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Osteoporosis & Dowager’s hump for spine

Updated: Oct 5, 2023


What is Osteoporosis?

Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and may break from a fall or, in serious cases, from sneezing or minor bumps.

Bone is made up of minerals, mainly calcium salts, bound together by strong collagen fibres. Our bones have a thick, hard outer shell (called cortical or compact bone) which is easily seen on x-rays. Inside this, there’s a softer, spongy mesh of bone (trabecular bone) which has a honeycomb-like structure.

Bone is a living, active tissue that’s constantly renewing itself. Old bone tissue is broken down by cells called osteoclasts and is replaced by new bone material produced by cells called osteoblasts.

Who gets osteoporosis?

Osteoporosis is common around the world, and the risk increases with age. Anyone can get osteoporosis but women are about four times more likely than men to develop it. There are two main reasons for this:

  1. The process of bone loss speeds up for several years after the menopause, when the ovaries stop producing the female sex hormone oestrogen.

  2. Men generally reach a higher level of bone density before the process of bone loss begins. Bone loss still occurs in men but it has to be more severe before osteoporosis occurs.

What Are Symptoms and Signs of Osteoporosis?

Early in the course of the disease, osteoporosis may cause no symptoms. Later, it may cause height loss or dull pain in the bones or muscles, particularly low back pain or neck pain.

Later in the course of the disease, sharp pains may come on suddenly. The pain may not radiate (spread to other areas); it may be made worse by activity that puts weight on the area, may be accompanied by tenderness, and generally begins to subside in one week. Pain may linger more than three months.

People with osteoporosis may not even recall a fall or other trauma that might cause a broken bone, such as in the spine or foot. Spinal compression fractures may result in loss of height with a stooped posture (called a dowager’s hump).

Fractures at other sites, commonly the hip or bones of the wrist, usually result from a fall.

Can Any Foods Help Prevent Osteoporosis?

Many foods can help prevent osteoporosis. A number of scientific studies have shown that eating more fruits and vegetables leads to stronger bones. Low-fat dairy products are high in calcium, and many are fortified with vitamin D and help strengthen bones. Fatty fish such as salmon, mackerel, tuna, and sardines are high in vitamin D. Canned sardines and salmon (with bones) are high in calcium.

Is It Possible to Prevent Osteoporosis?

Building strong bones during childhood and adolescence can be the best defense against developing osteoporosis later. The average woman has acquired 98% of her skeletal mass by 30 years of age.

There are four steps to prevent osteoporosis. No one step alone is enough to prevent osteoporosis.

  1. Eat a balanced diet rich in calcium and vitamin D and high in fruits and vegetables.

  2. Engage in weight-bearing physical exercise.

  3. Adopt a healthy lifestyle with no smoking or excessive alcohol intake.

  4. Take medication to improve bone density when appropriate.

What Is the Medical Treatment for Osteoporosis?

Treatment for osteoporosis focuses on slowing down or stopping the mineral loss, increasing bone density, preventing bone fractures, and controlling the pain associated with the disease.

Some 40% of women will experience a broken bone (fracture) due to osteoporosis during their lifetime. In those who have a vertebral fracture (in their back), one in five will suffer another vertebral fracture within one year. This condition potentially leads to more fractures. This is called a “fracture cascade.” The goal of treatment is to prevent fractures.

Diet: Young adults should be encouraged to achieve normal peak bone mass by getting enough calcium (1,000 mg daily) in their diet (drinking milk or calcium-fortified orange juice and eating foods high in calcium such as salmon), performing weight-bearing exercise such as walking or aerobics (swimming is aerobic but not weight-bearing), and maintaining normal body weight.

Specialists: People who have spinal, hip, or wrist fractures should be referred to a bone specialist (called an orthopedic surgeon) for further management. In addition to fracture management, these people should also be referred to a physical and occupational therapist to learn ways to exercise safely. For example, someone with spinal fractures would avoid touching their toes, doing sit-ups, or lifting heavy weights. Many types of doctors treat osteoporosis, including internists, generalists, family physicians, rheumatologists, endocrinologists, and others.

Exercise: Lifestyle modification should also be incorporated into your treatment. Regular exercise can reduce the likelihood of bone fractures associated with osteoporosis. Studies show that exercises requiring muscle to pull on bones causes the bones to retain, and perhaps even gain, density. Researchers found that women who walk a mile a day have four to seven more years of bone in reserve than women who don’t. Some of the recommended exercises include weight-bearing exercise, riding stationary bicycles, using rowing machines, walking, and jogging. Before beginning any exercise program, make sure to review your plan with your doctor.

Causes for a dowager’s hump / hunchback

A dowager’s hump is usually caused by vertebral fractures due to osteoporosis. This is a metabolism-related skeletal disease that is also known as “bone loss”. Post-menopausal and elderly women are particularly affected. The earlier colloquial expression therefore for the hunchback associated with the disease is “dowager’s hump”. In osteoporosis, the bones lose density and stability. Fractures are particularly common in the femur and spine. If the vertebral bodies collapse, it is referred to as “compression fractures”.

Symptoms of dowager’s hump / hunchback

The complaint of back pain is considered to be the main symptom of osteoporotic vertebral fracture. If there is acute back pain, then vertebral fractures are suspected – especially if the affected person is over 50 years old and there are risk factors for osteoporosis. In osteoporosis, pulmonary function may also be impaired by fractures (bone fractures) and curvature in the thoracic spine.

Treating dowager’s hump – hunchback

If the dowager’s hump is caused by osteoporosis, Spinomed back orthoses can be used to accompany the therapy. They activate the back muscles and can reduce the kyphosis angle (angle of curvature). Click here for - Artificial Fingers


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