Fractures are the main concern in osteoporosis. With the bone weakened to a significant degree, depending on the severity of the disease, a fracture can occur with even minor injuries or falls. The osteoporosis patient has to therefore be vigilant and avoid situations where there may be an increased risk of injuries or falls. Nevertheless, most fractures with osteoporosis occurs in during everyday tasks and often within the household. Fractures have major implications on a person’s physical and even mental health in the long term since osteoporosis complicates the normal healing ability of the bone.
The weakened bones in osteoporosis can easily sustain a fracture. The greater concern though is that ability of the bone to repair itself dully is also impaired. In osteoporosis the bone mineral density is reduced mainly due to an underactivity of the bone cells that lay down new bone (osteoblasts) or overactivity of cells that resorb bone (osteoclasts). This constant laying down of new bone and resorption of old bone is an ongoing process in the body known as remodelling. In osteoporosis this remodelling is dysfunctional. Therefore the repairing of damaged bone tissue is impaired.
A fracture may have a wide range of implications. Firstly mobility is severely hampered as is the case with any person who sustains a fracture even if osteoporosis is not present. However, the normal repair time and process being impaired in osteoporosis means that a person is immobile for longer. This has several consequences on muscle activity, surrounding bones, as well as the nerves and blood vessels lying nearby. Even though surgery can be helpful in providing strength to the bone, it also carries the risk of complications, some of which can be fatal in older patients in particular.
Falls are one of the main mechanisms by which fractures occur especially of the long bones of the leg and arm and hip. With osteoporosis of the back bones (vertebral column), fractures can occur even without a fall or major trauma. The spine has to bear and transmit the body weight downwards to the legs and compressions fractures of the vertebrae may occur. This can cause compression of the nerve root emanating from the spinal cord (pinched nerve). Therefore symptoms will be experienced along the course of the nerve, even at the periphery of the limbs further contributing to the patient’s suffering.
It is important that osteoporosis patients receive treatment for the condition since it is often progressive and gets worse over time. This is the most effective way to avoid fractures in the long term. Frequent bone scans are also necessary to monitor the progression of the disease and response to treatment. The risk of fractures can be assessed by a Risk Fracture Calculator which takes several factors into account such as the age of the patient, gender, bone mineral density (BMD), weight and lifestyle factors such as cigarette smoking and alcohol use. High risk patients need to take greater measures to avoid a fracture.
Simple measures to avoid fractures are therefore important considerations for the osteoporosis patients. This involves aspects such as wearing the correct footwear especially when exercising, removing any obstacles in the home environment that can lead to falls and avoiding situations where there is a greater risk of injuries and falls. Nevertheless the fear of falls should not severely restrict an osteoporosis patient from continuing with life.