What is Osteoporosis?
Osteoporosis is a condition that manifests with insidious pain, bone fractures, deformities, loss of height, hunching of the back, and lower back and back pain. Although it is considered a physiological disease that occurs with aging, osteoporosis can also be seen in younger individuals due to genetic factors.

Osteoporosis is a rare disease that may cause you to regret not taking better care of yourself as you age. It progresses silently and often shows no symptoms until fractures occur.

All the bones in the body can be affected by osteoporosis. Silent fractures, especially in the spine, can lead to vertebral compression, which results in height reduction. Bone loss in osteoporosis, particularly post-menopause, is most significant during the first few years.

What Causes Osteoporosis?
In a healthy individual, bone tissue increases from birth and peaks around age 35. After this point, a gradual loss in bone mass and density occurs and continues over time.

Bones undergo a continuous cycle of formation and breakdown. This process is influenced by hormonal, endocrine, metabolic, and environmental factors. Additionally, nutrition, physical activity, and genetics also play a role.

Due to daily stress and load, bones experience microscopic fractures, which are normally repaired by the body. However, if this repair process is inadequate, bone strength diminishes.

Causes include:

• Inadequate intake of calcium, phosphorus, and vitamin D
• Being female, especially post-menopausal
• Genetic predisposition and advanced age
• Thyroid disorders and diabetes
• Decreased sex hormone levels
• Sedentary lifestyle
• Smoking
• Excessive physical activity
• Amenorrhea (absence of menstruation) in young female athletes and ballerinas, which increases risk

What Are the Symptoms of Osteoporosis?
Osteoporosis usually progresses silently until a fracture occurs. In early stages, there are often no symptoms. Even when fractures do occur, they may not always be noticeable, making early diagnosis difficult unless routine screening is done. A bone densitometry test (bone scan) is a highly effective diagnostic tool.

The most common complaint in symptomatic patients is back and spine pain, which is often caused by microfractures in weakened bones.

Other symptoms include back and lower back pain, loss of height, increased hunching, curved posture, and skeletal deformities. A loss of 4–6 cm in height compared to youth may raise suspicion. The most serious complication is hip fractures.

How Can Osteoporosis Be Prevented?
Even in elderly or osteoporotic patients, if the bones are supported by muscles, the risk of fractures can be minimized. Strong bones require a healthy muscular and nervous system and sufficient calcium reserves. Foods rich in calcium such as white cheese, milk, yogurt, and dark leafy greens should be consumed regularly. Calcium supplements may be prescribed if needed under medical supervision.

Vitamin D is essential for calcium absorption. Exercise and physical activity are vital; the simplest form is regular walking.

Who is at Risk for Osteoporosis?
Women with thin bones, light skin, and light-colored eyes are at higher risk. Early menopause and family history of early menopause also increase risk.

Modifiable risk factors include:

• Increasing daily physical activity (a sedentary lifestyle is a major risk)
• Quitting smoking
• Improving nutrition
• Avoiding extreme thinness (muscle deficiency)
• Ensuring adequate calcium intake
• Being cautious with certain medications (e.g., corticosteroids, epilepsy drugs)
• Avoiding carbonated drinks and limiting coffee intake

Non-modifiable risk factors include age, gender, family history of osteoporosis, hysterectomy, menopause, long-term corticosteroid use, and thyroid disorders. Those in risk groups should consult a doctor.

How is Osteoporosis Diagnosed?
Osteoporosis is diagnosed through a method called Dual-Energy X-ray Absorptiometry (DEXA). DEXA measures bone mineral density and provides information for diagnosis, predicting fracture risk, and monitoring disease progression.

How is Osteoporosis Treated?
Treatment should be planned by a physician based on:

• The severity of the disease
• Bone-related issues over the past 10 years
• Bone density test results

If there are no major fractures, treatment should begin with preventive measures. The main goal is to activate the patient and promote regular exercise. Brisk walking is very beneficial. Depending on the patient’s age and general condition, muscle-strengthening aerobic exercises can also be added.

Preventive medications may reduce or stabilize bone breakdown and should be prescribed according to the patient’s age group. However, without accompanying exercise, these medications alone will not be sufficient.

For patients with vertebral fractures due to advanced osteoporosis, a back brace may be recommended along with regular exercise to reduce pain. Painkillers should be used under medical supervision.

Early diagnosis is crucial for this silent disease. Bone mineral changes should be monitored every 1–2 years in at-risk patients, and bone loss should be tracked through blood and urine tests.