OSTEOPENIA

 

What Is Osteopenia?

 

Osteopenia refers to a condition in which the patient develops lower bone mineral density (BMD) than normal compared to others of similar age (Zhou, Liu, Qin, & Liu, 2020). Usually, a person of 35 years old has a peak bone mineral density level. Bone mineral density indicates the mass and strength of the bone. This process helps to measure the amount of minerals present in the bone. Physicians can estimate the chances of breaking a bone by measuring bone mineral density.

People with osteopenia usually have lower levels of bone mineral density and have a higher risk of breaking a bone. Osteopenia itself won’t show any signs or symptoms but increases the chances of developing osteoporosis. Osteoporosis refers to another clinical condition that weakens the bone and makes it easier to break. This condition develops slowly over many years and leads to fractures. Studies show that every 3 seconds an osteoporotic fracture occurs among patients. (Zhou et al., 2020).

Osteopenia usually develops as the inside of your bones lose calcium, mostly after 50 years of age (Ramin et al., 2018). Some actions taken earlier in life can easily prevent osteopenia. Physicians recommend adopting the proper diet and exercise to keep the bones strong. Peoples with stronger bones have less chance to develop osteopenia in older age. Due to lower estrogen levels, women can quickly develop osteopenia after menopause. Adoption of some healthy measures to prevent osteopenia eventually reduces the risk of developing osteoporosis.

What Are The Common Symptoms And Causes Of Osteopenia?

 

Osteopenia usually appears asymptomatic meaning shows none of the typical symptoms in patients. Losing bone density won’t produce any symptoms unless osteoporosis develops.

Our bone mass constantly changes throughout our life. After we reach peak bone mass, the body starts to break down the older bone faster than the growth of newer bones. This ultimately causes the loss of bone density. Osteopenia possesses some modifiable and non-modifiable risk factors such as dietary habits, using certain drugs, aging process, etc. People with more risk factors will develop osteopenia faster than others. Some other risk factors may include (Confortin et al., 2020):

  • Gender: Due to lower estrogen levels, females quickly develop osteopenia after menopause.
  • Age: Being older than age 50 makes you more susceptible to osteopenia. Almost every person loses 0.5% of their bone mass every year after age 50. Almost half of Americans develop osteopenia after reaching 50 years of age.
  • Genetics: Having a hereditary history of lower BMD increases the risk of developing osteopenia by over 50%.
  • Lifestyle factors: Several factors such as a low-quality diet with poor nutrition, inadequate exercise, lack of calcium and vitamin D, smoking, alcohol consumption, early menopause, removal of ovaries before menopause, taking some medications like steroids, etc.

Certain other conditions also increase the risk of developing osteopenia. These includes (Torpy, Lynm, & Glass, 2006):

  • Anorexia nervosa
  • Crohn’s disease
  • Celiac disease
  • Bulimia
  • Hyperthyroidism
  • Hyperparathyroidism
  • Certain inflammatory conditions like rheumatoid arthritis, lupus, etc.

How Do Spinal Specialists Diagnose Osteopenia?

 

According to studies, one out of every three white and Asian males over the age of 50 has poor bone density (Confortin et al., 2020). If patients meet the following requirements, the National Osteoporosis Foundation (NOF) and the International Society for Clinical Densitometry (ISCD) recommend doing a DXA (dual X-ray absorptiometry) test.

  • Adults over 65 years of age (including men and women)
  • Women under 65 years of age and postmenopausal
  • Adults under 65 years of age who have one or more risk factors

Spinal specialists measure the bone density levels in the spine, hip, wrist, or finger by using the Dual-energy X-ray absorptiometry (DEXA or DXA) test. This painless test uses X-rays that emit less radiation than a standard X-ray. DEXA compares your bone density to that of a 30-year-old man or woman of the same sex and race. Physicians can easily diagnose osteopenia by observing your DEXA T-score. If this score ranges between–1.0 to–2.5, and physicians will confirm you as a patient with osteopenia. T-score between +1.0 to–1.0 shows normal bone density and if this score exceeds 2.5, then you will most likely develop osteoporosis.

How Do Spinal Specialists Treat Osteopenia?

Patients may combat age related loss of bone density by making simple lifestyle changes. Patients who regularly perform weight bearing exercises have a strong chance of combatting Osteopenia. Exercises such as walking, stair climbing or weight lifting all have positive effects on bone strength. Whether from consuming foods naturally high in vitamins or from taking doctor recommended supplements, consuming a diet rich in Calcium and Vitamin D also contributes to bone health.

The main goal of treating osteopenia includes preventing osteoporosis. You can easily prevent this by adopting healthy behaviors like a proper diet with good nutrition, doing regular exercise, avoidance of smoking or drinking alcohol, etc. Taking additional calcium or vitamin D supplements can help the patient to avoid osteoporosis. Patients with a T score under -2 need to avoid heavy weightlifting and perform regular exercise. This sometimes leads to some complicated spinal problems like herniated disc, fractured disc, spondylolisthesis, etc. that requires additional treatment procedures. Research shows that even a small exercise can help you to increase your BMD and reduce the risk for fracture.

If your score approaches -2.5, your doctor may recommend that you take specific drugs to keep your bones healthy (Lems et al., 2011). Medications for treating osteopenia may include bisphosphonates (alendronate, risedronate, and ibandronate), selective estrogen receptor modulators (SERMs), etc. Physicians suggest using hip abductors to strengthen the hips and improve balance. For any kind of question, contact us.

References

 

Confortin, S. C., Ono, L. M., Marques, L. P., Ceolin, G., D’Orsi, E., & Barbosa, A. R. (2020). Osteopenia/Osteoporosis and Its Association with Sarcopenia: EpiFloripa Aging Study 2013/2014. Portuguese Journal of Public Health, 38(1), 15–22. https://doi.org/10.1159/000508924

Lems, W. F., Raterman, H. G., Van Den Bergh, J. P. W., Bijlsma, H. W. J., Valk, N. K., Zillikens, M. C., & Geusens, P. (2011). Osteopenia: A diagnostic and therapeutic challenge. Current Osteoporosis Reports, 9(3), 167–172. https://doi.org/10.1007/s11914-011-0062-3

Ramin, C., May, B. J., Roden, R. B. S., Orellana, M. M., Hogan, B. C., McCullough, M. S., … Visvanathan, K. (2018). Evaluation of osteopenia and osteoporosis in younger breast cancer survivors compared with cancer-free women: a prospective cohort study. Breast Cancer Research, 20(1), 1–10. https://doi.org/10.1186/s13058-018-1061-4

Torpy, J. M., Lynm, C., & Glass, R. M. (2006). Osteopenia and Preventing Fractures. Jama, 296(21), 2644. https://doi.org/10.1001/jama.296.21.2644

Zhou, J., Liu, B., Qin, M. zhao, & Liu, J. ping. (2020). Fall Prevention and Anti-Osteoporosis in Osteopenia Patients of 80 Years of Age and Older: A Randomized Controlled Study. Orthopaedic Surgery, 12(3), 890–899. https://doi.org/10.1111/os.12701