What is Osteoporosis?
Osteoporosis is a condition characterized by a gradual onset of pain, bone fractures, deformities, height loss, hunchback, and back and waist pain. It is considered a physiological disease related to aging but can also occur at a young age due to genetic reasons.

Osteoporosis is one of the rare diseases that silently progresses and usually shows no symptoms until bone fractures occur, often causing regret later with thoughts like “I wish I had taken better care of myself.” All bones in our body are affected by osteoporosis. Silent fractures in the spine cause vertebral collapse, leading to height loss. In particular, bone loss occurring after menopause happens most intensely in the first few years.

What Causes Osteoporosis?
In a healthy individual, bone tissue grows from birth and reaches its peak density around age 35. After this peak, bone density and mass gradually decline over time.

Bone tissue undergoes a continuous process of remodeling—breakdown and rebuilding. Hormonal, endocrine, metabolic, and environmental factors influence this process. Additionally, nutrition, physical activity, genetic traits, and other factors play a role.

Bones undergo microscopic fractures due to mechanical load continuously. Normally, the body initiates repair immediately, and the damaged area is quickly healed.

Factors increasing osteoporosis risk include:

• Insufficient intake of calcium, phosphorus, and vitamin D
• Being female and postmenopausal
• Genetic predisposition and advanced age
• Thyroid hormone disorders, diabetes
• Decreases in sex hormones
• Sedentary lifestyle
• Smoking
• Excessive physical activity
• Amenorrhea (absence of menstruation) in young female athletes and ballerinas, which increases osteoporosis risk.

What Are the Symptoms of Osteoporosis?
It is a silent disease until fractures occur. Usually, there are no early symptoms. Fractures that may occur sometimes do not cause noticeable symptoms. Therefore, diagnosis is difficult without screening until osteoporosis reaches an advanced stage. Bone densitometry (bone density scan) is a very useful diagnostic method to detect osteoporosis.

The most common complaints in symptomatic patients are pain in the spine and back, believed to be caused by microscopic fractures in weakened bones.

Symptoms of osteoporosis include back and waist pain, height loss, increased hunchback, poor posture, and deformities. Height loss of 4-6 cm compared to youth should raise suspicion of osteoporosis. The most serious danger of osteoporosis is hip fractures.

How Can Osteoporosis Be Prevented?
Osteoporotic bones, as long as they are supported by muscles, can minimize the risk and occurrence of fractures, even if the patient is elderly or has osteoporosis. For bones to resist fractures, healthy muscle tissue and nervous system that protect and mobilize the bone are necessary. For all this, sufficient calcium stores in the bones are required. Foods rich in calcium, such as dairy products like white cheese, milk, yogurt, and dark green vegetables, should be consumed regularly. Calcium supplements can be taken under medical supervision if needed. Vitamin D is necessary for calcium to be absorbed into the bones. Exercise and sports, especially simple activities like regular walking, are essential.

Who Is at Risk for Osteoporosis?
Thin-bodied, light-eyed, fair-skinned women are more at risk. Women who experience early menopause or have a family history of early menopause are also at higher risk.

Some modifiable risk factors for developing osteoporosis and preventing fractures include:

• Increasing daily physical activity (a sedentary lifestyle is a major risk factor)
• Quitting smoking
• Correcting nutritional deficiencies
• Avoiding excessive thinness (muscle weakness)
• Maintaining normal calcium intake
• Monitoring the use of certain medications (such as corticosteroids, epilepsy drugs)
• Avoiding carbonated drinks like soda and cola, and reducing coffee intake.

Non-modifiable risk factors include age, gender, family history of osteoporosis, previous hysterectomy, menopause, long-term corticosteroid use, thyroid diseases, etc. People at risk should consult a physician first.

How Is Osteoporosis Diagnosed?
Osteoporosis is diagnosed using a method called Dual-energy X-ray Absorptiometry (DEXA). DEXA measures bone mineral density, providing information for diagnosis, fracture risk assessment, and monitoring the disease’s progression.

How Is Osteoporosis Treated?
Treatment depends on:

• The severity of the disease
• Bone health problems within the last 10 years
• Bone density measurement results

In patients without obvious macro bone fractures, treatment should start with preventive measures. The main goal of preventive treatment is to activate the patient and encourage exercise. Brisk walking is very beneficial. Additionally, aerobic exercises to strengthen muscles may be added depending on the patient’s age and general condition.

Preventive medications can reduce or balance bone loss. These treatments should be used according to the patient’s age group but are not sufficient alone without exercise.

In patients with advanced osteoporosis and vertebral fractures causing pain, wearing a back brace alongside regular exercise may be recommended. Painkillers can be used under medical supervision to relieve pain.

Early diagnosis is crucial in osteoporosis, a silent disease. At-risk patients should have their bone mineral density monitored every 1-2 years, and bone resorption should be evaluated through blood and urine tests.