osteoporosis
OSTEOPOROSIS
Osteoporosis is the progressive, systemic skeletal disease characterized by decreased bone mass and micro-architectural deterioration of bone tissue leading to increased bone fragility and susceptibility to fractures.
The more risk factors (eg history, of fracture, advanced age, comorbidities, impaired vision) that are present, the greater the risk of fracture.

Lifestyle Modification

Exercise
  • Regular weight-bearing exercises and muscle strengthening exercises can improve agility, strength, posture and balance, which may help to prevent falls
    • Jogging, brisk walking, tai chi, weight training
    • Type of exercise will depend on age of patient and physical ability
    • At least 30 minutes of regular exercise 3-4 x/week is recommended
  • May modestly increase bone density (for as long as exercise is being done)
Avoid Cigarette Smoking and Excessive Alcohol Consumption
  • Both associated with increased risk of osteoporotic fractures and should be avoided
  • Alcohol intake may be limited to <2 units/day
Limit Caffeine Intake
  • Caffeinated drinks should be limited to <1-2 servings/day (240-360 mL/serving)

Fall Prevention

  • Counsel the patient, especially the elderly, on ways to reduce risk of falls
    • Measures to prevent falls (eg installing grab bars/handrails, nonslip flooring, adequate lighting, removing loose wires, keeping things within reach)
    • Hip protectors may help reduce the impact on the hip during the fall
  • Evaluate for certain medications (eg sedatives, hypnotics, narcotic analgesics, antihypertensives), neurologic conditions, alcohol, poor vision and hearing, frailty and deconditioning as these may lead to falls
  • Recommend exercise and physical therapy referral

Support Devices

  • Eg braces, lumbar corset, posture-training support devices
  • Recommended for patients with acute vertebral fractures or multiple vertebral fractures associated with chronic pain
  • Provides significant pain relief by decreasing the load on fracture sites and realigning the spinal column
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