Osteoporosis is the name given to a reduction or thinning in the total mass of bone present in the body. The precise mechanism causing this disease is unclear. It is found most frequently in women after the menopause, particularly in the older woman; and in people receiving long-term treatment with steroid compounds, eg, for rheumatoid arthritis. Sometimes the condition is noted in younger women who have had their ovaries removed (oophorectomy). Inadequate physical activity promotes generalised osteoporosis and the condition also occurs in various glandular disorders and in cases of severe malnutrition and chronic renal (kidney) disease.
The condition is of variable severity. In its mild form it may give rise to no symptoms and may be a chance X-ray finding. When the condition is more severe, pain may be a feature. This is usually due to fractures of the "brittle" bones, often occurring after only minor injury. Persistent backache may occur later on in the disease, due to progressive compression or collapse of several vertebrae. The healing of fractures is not usually impaired and, with healing, the pain usually subsides. There is also a tendency for the condition to improve spontaneously, or with treatment. Suitable physical exercise is also helpful.
Care Needs and Mobility Considerations
(i) In all but its most severe forms osteoporosis of itself may be symptomless and give rise to no mobility problems or care needs. Even when there has been very considerable loss of bone mass it will be the pain and functional limitations associated with fractures or bone collapse (particularly in the back) that may give rise to care needs and mobility problems. In these severe cases (generally in elderly women) there may well be considerable care needs arising from disability associated with fractures. These commonly occur in the region of the wrist, back and hip joint. When fractures occur in the back or in the weight-bearing joints there may well be adverse effects on walking. Progressive collapse of the spinal vertebrae may result in a shortened, curved back causing chronic pain and walking problems.
(ii) A person affected with this level of disease and its complications may also have difficulty with getting in and out of bed, rising from a chair, dressing and undressing, preparing a main meal and attending to toilet needs. Under such circumstances, and particularly in elderly people, there may be care needs both by day and by night.
(iii) When assessing the care needs which may arise, consideration should also be given to any other recorded disability(ies) which may give rise to mobility problems or care needs in their own right and which may interact with any needs arising from osteoporosis.
(iv) Although the intellect is not affected in this disease, any tendency to fall may give rise to supervisory needs in elderly frail people, because of the increased risk of broken bones, and difficulty in rising after a fall.
Duration of Needs
Fractures heal at the normal rate, so that any resultant disability may not last more than a few weeks or months. This is particularly so in the younger person. In elderly people with osteoporosis who have sustained frequent fractures with progressive collapse of the spinal vertebrae, significant improvement in disability and care needs is unlikely during the remainder of the person's life.
For more detailed information please see our osteoporosis pages.