The health of our bones plays a critical role in our ability to move our bodies, lift everyday items and maintain our independence. Threats to our mobility include osteoporosis and a lesser-known condition called osteopenia.
“Osteopenia is also known as low bone density,’” says Richard Kirkpatrick, an orthopedic surgeon with Oklahoma Sports and Orthopedic Institute in Norman. “It’s sometimes considered a precursor to osteoporosis, but it’s important to note that not all patients diagnosed with osteopenia will progress to osteoporosis.”
Patients with osteoporosis have a high risk of fracturing a bone, while patients with osteopenia have varied levels of risk.
“Oftentimes a [fracture assessment] score, which takes into account the patient’s personal and family history, is used to give us an estimation of a patient’s fracture risk when they have osteopenia,” Kirkpatrick says. “Evaluating bone health is most commonly done using a DXA, or dual-energy X-ray absorptiometry. The bone mineral density scores from this easy, noninvasive test are compared to normal. Osteopenia is diagnosed when the DXA score is from minus-1 to minus-2.4. Osteoporosis is diagnosed when the score is minus-2.5 or worse.”
Yogesh Mittal, an orthopedic surgeon at the Orthopaedic Center in Tulsa, says osteopenia usually has no symptoms, but people with the condition face challenges.
“There are some activity restrictions to prevent injury that can alter recreational living,” he says. “Running and impact activity are generally difficult to enjoy for fear of injury, including stress fractures. There is also a fear that a traumatic episode could lead to a significant injury, such as a hip fracture or compression fracture.”
He says early treatment for osteopenia includes weight-bearing exercises and limiting one’s intake of carbonation, nicotine and caffeine. Vitamin D, calcium and vitamin K2 are added to a patient’s diet, and, if the condition is severe, oral medications can help to limit bone deterioration.
Kirkpatrick says osteoporosis has few symptoms, but one out of two women and one out of four men age 50 and older develop an osteoporotic fracture.
“Fracture is often the first sign the disease exists,” he says. “Symptoms occurring late in the disease include bone pain, loss of height, back pain due to spinal fractures and stooped posture or kyphosis.”
He says the worst part of an osteoporotic fracture is disability.
“For many patients, they will never regain 100 percent function,” Kirkpatrick says. “They may lose the ability to drive, do their own hair or cook their own meals. One of the most common causes of assisted living and nursing home admissions is osteoporotic fracture. Sometimes the best reason to treat osteoporosis is to preserve physical independence.”
He says nutrition and weight-bearing activity are important to prevent or delay the onset of bone loss and encourages people who experience a fracture to check their bone health.
“Don’t take a chance. Fracture begets fracture,” Kirkpatrick says. “The likelihood of a subsequent fracture is very high. Don’t wait until you have suffered three fractures before evaluating your bones. Well-tolerated, bone-building medications can be used for just a couple of years to help regenerate your skeleton and significantly reduce your fracture risk. It’s important to initiate them before the most disabling fractures occur.”