“A major aspect of orthopaedic practice today is obviously trauma based – i.e. fractures because of poor traffic rules and the expanding population that our country has,” says Orthopaedic Surgeon, Dr. Shailendra S Telang. The majority of casualty patients today are trauma related. Trauma like Dr. Telang says translates into fractures. Broken bones are included in it. Women in particular are affected by trauma due to osteoporosis.
Dr. Telang explains, “A common fracture that we see in the older population is the hip fracture. This usually happens after a trivial fall. They could get a hip fracture sometimes even while turning in bed. Again the culprit is osteoporosis. Usually the calcium in our body is maintained by many mechanisms, one of them being the hormonal regulation. In a female after menopause, there is an alteration in the hormonal level. The hormone production suddenly stops. This causes demineralization or the calcium in the bones comes out into the blood. The bones become soft because they become devoid of calcium. They become like hollow shells. Any stress in this condition causes a fracture. For the older population the commonest area of fall is the bathroom. There should be metal bars on the walls of the bathroom for them to hold on to in case they slip.”
Osteoporosis is seen in women as early as 35 years of age. The problem with osteoporosis is that it often does not present any symptoms until bones fracture. Also sometimes osteoporotic fractures go undetected until they cause symptoms. Pain and disability form the symptoms of fracture. This depends very much on the location of the fracture. The aging process in a woman includes the loss of 0.3-0.5% bone density per year. In women, estrogen hormone maintains the bone density. After menopause, with the drop in estrogen levels, there is increased loss of bone density. An important cause of osteoporosis in women is the increased bone loss after menopause. Hormone replacement therapy may help after menopause. However, it may not make much difference once the post-menopause 6 year window period is over.
The risk factors for osteoporosis include Asian women with thin and small body frame, family history of osteoporosis, and habits of cigarette smoking and excessive alcohol consumption. Osteoporosis also occurs in women due to poor diet, lack of calcium supplementation, repeated pregnancies, poor exposure to sunlight, poor amount of exercise, sedentary lifestyle, etc. Dr. Telang insists, “Every woman after menopause should get her Bone Mineral Densitometry (BMD) done to evaluate osteoporosis. It is a very simple test. It is the scan of the leg. It shows the amount of calcium that is present in the body. It gives the orthopaedic surgeon a basic guideline to treat the patient. If the patient has normal calcium levels we don’t have to do anything. If diagnosed, osteoporosis can be treated with plain calcium. If it is of a higher degree, we add Vitamin D3. Depending on the severity, we also use steroids and other drugs. It is an irreversible degenerative disease, which is also one of the aging changes. You can only decrease the amount of damage.”
Daily walking, sunlight exposure and good calcium rich food can also delay the onset of osteoporosis.
This article was previously published in Eve’s Times magazine and is reproduced here with the permission of the editor Swati Amar.