Pernicious osteoporosis

Derived from a Greek word meaning porous bones, osteoporosis is known as the ‘silent killer’, that leads to disease of bones and to an increased risk of fracture. This silent progressive metabolic bone disease is widely prevalent among Indian women, where the patient suffers from a broken bone. According to Association of Spine Surgeons of India, currently there are about 28 million osteoporosis patients in India out of which 80 per cent are females. This number is expected to increase by five million in the next one year.

According to World Health Organization (WHO), osteoporosis is second only to cardiovascular disease as a global healthcare problem and it is projected that one out of every three women will suffer from osteoporosis. A survey of 100 doctors was conducted across metros in India in order to gauge awareness levels among the medical fraternity about the condition.

Causes

According to the doctors surveyed, the main reason for a surge in osteoporosis in the country is due to dietary deficiency of calcium, which if prevalent from an young age, leads to a lower peak bone mass. Mal-absorption of calcium due to a subclinical deficiency of Vitamin D may also lead to osteoporosis.

A gynaecologist in Delhi said, “Most women in their post menopause stage approach us with joint and back pain. They think that it is due to old age and they fail to understand that it may be due to osteopenia. Ostopenia is a condition where bone mineral density is lower than normal. It is considered by many doctors to be a precursor to osteoporosis. Apart from fractures, other common symptoms are stoop posture and fatigue while undertaking day-to-day activities.”

An orthopaedic surgeon in Mumbai said, “Osteoporosis is very common in females. People suffering from osteoporosis usually approach us when things become too late because they ignore the early symptoms.”

According to the doctors surveyed, as one gets older, the body’s ability to restore bones and absorb calcium decreases, which causes the bones to take the structure of a honey comb. This results in weak bones specially in the hip areas.

An orthopaedic surgeon in Kolkata said, “The fact is, we build bone density only till the age of 30, after which the calcium level depletes, which is precisely why a healthy diet and exercise is so important early in life.”

According to an orthopaedic surgeon in Chennai, “In India both male and female within the age group of 50 to 60 suffer from osteoporosis whereas in the western countries this disease is found in people above the age of 70. Everything depends on the diet and lifestyle.”

A gynaecologist in Delhi said, “It is quite disturbing to see that more young females are approaching us with the symptoms of osteoporosis. We need to teach school students about the importance of a healthy diet and life style, otherwise the number of patients suffering from osteoporosis would continue to increase.”

According to all doctors who took part in the survey, unless the the population understands the importance of both calcium and vitamin D intake, it would be difficult to curb this problem.

One of the most common factors which puts an individual at a higher risk of osteoporosis is menopause as the hormonal changes aggravate the problem. An orthopaedic surgeon in Delhi says that consumption of alcohol, smoking and leading a more sedentary lifestyle may lead to osteoporosis. This is the reason why doctors are seeing a larger number of young patients, analyses this doctor.

Although certain medications can speed up the process their volume of contribution is not so much, as mentioned by a gyneacologist in Mumbai. In certain cases, religious beliefs could also play a role in the progress of osteoporosis, according to a GP from Delhi. He points out that women who need to always be veiled when they step out of their house could have vitamin D deficiency due to lack of exposure to sunlight.

Most patients feel that intake of calcium and Vitamin D supplements would solve the problem this is not the case. Many doctors suggest hormonal treatment, but the cost and apprehension of side effects deter most patients. Physical exercise is also important to help strengthen the bones. Most commonly, doctors prescribe bisphosphonates and other steroid- based medications, but once again compliance plays a huge role in its success.

A gynaecologist in Chennai mentioned, “Women have the worst compliance, they either forget or not willing to spend money on medication.”

A Delhi-based gynaecologist pointed out that it is very important to educate school children about having proper diet and importance of treatment.

The order of the day is to increase knowledge levels, by holding camps in schools and neighbourhoods for free testing and providing information about osteoporosis. Education should include early warning signs of osteopenia, and importance of regular resting for women. In most cases doctors have seen that although patients are aware about osteoporosis they do not understand the seriousness of the disease. As per a gynecologist in Mumbai,“In countries like the US, many companies have started support groups and forums on which people can come together and discuss their apprehensions questions etc. Something like this is needed in India.”

The government needs to play a more active role before osteoporosis turns into an epidemic. It should be given an equal importance as diabetes and hypertension. The medical fraternity looks forward for better medication with lesser side effects. In the end, according to the doctors surveyed, prevention is better than treatment in order to make the future of women in India healthier and brighter.

Disclaimer: Statements and opinions expressed in this article are those of 100 doctors (diabetologists, nutritionists) across urban cities (Delhi, Mumbai, Hyderabad, Chennai, Kolkata, and Bangalore). While every care has been taken in the compilation of this information, the authors will not be responsible for any claim, loss, damage or inconvenience caused as a result of any information within these pages.