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Osteoporosis, or porous bones, is a condition where bone density and structural quality of the bone deteriorates, leading to bone weakness and fragility. Osteoporosis is a "silent" disease with a global epidemic; however, osteoporosis is largely preventable and certainly treatable. Basically, osteoporosis occurs when there is too little bone formation, when there is too rapid bone resorption or when both occur simultaneously.

OSTEOPOROSIS SYMPTOMS

Normally, the first symptom of presentation for osteoporosis is fracture(s). Pain can often accompany the fracture(s). Fractures can affect the whole skeleton, but they normally occur in three common places, namely the hip, the spine and the wrist. Fractures are commonly associated with the risk of further fractures and mortality.

Secondly, patients with osteoporosis can show physical changes such as loss of height and kyphosis (upper spine curvature) with spinal fractures. These can be the first indication for many fractures, which are highly linked to osteoporosis.

In addition, immobility and independence in daily living can also be observed as symptoms in some patients with osteoporosis. These patients normally rely on care givers at home or in aged care facilities to assist them, thus the level of care often increases for them.

OSTEOPOROSIS TREATMENT

(a) NON-DRUG OPTIONS

Patients with osteoporosis can benefit from regular weight-bearing physical activities to keep the bones strong and able to withstand pressures or weights. Besides, these patients (especially the elderly) can consider balance training to reduce the risk of falls and fractures. Medication management (eg. reducing the use of sedatives) as well as improving poor vision and hearing can also contribute to reduction in falls and fracture incidence. Another consideration is home and environment modification, such as installing handholds, adjusting the positioning of lighting and replacing inappropriate footwear. Hip protectors may be useful, but evidence for efficacy is still conflicting. It may be useful to avoid medications that can lead to osteoporosis such as phenytoin (Dilantin) and corticosteroids.

(b) CALCIUM

Calcium supplementation may reduce bone loss in osteoporosis, particularly in late post-menopausal women with a low dietary calcium intake. Calcium is less effective than other treatments when used as a sole therapy, hence consider its use in combination with other treatments. The cheapest form of calcium available is calcium carbonate; calcium citrate

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