Dr Adriaan Liebenberg My Spine Lumbar | Page 27

My Spine - Lumbar What are the symptoms? Bone loss occurs without symptoms. People can lose bone mass over a long period of time without being aware of it. The first indication of osteoporosis is frequently a fracture of the spine, hip or wrist following a simple fall. When bone loss is severe and osteoporosis is advanced, the following symptoms can occur: Pain in the lower back Neck pain Leg cramps at night General bone pain and tenderness Abdominal pain Rib pain Broken vertebrae Brittle fingernails Loss of height of the vertebrae and a stooped posture are the main effects of osteoporotic spinal fractures. How is it diagnosed? Osteoporosis is diagnosed with spinal X-rays, a spinal CT scan or a bone den- sity scan (Dexa scan). A suspicion of osteoporosis is usually present when a spinal fracture occurs where there has been only a small amount of force pres- ent, such as a simple fall. How is it treated? The best treatment is prevention. Adequate calcium and vitamin D intake and exercise are important preventative aids against osteoporosis. Avoiding smoking and excessive alcohol intake are other important factors. There are a number of drugs that may help to increase bone density. The antiresorptive medications, biphosphonates (alendronate, ibandronate and risedronate), cal- citonin, oestrogens and raloxifene affect the bone remodeling cycle. 27