Osteoporosis is a systemic disease that gradually weakens the bones, leading to painful and debilitating fragility fractures (broken bones).
These fractures can occur after a minor fall from standing height, or as a result of a bump, a sneeze, or even from bending over to tie a shoelace. Any bone can break due to osteoporosis, but some of the most serious and common fractures are those of the spine and hip.
Our bones are living tissue that’s constantly replacing itself. From the moment of birth until young adulthood, bones are developing and strengthening. Our bones are at their most dense in our early to mid-20s. This is called peak bone mass age.
Some of our bone cells (osteoclasts) dissolve old bone tissue, causing cavities to form on the bone surface. This process is called resorption. Once this process is done, the cavities are filled with new bone deposited by bone-building cells (osteoblasts) during the remodeling process.
This process of resorption and remodeling is a normal part of bone biology through all life stages. It generally takes around 10 years to completely replace your skeleton. As we age, usually from 35 onwards, the osteoblast cells slow down.
For people with osteoporosis, bone loss (resorption) outpaces the growth (remodeling) of new bone. Bones become porous, brittle and prone to fracture.
Who gets osteoporosis?
Osteoporosis is a serious, common, and costly disease. It’s estimated that, worldwide, an osteoporotic fracture occurs every three seconds. One in three women and one in five men over the age of 50 will suffer a fracture in their remaining lifetimes.
In women over 45 years of age, fractures due to osteoporosis result in more days spent in hospital than many other diseases, including diabetes, heart attacks, stroke and breast cancer.
In men, the lifetime risk of fracture is greater than the risk of developing prostate cancer. What’s more, few older men are on the alert for osteoporosis, even though one in five will have a fracture. One-third of all hip fractures worldwide occur in men. Studies also show that 37% of male patients die in the first year following a hip fracture.
In South Africa, with our diverse population groups, we know that osteoporosis can occur in all race groups. Local studies have shown that bone mass is more or less equal in everyone. Hip fractures may occur less in our black population, but osteoporosis in the spine and subsequent spine fractures seems to occur equally in all race groups.
Symptoms of osteoporosis
Image: Osteoporosis from Shutterstock
Reviewed by Teréza Hough, CEO of the National Osteoporosis Foundation of South Africa: www.osteoporosis.org.za. October 2017.