What is osteoporosis?

Osteoporosis is a disorder that results in bone becoming less dense. This results in an increased risk of fracture and compression and may lead to pain.

How common is osteoporosis?

Osteoporosis caused half a million wrist fractures and 250 thousand hip fractures in the United States in 1987. Compression fractures of the spine occur so often that statistics are not even able to be kept. Complications arising from osteoporosis are now the twelth leading cause of death in the United States. These are primarily related to complications resulting from hip fractures, which result in immobility of elderly patients.

Who gets osteoporosis?

People at greatest risk for osteoporosis include:

• The elderly
• Females after menopause or after removal of ovaries
• Caucasians and Asians
• People with small-framed builds
• People with low calcium intake and lack of exercise
• Smokers
• People on corticosteroids

What causes vertebral compression?

Normally, the vertebrae are able to withstand the normal stresses of daily activities, such as changing positions, reaching and bending, lifting and carrying, coughing and sneezing.. In people whose bone has become osteoporotic, simple activities like those mentioned above can cause sudden collapse or “compression” of the vertebral body. Often this collapse occurs in the front portion of the vertebral body. This results in loss of height of the bone with consequent “anterior wedging”.

What are the symptoms of osteoporotic compression fracture?

The patient experiences acute onset of pain which is often severe. Unlike disc disease, lumbar stenosis or facet pain, there is no particular posture which is especially bad. The patient feels most comfortable in bed and immobile. Even simple motions such as rolling from side to side in bed or sitting up can be excruciating.

What is the natural history of osteoporosis?

Although bed rest is important initially, if the patient remains at bed rest for a prolonged period of time, further weakening of the bone occurs. In addition, the patient becomes deconditioned, stiff, and is at risk for complications related to immobility (e.g. phlebitis). As far as the acute pain related to the compression itself, this generally resolves over the course of several weeks to months. There is now ample evidence that the patient’s activity level, posture and exercises, as well as intake of calcium, estrogen and other medications, all affect the course of the patient’s condition.