Osteoporosis New Zealand

Frequently asked questions about osteoporosis

What is osteoporosis?

Osteoporosis (porous bones) is a condition where bone is lost or destroyed by the body more quickly than it is replaced, causing bone mass to be significantly lower than in young adulthood. The skeleton weakens over time and fractures may occur. The most common bones to fracture are the vertebrae (spine), wrist and hip.

How do I know if I have osteoporosis?

Most people don't know when they have osteoporosis; like high blood pressure or high cholesterol it is a silent condition which usually first becomes apparent when a broken bone occurs. However, loss of height or the development of a 'dowagers hump' can be an indication of osteoporosis.

Your doctor can detect osteoporosis by a special test known as a bone density scan (DXA scan) which can be performed at a hospital or radiology clinic.

How can osteoporosis affect me?

Developing a 'dowagers hump' with the ensuing loss in height is often an early sign of osteoporosis. One often has back pain associated with this, caused by both the micro-fractures occuring in the vertebrae as well as muscle pain as the body tries to 're-align' itself with the permanent change in posture.

Broken bones are the most common problem caused by osteoporosis.  The bones in your wrist, spine and hip are the most likely to break.

Fractures are extremely painful and can seriously affect your quality of life.

Hip fractures are the most serious as they can lead to long-term hospitalisation, chronic pain, permanent disability and loss of independence.

Once you've had one fracture you are more likely to have further fractures.

Who gets osteoporosis?

Osteoporosis mainly affects women and men over the age of 50 years.

In New Zealand about a half of women and nearly one third of men over the age of 60 will suffer a fracture caused by osteoporosis.

Bone loss increases as we get older, and in particular women experience significant bone loss when menopause starts and the level of oestrogen falls.

People with lower bone density are more likely to develop osteoporosis in old age.

Who has the greatest risk of getting osteoporosis?

Some people are more likely than others to get osteoporosis.

Check if the following risk factors apply to you. The more risk factors you have the greater your risk of developing osteoporosis, and if you have several risk factors, consider having a bone density scan.

Discuss this with your doctor.

• Previous history of fracture.
• Female.
• Family history of osteoporosis.
• Age 50 years or older.
• Thin, 'small-boned'.
• Post menopause or early menopause.
• Low level of calcium in diet - less than four servings of dairy products a day.
• White, Caucasian or Asian ancestry.
• Less than 30 minutes outdoors in sunlight each day.
• Less than 30 minutes of physical activity each day.
• Smoker.
• Heavy alcohol drinker.
• Long-term use of certain medications, including steroids (e.g. cortisone and prednisone) and anticonvulsants.

How do I reduce my risk?

You can take these simple steps to help build and maintain strong bones:

• Keep active with 30 minutes of physical activity each day. Weight-bearing exercise that works the muscles against gravity helps keep your bones strong.  Walking, dancing, golf, tennis and low-impact aerobics are good weight bearing activities.
• Eat a balanced diet that is high in calcium. Dairy products, such as milk and cheese, are calcium-rich foods. Up to the age of 50 years everyone needs around 1000 mg of calcium every day to preserve body mass and reduce the risk of fracture. In women, after menopause this should increase to 1300mg per day. One glass (200ml) of high-calcium milk provides over 400mg of calcium (check the label for the calcium content).
• Spend 30 minutes outdoors in sunlight each day to ensure an adequate supply of vitamin D. Your body needs vitamin D to absorb calcium.
• Limit your intake of alcohol preferably to two drinks a day.
• Don't smoke.

Can younger people get osteoporosis?

Yes they can, especially those who start to lose bone density early.

Young women who over-exercise and stop having periods have a high risk of developing osteoporosis, as do those who suffer from anorexia and bulimia.

People with a low calcium intake are also at risk. Calcium is a mineral that is essential for building bones.

There are some medical conditions and treatments which can increase the likelihood of osteoporosis.

What questions will my doctor ask me when I discuss osteoporosis?

Your doctor will want to know a number of things:

• Do you have a history of broken bones?
• Is there a history of osteoporosis in your family? If you don't know then symptoms like your mother or grandmother 'shrinking' as they aged may be an indication - mention this to her.
• Did they have a 'dowagers hump'?
• Do your bones seem to break easily?
• What is you weight ?
• Do you smoke or drink alcohol regularly?

and have you ever suffered from an eating disorder?

What other treatments are available?

There are two subsidised treatments specifically for osteoporosis:

• Etidrate, which can be prescribed by your GP and is a useful treatment for osteoporosis.
• Alendronate is a more potent medicine and is available for people with diagnosed osteoporosis and a history of a fragility fracture.

These are both bisphosphonates, which bind to the surface of the bone, providing a protective coat that slows down the resorption of bone by the body. They increase bone density and can halve fracture risk.

Vitamin D metabolites are special forms of vitamin D which are sometimes prescribed to improve bone density. These are usually used in combination with a bisphosphonate.

Calcium and vitamin D supplements are also helpful in treating osteoporosis.

There are other effective drugs available for the treatment for osteoporosis that are not subsidised but which you can ask your doctor about.

What is the difference between osteoporosis and osteoarthritis?

Osteoporosis is a low bone mass which impairs bone strength. Bone health is affected by both genetic and environmental factors.

Osteoarthritis a condition of joints and arises from the loss of cartilage from the ends of bone. It is caused by wear and tear, trauma and other contributing factors link obesity and age. Genetic factors also play a part.