Osteoporosis and Osteoarthritis

There is often some confusion between these two conditions, but either way neither is going to make your day any better. Both are boney issues and so there are some similarities, but should you contract either, it is good to know what to expect in the way of symptoms and treatments. So the need to differentiate is important. These conditions develop differently, have different symptoms, are diagnosed differently, and are treated differently.

Osteoporosis

• Osteoporosis is a condition in which the bones become less dense through a loss of bone tissue, and therefore more likely to fracture. It can result in a loss of height, severe back pain, and change in posture.
• Known as the silent disease, Osteoporosis can progress undetected for many years without symptoms until a fracture occurs. Osteoporosis is diagnosed by a bone mineral density test, which is a safe and painless way to detect low bone density.
• Risk factors include: Thinness or small frame; Family history of the disease; Being postmenopausal; Abnormal absence of menstrual periods (amenorrhea); Prolonged use of certain medications; Low calcium intake. Lack of physical activity. Smoking. Excessive alcohol intake.

Arthritis

Arthritis is an inflammatory condition that affects the joints and surrounding tissues. Knees, wrists, fingers, toes, and hips are specific areas that succumb to this complaint.

Osteoarthritis

Osteoarthritis is a painful, degenerative joint disease that often involves the hips, knees, neck, lower back, or small joints of the hands. It often results from repetitive movements such as in sport, factory work, or carrying too much weight. Eventually injury or repeated movement wears away the cartilage that cushions the ends of the bones in the joint. As a result, the bones rub together, causing a grating sensation. Joint flexibility is reduced, bony spurs develop, and the joint swells. Usually the first indication is pain during or after exercise or certain movements.

Osteoporosis and Osteoarthritis

The major element that these two conditions share, is that they are mostly attributed to aging. But the two conditions are significantly different. Osteoporosis is known as the silent disease because often there are no symptoms to warn the individual that their bones are thinning, becoming less dense, and developing that latticework frame that can fracture at any minute from too much weight or a sudden twisted movement, or from sudden impact like a fall. Osteoporosis refers to “porous bone” where the quality and density of bone is decreased, so that it becomes weak and brittle, and can very easily fracture.

Osteoarthritis on the other hand, is an inflammatory condition that affects the joints – like the hips, knees, spine and joints in the hands. Unlike with osteoporosis, it is something that becomes noticeable fairly quickly through joint stiffness, declining flexibility, bone spurs and most certainly, that real kicker, pain.

In short, the two conditions are not linked. Some people are unfortunate enough to have both conditions – both conditions are more common in women, although increasing data is becoming available, showing the diseases are reflecting in men as they age, and as lifespans increase.

Hereditary causes are often the risk factor of developing either condition. But if you get the one, it doesn’t necessarily mean you will have the other as well, nor does the presence of one mean you are immune to the other. Having osteoporosis as well as osteoarthritis significantly affects the joint replacement surgery that you might need to undergo for osteoarthritis. Bones that originally supported that joint must be strong enough for the operation to be a success. Therefore all people with osteoarthritis must be evaluated for osteoporosis.

Testing for Osteoporosis versus Osteoarthritis

If afflicted with the early signs of osteoarthritis, such as tenderness, swelling and pain in affected joints, the first step is an X-ray. This will confirm loss of cartilage – a hallmark of osteoarthritis – shown up by diminished space in the joints. The signs of fluid build-up in the joint will indicate inflammation.

With osteoporosis, however, because it’s usually without symptoms, it’s best to have regular testing after the age of 60, or after the menopause, or if there is a history of the disease in the family. This is known as a bone density test and it will give clear indications as to whether your bones are thinning, putting you at risk of a fracture at any stage.

Managing Osteoarthritis: Usually medication is the chosen route to manage the pain, including: Pain relievers like acetaminophen; Nonsteroidal anti-inflammatory drugs like ibuprofen; Steroid injections into the joint; Hyaluronic acid – fluid that’s injected to replace lacking joint lubricant; and surgical joint replacement in severe conditions. Weight-bearing exercises are important to try and keep the joints as strong and flexible as possible.

Managing Osteoporosis: A diet rich in calcium and vitamin D, regular weight-bearing exercise, and a healthy lifestyle can prevent or lessen the effects of the disease. Exercise is nearly always advised with the emphasis on stretching, strengthening muscles, improving posture, and range of motion, such as low-impact aerobics, swimming, tai chi, and low-stress yoga. Patients may be prescribed a medication to decrease bone breakdown and then another to stimulate bone formation. Staying as physically active as possible – walking, swimming, yoga, and dancing, are all good for both conditions, allowing you to keep a low pressure on joints and bones while keeping them working!

NOFSA (National Osteoporosis Foundation South Africa)

NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.

Find out more about our work at: www.osteoporosis.org.za