Keeping You Bodywise: Do I Have Osteoarthritis or Osteoporosis?

by TOI Admin December 2, 2013


By Rizwan Mansoor, M.D.

In my practice, I often come across the question “Do I Have Osteoarthritis or Osteoporosis?” It is an obvious answer to some but may be very confusing for many.  Despite the fact that osteoporosis and osteoarthritis are completely  different conditions, they are frequently confused because both names start with “osteo.”  The following article describes the key differences between osteoarthritis and osteoporosis.

When one takes a look at the words “osteoporosis” and “osteoarthritis” it is easy enough to think that these conditions are closely related. Despite the “osteo” portion of each word, osteoporosis and osteoarthritis are like apples and oranges. The root word, osteo, means bone. While both conditions impact the bones, osteoarthritis “-arthritis” effects the joints between the bones while osteoporosis “-porosis,” meaning porous bone, effects the bones directly.

Osteoarthritis

There are over one hundred types of arthritis, but the most common is osteoarthritis. Osteoarthritis, also known as degenerative joint disease, is a form of arthritis caused by inflammation, breakdown, and the eventual loss of cartilage in the joints. According to The Arthritis Foundation, about 27 million Americans are affected by osteoarthritis.

Risk factors associated with osteoarthritis include obesity, genetics and previous trauma to a joint. Osteoarthritis is more common among females than males, especially after the age of 45 years. Although osteoarthritis is more common in older people, younger people can develop it - usually as the result of a joint injury, a joint malformation, or a genetic defect in joint cartilage.

Osteoarthritis can be a very painful, debilitating and mobility-restricting condition. Many seek treatement because of the associated pain. Osteoarthritis can be diagnosed and managed with the help of a Rheumatologist. Rheumatologists offer a full evaluation of the patient’s osteoarthritis to confirm the diagnosis and make sure the patient does not have a different type of joint problem, such as gout or rheumatoid arthritis.

There are many types of treatments for osteoarthritis that are designed to reduce joint pain, increase flexibility and improve joint function. Treatments for osteoarthritis include decreasing the amount of work the joint has to do, exercise, pain relief medication, heat and ice treatments, and weight control. Severe arthritis may be treated with joint replacement surgery.

Osteoporosis

While osteoarthritis is a degeneration of a joint, osteoporosis is the loss of bone mass which increases the risk of fractures, even spontaneously. Osteoporosis is a painless condition, which only becomes painful if one experiences its consequences, i.e. a fracture or a broken bone.

It is important to remember that pain is not always a symptom of a disease process. For example, pain symptoms are not present in diabetes, high blood pressure or thyroid disease. Since osteoporosis is an asymptomatic condition and prevalent and progressive in the aging population, it has to be actively looked for. Early intervention and management is important to significantly reduce the sickness consquent to bone fractures of the spine and hips. According to the American Academy of Orthopaedic Surgeons (AAOS), patients who suffer hip fractures are at higher risk for preamature death or loss of indepenence after the fracture.  In fact, those who experience the trauma of an osteoporotic hip fracture have a 24 percent increased risk of dying within one year following the fracture.

Rheumatologists are experts in diagnosing osteoporosis and can provide and monitor the best treatments for this condition. The risk of osteoporosis may also be reduced by being aware of risk factors and taking action to slow down bone loss. Low bone mineral density is a major risk factor for fracture, the main consequence of osteoporosis. Osteoporosis is more common in women over the age of 50 and after menopause. Other key risk factors include advanced age, petite size, prior low-trauma fractures, smoking, increased alcohol consumption, rheumatoid arthritis, dietary deficiencies, a history of falls and use of certain medications, such as steroids. Family history of a fragility fracture is often a contributing factor.

Osteoporosis can be treated with lifestyle changes and use of prescription medication. Paying attention to diet (adequate calcium and vitamin D intake) and regular physical activity are important lifestyle changes. Weight-bearing and strength training exercises can help to manage pain and improve the strength of bones and muscles, which helps prevent falls. Broken hips caused by osteoporosis usually need to be repaired surgically. This can include the use of specialized “pins and plates,” but can also involve hip replacement surgery. This is determined by the orthopaedic surgeon based on the exact type of hip fracture that occurred. If you have osteoporosis, there are effective medications which can reduce your risk of fracture.

The take-home message of this article is to be aware of the facts and to be proactive in seeking expert advice from your rheumatologist for appropriate screenings and treatments. Both osteoarthritis and osteoporosis can effect the quality of life, each in different ways. Since both are a part of the aging process, preventative measures should always be taken. As the saying goes, “a stitch in time saves nine.”

Dr. Rizwan Mansoor is Board Certified in Rheumatology by the American Board of Internal Medicine. His clinical interests include the diagnosis and treatment of arthritis, osteoporosis, fibromyalgia and autoimmune diseases. Dr. Mansoor attended medical school at Dow Medical College and completed his residency at the Bergen Regional Medical Center in Paramus, NJ.  Additionally, he obtained his fellowship training at the University of Florida. Dr. Mansoor practices at The Orthopaedic Institute’s Lake City, Gainesville and Ocala facilities.

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