What is osteoporosis ?

Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to the abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones.

Osteopenia, by definition, is a condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis.

Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injuries that normally would not cause a bone to fracture. The fracture can be either in the form of cracking (as in a hip fracture) or collapsing (as in a compression fracture of the vertebrae of the spine). The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone.

Causes & Risk Factors

The following are factors that will increase the risk of developing osteoporosis:

  1. Female gender
  2. Caucasian or Asian race
  3. Thin and small body frame
  4. Family history of osteoporosis (for example, having a mother with an osteoporotic hip fracture doubles your risk of hip fracture)
  5. Personal history of fracture as an adult
  6. Cigarette smoking
  7. Excessive alcohol consumption
  8. Lack of exercise
  9. Diet low in calcium
  10. Poor nutrition and poor general health, especially associated with chronic inflammation or bowel disease
  11. Malabsorption (nutrients are not properly absorbed from the gastrointestinal system).
  12. Low estrogen levels in women (which may occur in menopause or with early surgical removal of both ovaries)
  13. Low testosterone levels in men (hypogonadism)
  14. Chemotherapy that can cause early menopause due to its toxic effects on the ovaries
  15. Amenorrhea (loss of the menstrual period) in young women is associated with low estrogen and osteoporosis; amenorrhea can occur in women who undergo extremely vigorous exercise training and in women with very low body fat (for example, women with anorexia nervosa)
  16. Chronic inflammation, due to chronic inflammatory arthritis or diseases, such as rheumatoid arthritis or liver diseases
  17. Immobility, such as after a stroke, or from any condition that interferes with walking
  18. Hyperthyroidism
  19. Hyperparathyroidism
  20. Low Vitamin D.
  21. Certain medications can cause osteoporosis. These medicines include long-term use of heparin (a blood thinner), antiseizure medicine such as phenytoin (Dilantin) and phenobarbital, and long-term use of oral corticosteroids (such as prednisone).


The goal of treatment of osteoporosis is the prevention of bone fractures by reducing bone loss or, preferably, by increasing bone density and strength. Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fractures, none of the available treatments for osteoporosis offers complete cures.

In other words, it is difficult to completely rebuild bone that has been weakened by osteoporosis. Therefore, prevention of osteoporosis is as important as treatment. Prevention and treatment include calcium and vitamin D, exercise, and osteoporosis medications.

Clinical Approach:

  1. The Advanced CRRT treatment offers repairing and regenerating bone tissues. Its unique pulsed signals stimulate the formation of essential repairing growth factors like fibroblast and osteoblast. They may considerably help improving bone density.
  2. The Acowave Extracorporeal Shockwave therapy, as indicated by clinical studies, helps in avascular necrosis where the bone cells are dead due to compressed and compromised blood supply. Acowave ESWT, by stimulating biological response of the body, may help in the creation of various growth factors including:
    1. Bone Morphogenetic Proteins (BMP)
    2. Endothelial nitric oxide synthase (eNOS)
    3. Vascular endothelial growth factor (VEGF)
    4. Proliferating cell nuclear antigen (PCNA)
    5. Neovascularization & Angiogenesis

These may result in improved blood supply, tendon repair, bone repair & Tissue Regeneration.

Lifestyle Corrections and Medication approach

  1. Lifestyle changes, including quitting cigarette smoking, curtailing excessive alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin D.
  2. Medications that stop bone loss and increase bone strength, such as alendronate, risedronate, raloxifene, ibandronate, calcitonin, zoledronate, and denosumab.
  3. Medications that increase bone formation such as teriparatide.