Osteoporosis is a disease where the density and quality of your bones are reduced, as a result of age and various osteoporosis risk factors. The word “osteoporosis” literally means “porous bone.”
Your risk of a bone fracture increases as your bones become more porous and weakened. In serious cases of osteoporosis, even minor stresses — not just major falls or accidents — can cause bone fractures. Think coughing or sneezing, or bending or reaching for something. Fractures due to osteoporosis are most common in the hip, wrist, or spine.
In this article, we’ll discuss different osteoporosis risk factors, including merely having arthritis. It’s important to understand how arthritis and osteoporosis are connected, so you can ensure you’re getting appropriate testing and, if necessary, treatment.
In rheumatoid arthritis (RA) there’s often “local bone loss” where there is joint inflammation in the knees, hands, wrists, ankles or wherever the inflammation occurs in this autoimmune inflammatory condition, says Stephen Honig, MD, associate professor of rheumatology and director of the Osteoporosis Center at NYU Langone Health.
“Because of the release of inflammatory substances [in inflammatory arthritis], the bone next to the joint is often affected as well,” he said.
When people talk about the link between arthritis and osteoporosis, they’re generally talking about the inflammatory types of arthritis, which includes rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, and mixed connected tissue diseases, like scleroderma and polymyositis, says Dr. Honig.
Although bone loss is typical with aging, people with rheumatoid arthritis and other chronic inflammatory diseases often have systemic inflammation, which is associated with generalized bone loss, according to research in the journal Seminars in Arthritis and Rheumatism.
In addition, corticosteroid medications that people with arthritis commonly take to reduce inflammation and pain also increase your risk of developing osteoporosis (more on this below). (These are the best foods for arthritis pain.)
In osteoarthritis (OA), pain occurs due to wear and tear on joint tissue. It often involves the knees, hips, lower back, and small joints of the hands. This wearing away of the joint’s cartilage due to overuse of the joints or injuries of the joints leads to impaired flexibility, bone spurs, and swelling of the joint. Although some medical experts and researchers believe there is an association between bone mineral density and osteoarthritis, others see the two issues as distinct, but related through similar risk factors, such as age.
Here, familiarize yourself with other osteoporosis risk factors. Discuss these with your physician and learn what to do if you’re at an increased risk of osteoporosis.
Women are more likely to develop osteoporosis than men (although men do get osteoporosis too). Women’s bones are smaller and thinner than men’s bones, which make them more fragile. And loss of the hormone estrogen after menopause cause lead to accelerated bone loss in women, which explains why women are even more at risk of osteoporosis as they age, according to the National Osteoporosis Foundation. This is why it’s suggested that women get screened for osteoporosis earlier than men — age 65 for women and age 70 for men.
Your bones are not an inanimate skeleton; rather, they contain living tissue made from cells that are constantly being broken down and then replaced with new tissue. When you’re a child and a young adult, your body replaces old bone faster than it breaks down old bone, which causes your bone mass to increase. But after about age 30, which is considered peak bone mass, your body doesn’t replace old bone as quickly. Over time, this can increase the risk of developing osteoporosis.
Also, as you get older your ability to absorb and use calcium and vitamin D decreases; these nutrients are an important part of the bone rebuilding process.
What’s more, cognition issues and balance problems that are more common in older adults could lead to falls and fractures, which then also increase your risk of complications from osteoporosis.
Excessive thinness or a history with an eating disorder like anorexia could put you at risk of developing osteoporosis earlier. Studies have shown that a low body mass index (BMI) is related to osteoporosis and increased fracture risk. Women who have extremely low body weights (from eating disorders like anorexia) may also stop producing estrogen, a hormone that’s important for building and maintaining bone density. In some people, rheumatoid arthritis can cause weight loss, which could also affect your osteoporosis risk.
One of the biggest reasons someone with inflammatory arthritis is at a higher risk of osteoporosis is taking corticosteroid medication to manage symptoms. “With any patient who’s on long-term and high-dose corticosteroids, you have to worry about steroid-induced osteoporosis and fractures,” says Dr. Honig. Steroids are also used to help treat common arthritis comorbidities, such as lung disease and chronic obstructive pulmonary disease (COPD). “Taking corticosteroids can result in weakening of the bones,” he says. Taking an oral dose of 5 mg or so daily would predispose someone to systemic osteoporosis, says Dr. Honig. Here’s more info on how to prevent osteoporosis while you’re on steroid medication.
You might blame a weak ankle from sports injuries decades ago, but if you have a history of fractures, or even if you’ve only broken one bone in your lifetime, you’re at a higher risk of developing osteoporosis. If you’re over age 50 and have broken a bone, there’s a solid chance that fracture is related to osteoporosis.
Aside from your own history of fractures, if your parents have a risk of fracturing bones, particularly in the hips, or a parent has been diagnosed with osteoporosis, let your doctor know this information as well. A family history of hip fracture in parents was associated with a significant risk of all osteoporotic fractures in their children, according to research in the journal Bone.
If you were a regular cigarette smoker or still smoke on occasion, you’re at an increased risk for a fracture due to lower bone density and it may take longer for your bones to heal after a fracture. Research has found a direct relationship between smoking cigarettes and a decrease in bone density. Smokers also tend to be thinner and women who smoke may hit menopause earlier, which increases other osteoporosis risk factors. Quitting smoking, which is healthy for a million other reason, can also help limit bone loss and decrease your fracture risk.
Have you avoided dairy or dark greens most of your life? A diet that’s low in calcium (from such food sources as dairy products, fortified cereals and drinks, and dark leafy greens) could make you more at risk of developing osteoporosis. Your body needs the mineral calcium to make healthy bones and keep them strong. Your body can’t make calcium on its own; you only get it from foods and supplements. If you struggle to hit the recommended 1,200 mg of calcium daily, talk to your doctor about whether you could benefit from taking calcium supplements.
Read the full article on CreakyJoints.
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