In the lead up to World Osteoporosis Day on October 20 2013, the National Osteoporosis Society
released the stark announcement that osteoporosis is the cause of a bone fracture every two minutes in the UK. Although the condition is more common in women over 50 – affecting one in two – osteoporosis also leads to bone fractures in one in five men over 50. That means 3 million people in the UK alone are living with this condition – globally it’s 200 million.
Dr Millicent Stone, Consultant Rheumatologist at The Physicians’ Clinic and at The London Bridge Hospital
, explains why we all need to be more aware of osteoporosis and its impact. A small number of those affected are young athletes – in our second article for World Osteoporosis day you can find out more about Dr Stone’s work with young athletes
, female and male, who are at risk of osteoporosis and stress fractures.
Osteoporosis is silent
This makes bones more brittle and liable to break – the most common fractures in people with osteoporosis are those of the wrist, hip or spine. Vertebrae can fracture without any obvious injury, leading to back pain and difficulty with movement.
As osteoporosis is silent, it is difficult to find out who is at risk. “Some risk factors are important - people over 50 who smoke, drink more than three units of alcohol a day, are female and post-menopausal, have an inflammatory disease such as rheumatoid arthritis or who have a strong family history of osteoporosis are particularly at risk. These people may be offered a bone density scan - a DEXA (dual energy X-ray absorptiometry) scan, to find out if they do have osteoporosis,” says Dr Stone. It is also possible to have an ultrasound scan of your heel to give an indication of your bone density. “The value of heel ultrasound is to detect those at higher risk of osteoporosis but it can’t be used to give a definitive diagnosis,” she adds.
“Once a diagnosis of osteoporosis is made, drugs called bisphosphonates can be prescribed to help reduce fracture risk by around 50%. Clinical trials have shown that several bisphosphonates – such as alendronate, risedronate and strontium ranelate – do prevent fractures when taken regularly over a long time period,” explains Dr Stone.
“Another treatment option is Denusomab, a monoclonal antibody therapy that is given as an injection every six months. For more severe cases, the drug teriparatide, which is part of the molecule that forms human parathyroid hormone. This is one of the few drugs available that increases bone density – it can be given daily by injection for two years,” she adds.
You can also do a lot to improve your bone health by making lifestyle changes. Dr Stone and the National Osteoporosis Society recommend:
- Cutting out smoking
- Reducing the amount of alcohol you drink
- Doing at least five lots of 30 minutes of exercise each week
- Eating a healthy diet with plenty of calcium-rich foods and foods that contain vitamin D (milk, soya milk, other dairy and soya products, green leafy vegetables). Both calcium and vitamin D help to increase bone regeneration.
- Don’t avoid sunlight completely – it acts on your skin to enable your body to make vitamin D. Dr Stone suggests 20 minutes unprotected sunshine – or at least daylight – exposure each day.