Osteoporosis is often called the "silent disease" — it causes no pain in its early stages and most people are unaware they have it until a bone breaks. In India, it is estimated that over 50 million people are affected, with women — particularly post-menopausal women — at the highest risk. As a bone doctor and orthopaedic surgeon in Chandigarh, I regularly see patients who have suffered fragility fractures that could have been prevented with early diagnosis and treatment.
What Is Osteoporosis?
Osteoporosis literally means "porous bone." It is a condition in which the density and quality of bone are reduced, making bones weaker and more prone to fracture. The bones most commonly affected are the spine, hip, and wrist — fractures in these sites can be serious and life- altering, particularly in older adults.
Bone is a living tissue that is constantly being broken down and rebuilt. In healthy individuals, bone formation keeps pace with bone loss. In osteoporosis, bone loss outpaces formation — often beginning in the mid-30s and accelerating after the menopause in women.
Who Is at Risk of Osteoporosis in India?
- Post-menopausal women: Oestrogen plays a key role in maintaining bone density; its loss after menopause accelerates bone loss significantly.
- Men over 70: Testosterone decline leads to gradual bone loss.
- Vitamin D deficiency: Extremely common in India despite abundant sunshine — due to limited outdoor activity and dietary deficiency.
- Calcium-poor diet: Low intake of dairy, leafy vegetables, and calcium-rich foods.
- Family history: A parent or sibling with osteoporosis or a hip fracture increases your risk.
- Low body weight: Thin or small-framed individuals have lower bone mass and are at greater risk.
- Prolonged steroid use: Long-term corticosteroids for conditions such as asthma or arthritis reduce bone density.
- Smoking and excessive alcohol: Both interfere with the bone-building process.
How Is Osteoporosis Diagnosed?
The primary diagnostic tool is a DEXA scan (Dual- Energy X-ray Absorptiometry), which measures bone mineral density (BMD) at the spine and hip. The result is expressed as a T-score:
- T-score above −1.0: Normal bone density.
- T-score −1.0 to −2.5: Osteopenia (low bone density — a precursor to osteoporosis).
- T-score below −2.5: Osteoporosis.
Blood tests for calcium, phosphate, vitamin D, and parathyroid hormone levels are also important to identify reversible causes.
Prevention: How to Build and Protect Bone Density
Diet
- Calcium: Aim for 1000–1200 mg/day. Good sources include milk, curd, paneer, ragi (finger millet), sesame seeds, almonds, and dark leafy greens.
- Vitamin D: Essential for calcium absorption. Aim for 15–20 minutes of morning sunlight exposure daily. Supplementation (800–2000 IU/day) is often necessary in India.
- Protein: Adequate protein intake supports bone matrix formation.
Exercise
- Weight-bearing exercise: Walking, jogging, dancing, and climbing stairs stimulate bone formation.
- Resistance/strength training: Using resistance bands or light weights twice weekly significantly improves bone density at the hip and spine.
- Balance exercises: Yoga, tai chi, and single-leg stands improve balance and reduce fall risk.
Treatment of Osteoporosis
When lifestyle measures are insufficient or bone density is critically low, medications are available:
- Bisphosphonates (e.g., alendronate, risedronate): The most commonly used class. They slow bone breakdown and are available as weekly or monthly oral tablets or annual infusions.
- Calcium and Vitamin D supplements: A cornerstone of all osteoporosis treatment regimens.
- Denosumab: A six-monthly injection that inhibits bone breakdown.
- Teriparatide: A daily injection that actively stimulates bone formation — used for severe osteoporosis.
Osteoporosis is treatable and its fractures are largely preventable. If you are above 50 years old — especially if you are a woman or have any of the risk factors above — I recommend asking your doctor about a DEXA scan. Early detection can prevent a fracture that might otherwise have a profound impact on your independence and quality of life.
Dr. Mohak Kataria provides bone health evaluation and orthopaedic care in Chandigarh, Panchkula, Mohali, and Zirakpur.
Further Reading
Take care,
Dr. Mohak Kataria