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Osteoporosis

Dr. Chiam Tut Fu

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Dr. Chiam Tut Fu

Medical Director, Consultant Sports Medicine Physician at Thomson Wellth Clinic

MBBS (Singapore), MSS (Sports Medicine), MMed (Occupational Medicine), GD (Occupational Medicine)

Dr. Chiam Tut Fu specialises in the management of musculoskeletal pain due to sports injuries or age-related degenerative and orthopaedic conditions and myofascial causes like trigger points. He also has a special interest in weight management and smoking cessation.

Table of Contents

Osteoporosis or porous bones is a condition where your bones become weak and brittle. Brittle bones are then prone to fractures, even with very minimal trauma. Most common fractures from osteoporosis are in the hip, spine and wrist. Fractures in the spine and hip are of special concern as they almost always result in serious consequences such as hospitalization or even death. Over the last 30 years in Singapore, cases of hip fractures have increased 5 times in women aged 50 and above and 1.5 times in men of the same age group.

What are the signs of osteoporosis?

Osteoporosis is a ‘silent’ disease as there are usually no signs or symptoms in the early stages. However, in the later stages, you may experience back pain, loss of height, stooped posture and fractures of the spine, wrists or hips.

What causes osteoporosis?

Osteoporosis occurs when there is an imbalance between new bone formation and old bone resorption. Our bone mass peaks at about the age of 30. After that, bone mass gradually decreases. In pregnant and lactating mothers, there is a temporary increase in bone loss if the increased calcium demands of pregnancy or breastfeeding are not met by increased dietary intake of calcium. There is also a significant decrease in bone mass in women in the 5 to 7 years after menopause as the body produces less oestrogen which protects the body from bone loss.

Who are at risk of having osteoporosis?

  • Older people – the risk increases as one gets older
  • Female
  • Women who are menopausal or have had their ovaries removed, especially if they have menopause before the age of 45
  • Those who have a family history of osteoporosis or osteoporotic-related fractures
  • People who are thin and small built/underweight
  • Those who have previous fractures following a low-level trauma, especially after the age 50
  • People who do not consume enough calcium in their diet
  • Those leading sedentary lifestyles
  • Excessive alcohol drinkers – excessive amounts of alcohol reduce bone formation and also affects the body’s ability to absorb calcium
  • Smokers – smoking causes bone loss
  • People on prolonged use of medications such as corticosteroids

Osteoporosis can be diagnosed through a bone mass density test, commonly done using a DEXA scan. It measures the bone mineral density or bone strength at the hip and spine. The results of the BMD test will then help your doctor access your risk and make recommendations for the prevention or treatment of osteoporosis.

How to prevent osteoporosis?

1. Diet

  • Ensure adequate calcium, vitamin D either through your food or supplements. An adult 50 and above needs between 1000mg to 1200mg of calcium daily
  • Vitamin D is needed by the body to absorb calcium, and it can be obtained through skin exposure to sunlight, diet, or through supplements. An adult age 50 and above needs between 400-1000IU of Vitamin D daily

2. Weight bearing and resistance exercise

  • Weight-bearing exercises are activities where your bones support your body weight, and they help to build and maintain bone density. Some of these exercises include brisk walking, hiking, dancing, jogging, aerobics and tai chi
  • Resistance exercises like weight lifting, and push-ups will also help to increase muscle strength and decrease the risk of falls

3. Avoid smoking and excessive alcohol intake

  • Although you cannot ‘cure’ osteoporosis, you can prevent further bone loss, improve bone strength and reduce the risk of fractures. You can do this with medications, exercise and ensuring good nutrition with adequate calcium and Vitamin D

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