What is Osteoporosis?

Osteoporosis is a condition that means your bones are weak, and you're more likely to break a bone. Since there are no symptoms, you might not know your bones are getting weaker until you break a bone! You can't "catch" osteoporosis or give it to someone else. 'Osteoporosis' literally means 'porous bones' and is often referred to as the 'fragile bone disease' in an increased risk of fractures of the hip, spine, and wrist. Osteoporosis is often called a "silent" disease because it has no discernable symptoms until there is a bone fracture.

A broken bone can really affect a woman's life. It can cause disability, pain, or loss of independence. It can make it harder to do daily activities without help, such as walking. This can make it hard to participate in social activities. It can also cause severe back pain and deformity.

Often people are unaware that they have such fragile bones until their first fracture and while osteoporosis affects both men and women, women, particularly those over 50, are more susceptible - experts suggest that one out of every two women and one in five men over 50 will have an osteoporosis-related fracture in their lifetime.

To gauge the scale of the problem it is worth noting that 10 million Americans have already been diagnosed with osteoporosis and 34 million more have low bone mass, placing them at increased risk for this disease and experts say unless diet and lifestyle changes take place by 2020 half of all Americans over 50 will have weak bones.

Approximately three million people in the UK have osteoporosis, and there are over 230,000 fractures every year as a result,

Arthritis and osteoporosis are among the world's leading causes of pain and disability, and impose a substantial burden on health systems and as many countries have increasing aging populations, diseases which affect older citizens present significant challenges to governments juggling health budgets.

For older people, weak bones can be a deadly affair - in the elderly, a broken hip increases the risk of death over a three month period by as much as four times and surviving the injury often results in a downward health spiral with one in five people with a hip fracture ending up in a nursing home within a year.

Many others become isolated, depressed, or frightened to leave home because they fear they will fall.

Those most at risk of developing osteoporosis are people over the age of 50, women in particular, those with a low body weight, smokers, excessive alcohol drinkers,those with a history of fractures, and some medical conditions including rheumatoid arthritis, hyperthyroidism and parathyroid disease.

Other conditions may also be associated with osteoporosis such as diabetes and HIV (AIDS) and organ transplant recipients and people with some respiratory diseases may also be at more risk - some medicines such as corticosteroid tablets, anti-epileptic drugs and breast and prostate cancer drugs, also increase the risk

As a rule doctors will recommend treatments depending on an individual's situation - treatments for osteoporosis are taken to reduce the risk of broken bones and are being increasingly prescribed for people with a high risk of fracture.

Unfortunately, most of the drugs used to reduce the risk of broken bones in people with osteoporosis can cause side effects in some people, though these will depend on a lot of different factors.

Some of the bisphosphonate tablets can cause inflammation to the food pipe (oesophagus), sore throat and swallowing difficulties, musculoskeletal pain and chest pain.

Injectable bisphosphonates sometimes cause flu-like symptoms for a few days and raloxofine (Evista) and strontium ranelate (Protelos) slightly increase the risk of blood clots.

In order to reduce the risk of side effects there are strict instructions regarding how the bisphoshonate tablets are taken - for example, alendronic acid must be taken first thing in the morning, on an empty stomach, before the first food of the day.

The good news is that new treatments are continually being developed for osteoporosis and many are currently undergoing testing - these include anti-RANK ligand antibodies such as denosumab which have an effect on bone breakdown by inhibiting a local hormone called RANK ligand which affects the control of bone turnover.

Other research is examining growth hormones and the role played by genes and existing drugs are also being updated and improved. Ibandronate (Bonviva), for example, is available as an intravenous injection as well as a tablet.