The Age of Osteoporosis—Part 2

The thinning of the bone is a slow, gradual process that progresses as we age.  To understand the pathology, it helps to understand the normal physiology of bones.  Our bones are supportive structures that bear weight and transmit various stresses and forces.  They must be maintained to continue to function.  Think of a stucco wall or dry wall that develops cracks or holes.  This can compromise the structure’s integrity.  We will often cut out the bad part and patch it new stucco or drywall.

Your bones act very similarly and are always in a constant state of remodeling.  Bones react to various stresses and tend to thicken and strengthen in the areas with higher stress and take away from areas of less stress.  This maintenance of the bone is a fine balance between two major cells: osteoblasts and osteoclasts.

The osteoblasts build bone and the osteoclasts break down bone.  These two cells work in harmony for many years of our lives breaking down and rebuilding bone.  Unfortunately, as we age, the osteoblasts start slowing down.  Soon we are not building as much bone as we are breaking down.  And so begins the slow process of age-related bone loss.

The spectrum of bone loss is a continuum.  We tend to peak in our bone density around our twenties and slowly decline from there.  With time our bone density may decrease to a range we describe as osteopenia.  With further bone loss, we transition into an osteoporotic range.  This range is the most concerning for fragility fractures.

Of course, just like anything else, bone loss isn’t just a function of time.  Other factors can contribute to or worsen bone loss.  Diet and sunlight exposure are two environmental factors.  Metabolic bone diseases may also cause bone loss.  Certain medications may also contribute to bone loss.  The chronic use of prednisone, a steroid, is a classic example.

The physicians at Specialty Orthopedic Surgery are dedicated to the compassionate care of our patient’s osteoporosis concerns, big and small.  Let us know how we can help keep you moving.

Written by  Dr. Brimacombe, MD 

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