John A. Haugen Associates provides complete care for osteoporosis including testing, treatment and prevention.
Osteoporosis is a silent disease without symptoms until a fracture occurs. It is characterized by low bone mass and abnormal bone quality which decreases bone strength and increases the risk of fracture. Fractures occur most commonly in the vertebrae, hip, and wrist. They can cause chronic pain, stooped posture (dowagers hump), disability, and may result in death.
These problems are very common. In fact, almost 1 in 2 caucasian females will experience an osteoporosis related fracture in their lifetime. Osteoporosis occurs less frequently in African Americans, but when present, the risk of fracture is still present.
While age is the most significant risk factor for osteoporosis, other situations may increase the risk as well. All postmenopausal women 50 and older should be evaluated for osteoporosis risks to determine a need for bone mineral density (BMD) testing. Some of the major risk factors include increasing age, a prior osteoporotic fracture, low body mass index, steroid use, smoking, and estrogen deficiency. Dual energy x-ray absorptiometry, or DEXA, is an x-ray which can be used to measure hip and spine bone density to establish a diagnosis of osteoporosis. A normal test is a T-score of -1.0 and above. Low bone mass, or osteopenia, is a T-score of -1.0 to -2.5. Osteoporosis is defined as a T-score of less than -2.5. However, the BMD or T-score alone does not determine the need for treatment.
FRAX was recently developed to help guide treatment in postmenopausal women over 50 years old. It is not intended for younger women. FRAX uses BMD in the femoral neck and several risk factors to determine the 10 year probability of fracture. Women with a 10 year probability of hip fracture greater than 3% or major osteoporotic fracture greater than 20% should consider treatment. In addition, women with a previous hip or vertebral fracture or T-score less than or equal to -2.5 should also be considered for treatment. These are guidelines and may be individualized. You can access the FRAX (fracture risk algorithm)at www.shef.ac.uk/FRAX.
There are many interventions that women can use to promote bone health. In general, all women should insure adequate calcium (1200mg/day) and Vitamin D (800-1000IU/day) intake. Regular weight bearing and muscle strengthening exercises may also reduce the risk of fracture. Excessive alcohol intake (3 or more drinks per day) and smoking should be avoided. If a women requires treatment for low BMD or osteoporosis, there are a wide range of medications available for treatment.
Although osteoporosis has no warning signs, it is preventable and treatable. Talk to your physician about your risk profile and whether BMD testing is appropriate for you. These tests can be performed in our Edina office.