Osteoporosis is a common bone disease that affects both men and women, usually as they grow older. In fact, translated from the Greek, osteoporosis literally means 'porous bones'. It is a silent disease of the bones that makes them weaken and prone to fracture.

Bone is a living tissue that is in a constant state of regeneration, as old bone is removed (bone resorption) and replaced by new bone (bone formation). By their mid-30s, most people begin to gradually lose bone strength as the balance between bone resorption and bone formation shifts, so that more bone is lost than can be replaced. As a result, bones become thinner and structurally weaker.

Advanced age Bone loss occurs in adulthood, beginning in middle age and accelerating during menopause.

Female gender Women have less bone mass than men, so any decline over time will affect women more strongly. The younger a woman experiences menopause, the more rapidly she loses the benefits of estrogen.

Early menopause Estrogen helps keeps bones strong. The younger a woman experiences menopause, the more rapidly she loses the benefits of estrogen.

Corticosteroid use People who need to take medications such as prednisone, prednisolone or dexamethasone regularly are prone to accelerated bone loss.

Smoking Tobacco use accelerates loss of bone, especially in women.

Alcohol Overuse of alcohol increases the chance of developing osteoporosis.

Low body weight Underweight women often have lower bone mass than heavier women at similar ages.

Inadequate intake of calcium and vitamin D Both are necessary to allow bones to remodel properly.

Lack of physical activity Exercise is now recognized as a key factor in maintaining bone health.

In the early stages of bone loss, you usually have no pain or other symptoms. But once bones have been weakened by osteoporosis, you may have osteoporosis symptoms that include:

• Back pain, which can be severe if you have a fractured or collapsed vertebra
• Loss of height over time, with an accompanying stooped posture
• Fracture of the vertebrae, wrists, hips or other bones

Normally, x-rays are the easiest and cheapest way to diagnose fractures and other diseases of bones. However, osteoporosis doesn't show up in x-rays until it is quite advanced; bones have to lose about 40% of their calcium before it's noticeable on an x-ray film. So x-rays aren't of much use in early detection.

A more sensitive and accurate test is bone densitometry. This is a test that measures bone density that is, how much bone mineral there is packed into a given area of bone. The most accurate of these is called the dual energy x-ray absorptiometry (DXA) test.

The results of your bone density test will give you a T-score. The T-score compares your bone density with that of an average healthy young adult of your sex. Below you will see how to interpret your T-score:

• Above -1 = Your bone density is considered normal
• Between -1 and -2.5 = Your score is a sign of osteopenia, a condition in which bone density is below normal and may lead to osteoporosis
• Below -2.5 = Your bone density indicates you have osteoporosis

• Heavy Drinking Can Cause Osteoporosis. How to Keep Your Bones Healthy Even if You Do Drink

• If you drink at an unhealthy level, the very best thing you can do for your bone-health is to simply abstain from future drinking. But if you can’t or won't do that, there are some protective measures you can take to limit the harms of alcohol abuse on your bones.

• Understanding Osteoporosis - Calcium and Hormone Activity

• New research has found that although we can have little impact on bone mass after the age of twenty nine, we can have a large impact on bone strength well into our forties. Lifestyle choices that increase bone strength have to do with diet, supplementation and exercise.

• Keep all rooms free from clutter, especially on the floors
• Keep floor surfaces smooth but not slippery. When entering rooms, be aware of differences in floor levels
• Wear supportive, low-heeled shoes even at home.[ Avoid walking around in socks
• Be sure that all stairwells are well lit and that stairs have handrails on both sides. Consider placing fluorescent tape on edges of top and bottom steps
• For optimal safety, install grab bars on bathroom walls beside showers, and toilets. If you are unstable on your feet, consider using a plastic chair with a back and nonskid leg tips in the shower
• Use a rubber bath mat in the shower
• Keep a flashlight with fresh batteries beside your bed
• Add ceiling fixtures to rooms lit by lamps only; or hook up a lamp that is activated by a switch near the entry point into the room.
• Use at least 100-watt bulbs in your home
• If you must use a step stool, use a sturdy one with a handrail and wide steps for hard to reach areas. Or, reorganize work areas and storage to minimize the need for stooping or excessive reaching
• Consider purchasing a portable phone that you can take with you from room to room. It provides security because not only can you answer the phone without rushing for it, but you can also call for help should an accident occur

Once the bone has been lost, it can't be replaced. But the rate at which bone is lost can often be slowed by calcium and vitamin supplements, or by taking drugs that slows the resorption of bone.

Outdoor safety tips

• Use a walker or cane for added stability
• Wear warm boots with rubber soles for added Traction
• Look carefully at floor surfaces in public buildings. Many floors are made of highly polished marble or tile that can be very slippery.
• When these surfaces are wet, they become slick and dangerous. When floors have plastic or carpet runners in place, stay on them whenever possible

If you have osteoporosis, it is important not only to help prevent further bone loss, but also to prevent a fracture. Preventing falls is especially important for people with osteoporosis. j Falls may be the result of:

• Balance problems
• Poor vision
• Use of medications that affect equilibrium
• Chronic illness
• Reduced muscle strength
• Hazards in the home and workplace