Osteoporosis: Types, Symptoms, And Risk Factors
With the graying of America, more patients will enter our offices with osteoporosis. Fortunately, most will have only a relative contraindication to manipulation, giving us many options for relieving symptoms. Knowing what you can do for these patients is critical. Here are the types, symptoms, and risk factors associated with osteoporosis.
The two types of osteoporosis are primary and secondary. The amount of calcium left in the skeleton determines the existence of which type and either places a patient at risk for a fracture or not. Primary osteoporosis can consist of high- and low-turnover osteoporosis. Fractures of the vertebrae, hip, wrist, or forearm caused by falls or minor accidents should be associated with high-turnover osteoporosis. The risk for type 1 osteoporosis is greater in women than men. Low-turnover osteoporosis (type 2/senile osteoporosis) occurs when re-absorption and formation of bone are no longer coordinated.
In contrast, secondary osteoporosis is caused by medications like corticosteroids (which are used by about 30 million Americans), contraceptives, diuretics, and other medications. Diuretics are used to treat high blood pressure and depending on the type have different effects on osteoporosis. Contraceptives, that use progestin without estrogen, can cause a loss in bone density. Anti-seizure drugs and many other medications can increase the risk for bone loss, as can the blood thinning drug heparin along with other hormonal drugs that dominate over estrogen.
Osteoporosis becomes dramatically apparent far too often; whether it be a vertebral fracture, a fracture of the hip, forearm fracture, or any bony site where sufficient bone mass is lost. These fractures frequently occur after a microtrauma like bending, lifting, jumping, or falling. Pain, disfigurement, and debilitation are common in the latter phases of the disease. If gone undetected for too long of a time, spinal compression fractures will cause a large portion of the calcium to be lost and the vertebrae of the spine will start to collapse. This is usually relatively painless, but terrible for your health and can cause a decrease in height of up to 6 inches.
There are a number of factors that predispose a person to osteoporosis; gender, age, ethnicity, body type, family history, hormonal deficiencies, and lifestyle choices. Seventy percent of people with osteoporosis are women. Since aging causes bones to thin and weaken, half of all Americans over age 50 could be at risk for this condition by 2020. Although adults from all ethnic groups are susceptible to developing osteoporosis, Caucasians and Asians face a comparatively greater risk. Osteoporosis is more common in people who have a small, thin body frame and bone structure as well. People whose parents had a history of fractures may be more likely to have it. In women, estrogen deficiency is a primary risk factor. In men, a low level of testosterone increases risk. Lifestyle factors that affect susceptibility include dietary factors, exercise, smoking, and alcohol use.
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