Osteoporosis (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Catherine Burt Driver, MD
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
In this Article
- Osteoporosis facts
- What is osteoporosis?
- What are osteoporosis symptoms and signs?
- What are the consequences of osteoporosis?
- Why is osteoporosis an important public health issue?
- What factors determine bone strength?
- What are osteoporosis risk factors and causes?
- How is osteoporosis diagnosed?
- Who should have bone density testing?
- What is the treatment for osteoporosis, and can osteoporosis be prevented?
- Exercise, quitting cigarettes, and curtailing alcohol
- Calcium supplements
- Vitamin D
- Hormone therapy (hormone replacement therapy, menopausal replacement therapy)
- Medications that prevent bone loss and breakdown
- Choosing an osteoporosis medication
- Prevention of osteoporosis caused by long-term corticosteroids
- Monitoring osteoporosis therapy medication
- Prevention of hip fractures in elderly people with osteoporosis
- What are complications of osteoporosis?
- What is the prognosis (outlook) for patients with osteoporosis?
- Osteoporosis FAQs
- Find a local Internist in your town
Prevention of hip fractures in elderly people with osteoporosis
The FDA has approved hip protector garments for the prevention of hip fractures in elderly people with known osteoporosis. Brand names available include Hipsaver and Safehip. These can be helpful for selected patients who are in the nursing-home environment, although the real extent of protection against hip fractures that is gained with use of hip protectors is controversial.
Additionally, for those elderly people who use canes for walking, etc., it is essential that the rubber tips of the canes are regularly checked for any signs of wear. When this rubber wears through it presents a serious risk of causing the cane (and, therefore, the person) to slip, which can result in serious bodily
Controversy
Currently, it is not clear as to how long patients with osteoporosis being treated with bisphosphonates should continue the bisphosphonate treatment. Many doctors are interrupting treatment for a "drug holiday" off of the drug as it may not be necessary after five to seven years. Guidelines for duration of treatment of osteoporosis with bisphosphonates are being developed.
What are complications of osteoporosis?
The primary complication of osteoporosis is bone fracture. This may lead to no symptoms or be associated with severe, intractable pain. Recurrent fractures are common and can lead to deteriorating skeletal structure. Occasionally, fractures of the spinal vertebrae can push bone into adjacent nerves and/or spinal cord. This can require neurosurgical intervention. Osteoporotic vertebral fractures can also be relieved by vertebroplasty (kyphoplasty) procedures whereby the collapsed vertebra is inflated by a balloon and a cement (methylmethacrylate) is injected to reform structure to the vertebra.
Repeated vertebral compression fractures can lead to severe deformity of the spine of the chest (kyphosis) that can compromise breathing along with cause extreme loss of height. This can increase the risk of problems with any respiratory infections.
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