How to avoid osteoporosis

How to diminish the risk of fractures

Fractures due to osteoporosis are becoming increasingly common even in youngish people and today every second woman is in danger of being subjected to this at some point in her life.

Two hip operations and five leg fractures – it took a while before Sonja Rembo, just 60, was correctly diagnosed. After a polio injury when young she has been suffering from impaired capacity to move her right leg which means a well-known risk factor for fractures due to osteoporosis. Despite that it took 10 years before she received the correct diagnosis. When returning to the doctor one year later she was told that her fractures would become less frequent in the future thanks to proper treatment.

- I got so angry, not at the doctor but at the fact that something could have been done and that I could have had some help! This was in 1993 but even today only a few patients receive check-up and tests, diagnosis and treatment.

No Osteoporosis Patients Association existed at that time so Sonja Rembo, former Member of Parliament as well as former secretary of a managing director, decided - still very angry - to start one herself.

- I was so upset over the negligence from the medical care and its decision-makers towards all these middle-aged and older women, all suffering in silence. This year the National Osteoporosis Association celebrates its ten year anniversary. There are still too many people knowing nothing of the existing successful methods of treatment and the possibility to diminish their own risk of being afflicted.

The skeleton is a living tissue

The skeleton is a living tissue continuously being disintegrated and reconstructed in a constant adjustment to the demands from the skeleton and the rest of the body. The skeleton is not only the framework of the body but also a reservoir for the calcium that is needed by both nerves and muscles in different situations. Within 10-20 years the whole skeleton has been reconstructed and this continues all your life, controlled by various hormones as well as by the level of vitamin D and calcium in the body.

Why osteoporosis?

In a healthy adult person there is a natural balance between disintegration and reconstruction of the bone mass. But this balance deteriorates in a patient with osteoporosis where the disintegration is bigger than the reconstruction, making the skeleton more fragile with consequently impaired bone quality.

The risk of being afflicted increases with age. The body’s capacity to absorb calcium from the intestinal canal and the kidney’s capacity to transform vitamin D into its active form deteriorate as well.

The body compensates this condition by taking more calcium than normal from the skeleton which means that the density and the quality of the skeleton change.

A skeleton, fragile from osteoporosis, is nothing you feel or notice until the fractures happen. Therefore, you have every reason to do your best to diminish the risk yourself as far as possible. At the same time you have to pay attention to fractures following uncomplicated falls.

How do you avoid being afflicted?

Most important are physical exercise, no smoking and a balanced diet with dairy products and vitamin D, says Håkan Sinclair, geriatrician and senior doctor at Borås Hospital.

Research data show that vitamin D plays an important role in maintaining a strong skeleton. The body can assimilate vitamin D from fatty fish like salmon and mackerel as well as from the skin transforming sunlight into vitamin D.

During the winter it is harder for the skin to produce vitamin D and therefore it is even more important to stay outdoors as long as possible. A diet of fatty fish several times a week as well as physical exercise are also important for the skeleton.

How do you know if you are afflicted?

- A healthy skeleton does not fracture when you fall over your carpet or in the street. Such a fracture can therefore be a symptom of osteoporosis, says Håkan Sinclair.

If so, discuss osteoporosis with your doctor. Fractures of wrist, vertebra and hip are common but also upper arm and pelvis.

Vertebra compression or fracture of one or two lower back vertebras are the most common types. What you feel is a sudden pain between your shoulder blades.

- Every fracture from uncomplicated falls should be looked into. In order to assess the stability and strength of the skeleton you need an instrument measuring the density of the skeleton, preferably the whole skeleton, according to Håkan Sinclair.

In Sweden we have several such measuring instruments but unevenly distributed over the country.

- In certain parts of Sweden there are not enough instruments, which means that many patients are not treated correctly.

Every fracture increases the risk for more fractures so we should never neglect any fracture, thinking that it will not happen again after healing.

- Moreover, it is never too late to start treating osteoporosis, says Sonja Rembo.