasian and Asian people are more likely to develop it.

Osteoporosis does not have visible symptoms and can go undetected until a fracture occurs which severely impacts mobility.

"Known as a silent disease, a few signs that can help us spot osteoporosis are the slight loss of height, shortness of breath, which is due to the smaller lung capacity because of compressed disks, often fractures, and changes in posture as well as aches in the lower back. Diagnosis of osteoporosis is the first step to seeking treatment," says Dr Dhiware.

Dr Kothari lists the following symptoms of osteoporosis

• Loss of height (getting shorter by an inch or more).

• Change in posture (stooping or bending forward).

• Shortness of breath (smaller lung capacity due to compressed disks).

• Pain in the lower back.

"It is advised that women above the age of 60 should undergo a bone density test. Bone mineral density tests or dual-energy X-ray absorptiometry scans help determine how strong the bones are, whereas regular X-rays show the prevalence of the disease in the advanced stages. Diet and lifestyle are the most important risk factors that can be managed to avoid osteoporosis," says Dr Dhiware.

Involving higher amounts of calcium in your diet through sardines, leafy vegetables, dairy products, and supplements, strengthens bones and reduces the risk of osteoporosis in the future.

"Vitamin D is an equally important factor that helps the body absorb the calcium consumed, and one of the best ways you can source your vitamin D is sunlight. In addition to these, adding protein to your diet and maintaining a healthy lifestyle by reducing alcohol consumption, avoiding tobacco, and inducing regular exercise into your routine, helps avoid the disease," says Dr Dhiware.

"Bone mineral density (BMD) tests are also known as dual-energy X-ray absorptiometry (DEXA or DXA) scans is used to diagnose osteoporosis. These X-rays use very small amounts of radiation to determine how solid the bones of the spine, hip or wrist are," says Dr Kothari, adding, "all women over the age of 65 and all men above 70 years age should have a bone density test.

The DEXA scan may be done earlier for women and men who have risk factors for osteoporosis.

The goals for treating osteoporosis are to slow or stop bone loss and to prevent fractures, says Dr Kothari. Here are some tips:

• Fall prevention to help prevent fractures.

"The treatment should be individualised and tailored to each patient need," says the expert.

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