Osteoporosis Seminar

Dr.
Anmol Sharma
Senior Consultant – Trauma, Joint Replacement & Sports medicine
Ojas Superspeciality Hospital, PKL
OSTEOPOROSIS
Osteo = bones
Porosis = increased porosity
What is Osteoporosis?
• Osteoporosis is a disease that causes bones
to become weak and brittle
Bone
organic part inorganic part

(bone tissue – (minerals –
makes up the provides
architecture) hardness)
• Osteoporosis - Reduced bone mass, normal

mineralization
• can result in fractures from minor trauma.
• More common in women as compared to men
• Prevalence of osteoporosis in Indian women
aged more than 50 years has been reported to
be approx. 50 -60 %
• in males older than 50 years ranging from 20
to 25 %
• Affects millions of people everywhere, but
awareness about the disease is still low,
• It is second only to heart disease as a leading
global healthcare problem
Osteoporosis is a Serious Problem
70%
of people over 65 with osteoporosis have never
been screened and don’t know they have
osteoporosis
A ‘silent thief’
• silent because you never know when it happens
• thief because it robs you of a very vital body
constituent.
• As it progresses, it can lead to symptoms like
– Chronic Back pain
– Sudden back pain
– Multiple Joint pain
– Extreme tiredness
– Stooping or loss of height
• It may come to your attention only after you have
a fracture
Fractures in osteoporosis
• Any kind of fracture may occur,
but the most common are
fractures of the spine, hip, and
wrist.
• 1 in 3 women over age 50 will
experience osteoporotic
fractures during her remaining
lifetime , as will 1 in 5 men
over age 50
• Problems resulting from these
fractures- disability, loss of
independence, and even death
• A 50-year-old woman
has a similar life-time
risk of dying from hip
fracture as from
breast cancer.
• Hip fractures in the

elderly have a 1 year
mortaility rate of ~
30 %
• Osteoporosis is not an inevitable part of aging,
but is a disease that can be prevented and
treated, provided it is detected early.
• The main goal of treating osteoporosis is to

prevent such fractures in the first place.
Risk Factors
Risk Factors for
for Osteoporosis
Osteoporosis
Things you can’t change

1 Gender
2 Heredity
3 Age
4 Fracture history
5 Medical conditions
6 Medications
RiskFactors
Risk Factors for
for Osteoporosis
Osteoporosis
Things you can change
1 Calcium consumption
2 Vitamin D intake
3 Quit smoking
4 Alcohol consumption
5 Physical activity
6 Posture
7 Low body weight (BMI <20)
83 Some medications
Risk FactorsThat
Conditions for Cause Bone Loss
Osteoporosis
Diabetes Type II Alcoholism

Hyperthyroidism Cancers
Malabsorption Liver Disease
Rheumatoid Arthritis Disordered eating
Risk Factors for
Medications That Cause Bone Loss
Osteoporosis
Oral steroids Blood thinners
Anti-epilepsy drugs Antacids

Chemotherapy drugs Antipsychiatry medicines
How to Prevent the Osteoporosis
• Understand the Concept of Peak Bone Mass
– As we grow, we start accumulating bone strength.
– only up to the age of about 30 that you have the
potential to gather as much bone mass as possible.
– This is called peak bone mass.
– After that, we start losing bone gradually year-by-year,
– This happens equally in males and females, up to 45
years of age.
– In ladies, as menopause sets in, this loss of bone mass
is even more pronounced
How the Skeleton Changes
Peak Bone Mass
Menopause
Rapid Bone
Building
How to Prevent the Osteoporosis
• Start Early
• Accumulating and improving your “bone
balance” (like a bank balance) happens if you
start early in life.
• This happens by activities which stress the
bones, such as rope skipping, basketball,
gymnastics, dancing, jogging, etc.
Bones Are Living Tissue
Osteocla
sts
The more you load

the bones, the
more new bone is
built
Osteobla
sts
Osteoblasts- build new bone
Osteoclasts- remove old or damaged bone
Risk Factors
Calcium forPrinciple Mineral of Bone
is the
Osteoporosis Vitamin D
Nerves and muscles need calcium to function;

if not available, the body will take calcium from bones
The current RDA is 1,000-1,200 milligrams per day
3-4 servings of a calcium rich food = 1,000 - 1,200 mg

Dietary Sources of Calcium
Food Item Calcium Range

Dairy Low Fat Yogurt, Milk, Cheese 150-400 mg
Proteins Tofu (with Calcium), 75 - 400 mg
Sardines (With Bones),
Beans, Almonds,
Vegetables Okra, Broccoli 20-260 mg
Other Dried Figs, Makhana 120 - 450 mg
Foods
If Risk
YouFactors
Need aforSupplement
Osteoporosis
If you don’t eat 2-3 servings of a calcium-rich food
every day, you may need a supplement.
Two types of calcium supplement

1 Calcium citrate 2 Calcium carbonate
e.g., CCM e.g., Shelcal
Easier on stomach, Less expensive,
Take with or without food Take with food
Better absorption Poorer absorption
Body can only absorb 500-600 mg at a time
Do not take more than 1,500 mg/day
Risk Factors
Vitamin D is for
Essential
Osteoporosis
Calcium needs vitamin D to get absorbed in the intestine
Sunshine alone is not a reliable source of vitamin D
RDA varies from 600- 2,000 International Units per day
Food Item Vitamin D Range
Fatty Fish Salmon, Sardines, 150-500 IU
Dairy Milk, Fortified with D 100-125 IU
Other Foods Fortified Cereals, Juices 50-75 IU
Protein Egg Yolk 44 IU
It’s very hard to get enough vitamin D through diet!
Supplements are not expensive.
Support the Spine Bones
1 Practice great posture

2 Use great body mechanics
3 Expand chest muscles
4 Strengthen back muscles
5 Strengthen abs
(plank is great!)
Improve Posture
Strengthen back muscles
Standing “W” Exercise

1 Raise arms parallel to floor
2
Pull arms backwards,
pinch shoulder blades
3 Hold for 3 seconds. Breathe.
4 Repeat as often as you can!
Improve Leg Strength
Reduce falls and fractures
Modified Squat
1 Stand close to chair – feet hip
distance apart
2 Keep a straight back, hinge at hip
3 Squat back and hover over chair
4 Hold as long as you can, work up to 30 seconds

Balance to Prevent Falls
Risk Factors
Prevent Fallsfor
to Prevent Fractures
Osteoporosis
1
Stop multi-tasking
2
Remove trip hazards – wires, steps
3
Get your eyes checked
4
Keep a night light on
5
Get your medications checked - sedatives
6
Use a walking aid if imbalance present
7
Anti-skid mats in bathing area, grab bars
Prevent fractures
Get help carrying or
lifting heavy items.
If you are not careful, you
could fall,
or even suffer a spine
fracture without falling.
ALWAYS bend at the hips
with a straight spine.
Wear sturdy shoes.
Change at appropriate
time
Risk You
How Factors
Knowfor For Sure
Osteoporosis
Get a Bone Mineral Density Test

(also known as DEXA scan)
Benefit for
Women age 65+
Men age 70+
Anyone younger with a risk factor –
medicines, medical disorder
Anyone with a history of frequent fractures
Risk Factors for Your DXA Results
Understanding
Osteoporosis
< -2.5 T-score > -1.0 T-score
Even though you may have a low bone density,

you may not have an increased fracture risk.
Your peak bone density may never have reached the “normal” range.
Treatment
• Calcium and vitamin D supplements are NOT
the treatment for severe osteoporosis.
• Weight training, maintaining an active

lifestyle, and the routine use of back and neck
exercises helps most patients.
Treatment Options
Bisphosphonates – weekly/monthly/annually
Parathyroid Hormone injection
Denosumab injection
SERM (Selective Estrogen Receptor Modulators)

Points to remember
• Make sure there is enough calcium and
vitamin D in your diet from early in life
• Be physically active and do weight-bearing exercises, like

walking, jogging most days each week.
• Change lifestyle choices that raise your risk of

osteoporosis.
• Implement strategies to help decrease your risk of

falling.
Points to remember
• Calcium and vitamin supplements are not the
treatment for osteoporosis
• High risk candidates should get a DEXA scan to
diagnose early
• The earlier is the treatment started, the better is
the outcome
• If untreated, it can cause debilitating fractures of
the spine and hip bones
THANKS
• Deptt. Of Orthopedics,
• Ojas Hospital , Sec 26, Panchkula
• 24 hours for accident, trauma & spine injuries
Hip replacement Geriatric trauma

Knee replacement
Sports medicine & Arthroscopy

Contact:
Mr. Puneet Gupta
9855844455

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Dr.

organic part inorganic part

• Osteoporosis - Reduced bone mass, normal

• Hip fractures in the

• The main goal of treating osteoporosis is to

Things you can’t change

Diabetes Type II Alcoholism

Anti-epilepsy drugs Antacids

Peak Bone Mass

The more you load

Nerves and muscles need calcium to function;

The current RDA is 1,000-1,200 milligrams per day

3-4 servings of a calcium rich food = 1,000 - 1,200 mg

Food Item Calcium Range

Two types of calcium supplement

1 Practice great posture

Strengthen back muscles

Standing “W” Exercise

Reduce falls and fractures

3 Squat back and hover over chair

4 Hold as long as you can, work up to 30 seconds

Get a Bone Mineral Density Test

Even though you may have a low bone density,

• Weight training, maintaining an active

Parathyroid Hormone injection

SERM (Selective Estrogen Receptor Modulators)

• Be physically active and do weight-bearing exercises, like

• Change lifestyle choices that raise your risk of

• Implement strategies to help decrease your risk of

Hip replacement Geriatric trauma

Sports medicine & Arthroscopy

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