Osteoporosis
A bone disease that develops when bone mineral density and bone mass decreases, or when the quality or structure of bone changes. This can lead to a decrease in bone strength that can increase the risk of fractures.
Our bodies are constantly in the process of bone-building and bone-breakdown. When this process is imbalanced, bones become weak. Depending on the amount of bone loss, a person can develop osteopenia or if more severe, osteoporosis.
Osteoporosis is often referred to as a “silent” disease because you typically do not have any symptoms, and you may not even know you have the disease until you break a bone. Fractures can occur in any bone but happen most often in bones of the hip, vertebrae, and wrist.
Sustaining a fracture to the lower limbs can greatly affect mobility, independence and quality of life – with people aged over 45 years in Australia, reporting a poorer general health status when living with osteoporosis, compared to those without.
Risk factors:
- Sex – woman > men
- Age
- Body size – slender, thin-boned women and men
- Race – white and Asian women are at the highest risk
- Family history
- Changes to hormones
- Low estrogen levels in women after menopause
- Low levels of estrogen from the abnormal absence of menstrual periods in premenopausal women due to hormone disorders or extreme levels of physical activity
- Lower levels of testosterone in men
- Diet – beginning in childhood and into old age, a diet low in calcium and vitamin D can increase your risk for osteoporosis and fractures. Excessive dieting or poor protein intake can increase your risk for bone loss and osteoporosis
- Other medical conditions – endocrine and hormonal diseases, gastrointestinal diseases, Rheumatoid arthritis, certain types of cancer (breast and prostate), HIV/AIDS, and anorexia nervosa
- Medications – long-term use
- Glucocorticoids
- Antiepileptic medicines
- Cancer medications used to treat breast or prostate cancer
- Proton pump inhibitors (lowers stomach acid)
- SSRIs (Anti-depressants)
- Glitizines
- Lifestyle
- Low levels of physical activity and prolonged periods of inactivity can increase the rate of bone loss
- Chronic heavy drinking of alcohol
- Smoking


Diagnosis
Diagnosing osteoporosis requires an assessment of the bone mineral density (BMD). The most commonly used technique is a specialised ray known as a ‘Dual Energy X-Ray Ansorptiometry scan’ to determine bone mineral density (BMD) in the hips and spine.
Results:
Normal | Osteopenia | Osteoporosis | |
T-Score | 1 to -1 | -1 to -2.5 | -2.5 or lower |
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We are lucky enough to work on site with Riverside Medical Imaging at our West Gosford clinic. With state-of-the-art facilities, Riverside Medical Imaging performs x-rays, leg length studies and DEXA bone density scans. Their DEXA scan is a diagnostic tool for osteoporosis and osteopenia, enabling doctors to determine the extent of bone loss for clinical decision making. Riverside Medical Imaging will accurately quantify your T-Scores and get you on the right track CLICK HERE TO BOOK A SCAN TODAY.
Treatment
The goals for treating osteoporosis are to slow or stop bone loss and to prevent fractures.
- Proper nutrition
- Lifestyle changes
- Exercise
- Fall prevention.
There are a number of medical treatments that help you manage osteoporosis. These work by either slowing down the cells that break down bone, stimulating the cells that build new bone, or both.
- Bisphosphonates
- Calcitonin
- Estrogen agonist/antagonist
- Parathyroid hormone and parathyroids hormone related-protein analog – injection
- RANK ligand inhibitor – (PROLIA)
- Sclerostin inhibitor
Here at Riverside Podiatry, we help patients affected by or at risk of osteoporosis by helping reduce their risk of falls and improving their stability and comfort or their feet. We can also identify areas of high stress that may be more vulnerable to fractures, and work to reduce the stress to these areas, and redistribute weight more evenly over the bones and joints. Custom foot orthotics are a great tool to help achieve these goals, as is physical therapy and footwear assessment.
Your risk factors, symptoms, history and lower limb biomechanics will be thoroughly assessment at your appointment, so your podiatrist can develop and individualized treatment plan that is right for you.