Osteoporosis Treatment

What is Osteoporosis?

Osteoporosis is a disease where bone density is lost, and risk of breaking bones (fractures) increases. Fragility fractures occur in osteoporosis and are fractures that occur following a fall from standing height or less or with no trauma. The most common sites of fragility fracture are the spine (vertebral compression fractures), hip, and wrist. Fragility fractures also occur at the humerus, rib, and pelvis. One of the most serious type of fracture that can occur in osteoporosis is a hip fracture, which can occur as a result of a fall. There were an estimated nine million osteoporotic fractures worldwide in 2000.

The World Health Organization (WHO) has also defined osteoporosis based on dual-energy x-ray absorptiometry (DEXA) scan measurements. As your bone density decreases, your risk of fracture increases. Your bone density is commonly expressed as a "T-score." A T-score that is equal to or less than -2.5 is consistent with a diagnosis of osteoporosis, a T-score between -1.0 and -2.5 is classified as low bone mass (osteopenia), and a T-score of -1.0 or higher is normal.

What Causes Osteoporosis?

There are many risk factors which can lead to osteoporosis such as aging, a previous fracture, genetics, low body weight, medications (especially long term oral steroids), rheumatoid arthritis, poor nutrition, smoking, excessive alcohol intake and non-active lifestyle.

How do I know I have Osteoporosis?

As osteoporosis is known as a ‘silent’ disease, often you won’t know until you sustain a fracture.

Screening for osteoporosis is recommended in the following groups of people:

1. All women aged 65 and older
2. All postmenopausal women younger then 65 with risk factors for osteoporosis
3. Men aged 65 or older, or with risk factors for osteoporosis
4. Anyone who has sustained a fragility fracture

How can I Get Screening for Osteoporosis?

We will arrange a screening test called a DEXA (Dual energy X-ray absorptiometry) scan, which looks at bone density at the spine and hip, and can be used to predict your risk of further fracture. This takes around 20 mins and usually costs around $100 SGD. The T-score from the DEXA scan can be used to confirm whether you have osteoporosis or not. Your risk factor for getting a fracture can then be calculated using a special tool called the FRAX SCORE (https://www.sheffield.ac.uk/FRAX)

What if I Have Osteoporosis? What is the Treatment for Osteoporosis?

1. Reducing risk of fracture - There are some things you can do immediately to reduce risk of fracture. These include stopping smoking, cutting down alcohol consumption, and taking part in regular exercise to strengthen bone and muscle (eg. brisk walking, gym exercises).
2. Diet – you should eat at least 1200mg calcium and 1000 international units (IU) of vitamin D every day
3. Blood tests – your doctor may order some special blood tests to rule out any underlying medical conditions which may be a cause of your osteoporosis.
4. Medication – you may be prescribed special medication such as bisphosphonates, parathyroid hormone or denosumab to treat your osteoporosis.
5. Monitoring – you should have a repeat DEXA scan in 2 years time