Osteoporosis: Risk Factors, Vertebral Compression Fractures, and Prevention

About 52 million Americans1 have osteoporosis and low bone mass. Osteoporosis, which means porous

bone, is a serious disease that causes you to lose too much bone, make too little bone, or both. As your bones lose density, they become weaker and more likely to break. If you are 50 and older and have broken a bone, you should talk to your doctor who will most likely recommend a bone density test.

Although osteoporosis affects both women and men, studies suggest that approximately one in two women — as compared to up to one in four men age 50 and older — will break a bone due to osteoporosis. Twenty percent of senior citizens who break a hip will die within one year from problems related to the broken bone itself or surgery to repair it. Many of those who survive need long-term nursing home care.

Risk Factors
There are a variety of factors — uncontrollable and controllable — that put you at risk for developing osteoporosis. You should talk with your healthcare provider about your risk factors and together you can create a plan for protecting your bones.

Uncontrollable Risk Factors

  • Being over age 50
  • Being female
  • Menopause
  • Family history of osteoporosis
  • Low body weight/being small and thin
  • Previous broken bones or height loss

Controllable Risk Factors

  • Not getting enough calcium and vitamin D
  • Not eating enough fruits and vegetables
  • Getting too much protein, sodium, and/or caffeine
  • Being inactive
  • Smoking
  • Drinking too much alcohol
  • Losing weight

There are medications, such as steroids and antacids, and diseases, such as some autoimmune disorders, that can cause bone loss and increase the risk of osteoporosis.

Vertebral Compression Fracture — VCF
The most common complication of osteoporosis is vertebral compression fractures (VCF). In people with advanced osteoporosis, compression fractures can occur while going about one’s daily activities, such as bending or carrying heavy loads, or as the result of a minor fall.

The vertebrae are the building blocks of the spine stacked one on top of each other. With osteoporosis the blocks become hollow boxes. Compression fractures occur when the vertebrae collapse. Spinal compression fractures may lead to difficulty walking and/or loss of balance leading to an increased risk of falling and breaking a hip, or other bones.

One or more of the following symptoms can indicate a compression fracture:

  • Sudden, severe back pain
  • Worsening of pain when standing or walking
  • Some pain relief when lying down
  • Pain when bending or twisting
  • Loss of height
  • Deformity*

*Vertebral compression fractures can change the shape of the spine. One such deformity is known as kyphosis but often called “dowager’s hump” or “humpback.”

Treatment of Compression Fractures
Treatment includes pain medication, bracing, treatment of the osteoporosis, and in cases where the collapse is progressive or the pain is persistent, surgery. There are currently two therapeutic and preventative treatments for compression fractures called vertebroplasty and kyphoplasty. Although vertebroplasty and kyphoplasty are different procedures, both utilize injectable orthopaedic cement to stabilize the fracture, strengthen the spine, and relieve pain. Kyphoplasty may help restore some of the lost height of the vertebral body.

Post-operative image after kyphoplasty

Preventing Osteoporosis and Related Fractures
Despite the risk factors, osteoporosis is a highly preventable bone disease. Prevention begins with eating a well-balanced diet rich in vitamins and minerals including appropriate amounts of calcium and vitamin D, exercising daily, and making healthy lifestyle choices, such as not to smoke. There are also medications that can help increase bone density and strength.

If you are concerned about bone loss and osteoporosis, talk to your doctor and request a bone density test.

1. National Osteoporosis Foundation. Accessed March 7, 2014.

Updated on: 03/28/14

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