Monday, 25 November 2013

Osteoporosis – The Symptoms

Osteoporosis is defined as a condition of thinning of bone and bone tissues as a result of  the loss of bone density over a long period of time.
I. Symptoms
1. Back pain, as a result of fractured or collapsed vertebra
In the study to investigate the prevalence and factors associated with low back pain among adults in Taiwan. Methods: The National Health Interview Survey, a cross-sectional study, was conducted from October 2002 to March 2003 to gather data from 24,435 adults aged 20 years and older selected randomly from Taiwan’s general population, showed that patients with osteoporosis were more likely than those without osteoporosis to have low back pain (OR = 2.55, 95% CI = 2.33-2.78) or frequent low back pain (OR = 4.15, 95% CI = 3.66-4.70). The ORs of frequent low back pain in association with osteoporosis in men and women were 5.77 (95% CI = 4.66-7.15) and 3.49 (95% CI = 2.99-4.07), respectively(1).
2. Loss of height over time
In a study of 231 men and women over the age of 65 underwent DXA scan of their spine and hip (including bone mineral density and Vertebral Fracture Assessment), measurement of their height, and a questionnaire, showed that height loss was significantly associated with a vertebral fracture (p=0.0160). The magnitude of the association translates to a 19% increase in odds for 1/2 in. and 177% for 3 in. Although 45% had osteoporosis by either bone mineral density or fracture criteria, 30% would have been misclassified if bone mineral density criteria were used alone(2).
Others showed that Osteoporosis is a recognised co-morbidity in patients with chronic obstructive pulmonary disease (COPD) and may cause excessive height loss resulting in the ‘normal’ values and disease progression being under-estimated(3).
3. A stooped posture
Postural deformity might represent another risk factor for postural instability and falls. In the study to investigate the influence of spinal curvature on postural instability in patients with osteoporosis, showed that no significant correlations were observed between any parameters of postural balance and angle of thoracic kyphosis. However, all parameters showed significant positive correlations with angle of lumbar kyphosis (r = 0.251-0.334; p < 0.05-0.001). Moreover, lumbar kyphosis, but not thoracic kyphosis, showed a positive correlation with spinal inclination (r = 0.692, p < 0.001), and all parameters of postural balance showed significant positive correlations with spinal inclination (r = 0.417-0.551, p < 0.001)(4).
4. Easy bone fracture
In a multicenter, double-blind, placebo-controlled trial of randomly assigned 1199 men with primary or hypogonadism-associated osteoporosis who were 50 to 85 years of age to receive an intravenous infusion of zoledronic acid (5 mg) or placebo at baseline and at 12 months, found that Zoledronic acid treatment was associated with a significantly reduced risk of vertebral fracture among men with osteoporosis(5).
5. Neck and low back pain
In the study to determine the 1-year prevalence of neck pain and low back pain in the Spanish population and their association with sociodemographic and lifestyle habits, self-reported health status and comorbidity with other chronic disorders, found that neck and low back pain are prevalent and highly associated between them, more frequent in female (particularly neck pain) and associated to worse self-reported health status. Individuals with neck and low back pain were more likely than those without pain to have depression and other painful conditions, including headache and osteoporosis(6)
6.  Depression
Researchers showed there is  negative associations between depression and BMD variables in the three assessed areas. There were negative correlations between anxiety, stress and spine BMD, as well as a tendency towards negative relations in the right and left hip BMD. Concurrent hierarchical regressions showed that the addition of the three psychological variables increased the explained variance by 6-8 %. In addition, depression was found to have a unique significant contribution to the explained variance in right and left hip BMD(7).
7. Other symptoms
In the study to study compare symptoms at midlife, menopause attitudes, and depression among three groups of late peri- or postmenopausal women, namely, women with cardiovascular disease (CVD group), women with osteoporosis (Os group), and women in generally good health (Co group), showed that the CVD group reported significantly more severe symptoms at midlife than did the Co group; significantly more severe “psychosomatic symptoms” than did the Co group; and significantly more severe “gastrointestinal symptoms and swelling” and “vasomotor symptoms” than did either the Os group or the Co group. The CVD group also reported significantly greater depressive symptoms than did the Os group(8).
8. Etc.
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