Osteoporosis is a gradual thinning of bones that commonly occurs with advancing age. Bone, as living tissue, is constantly broken down and replaced. Osteoporosis develops when new bone formation fails to keep up with the loss of old bones, resulting in weakened, brittle bones. This process often begins silently, with no obvious symptoms until pain in the limbs or back emerges, or fractures occur even without significant trauma. When osteoporosis advances, the bones become so soft that fractures shatter the bone into small fragments, complicating surgical repair, which may require plates, screws, or nails. Ageing is a significant risk factor, with women—particularly post-menopausal women—at higher risk than men. A diet low in calcium, phosphorus, magnesium, and other essential minerals heightens susceptibility. Malnutrition, chronic alcohol, and tobacco use are also known contributors. Regular physical exercise from adolescence strengthens bones and muscles, which helps protect against osteoporosis later in life. Physical inactivity can reduce the effectiveness of calcium supplements in strengthening bones. Obesity, which is often associated with sedentary lifestyles, also raises the risk. Conversely, excessive physical activity without proper warm-up and a balanced diet may harm bones. Certain medications, like long-term corticosteroids, antacids, antithyroid drugs, and tetracycline, can increase osteoporosis risk by inhibiting calcium absorption. Endocrine disorders like diabetes and hypothyroidism also contribute, as do hereditary factors. Women with a family history of osteoporosis are at higher risk. Osteoporosis often affects the bones of the limbs, spine, and ribs. Elderly women may suffer spontaneous fractures in the thigh or hip. Vertebrae fractures can lead to deformities and chronic back pain, aggravated by minimal movement. Symptoms include severe leg pain, tingling, and numbness. Diagnosing osteoporosis typically involves clinical assessment, X-rays, and bone density tests. Because osteoporosis greatly impacts quality of life, with chronic pain and disability, prevention is key. A nutritious diet from a young age strengthens bones and reduces osteoporosis risk. Dairy products like milk, cheese, yoghurt, and curds are excellent sources of calcium. Fresh fruits, especially citrus fruits, bananas, and guavas, provide essential nutrients. Green leafy vegetables, fish with edible bones (like salmon and sardines), nuts, liver, and cod liver oil are also beneficial. Vitamin D from sunlight is essential for bone strength, so daily exercise outdoors is recommended. Regular exercise boosts bone density and helps maintain it. Even beginning an exercise routine in later life can benefit bone health. Avoiding alcohol and tobacco also reduces osteoporosis risk. Calcium and vitamin D supplements can help prevent and treat osteoporosis. However, it is far better to focus on prevention than treatment. The writer is Specialist internal medicine
