Counseling for Bone health

Bone is a living, growing tissue that mainly consists of collagen and calcium. Bones provide a
rigid framework, known as the skeleton, which protects soft organs and supports the body.
There are two types of bone in the body. Cortical bones are compact and dense and form the
outer layer of the bones. Trabecular or cancellous bones make up the bones’ inner layer and are
spongy with a honeycomb structure. The bones not only protect the organs from injury but also
allow the body to move and provide support. Additionally, bones act as a reservoir for minerals
such as calcium.
A person may have a condition or disease that affects the flexibility and strength of the bones.
These conditions may arise from various sources, including genetics, environmental factors, diet,
and infections.
Certain conditions or diseases can affect bone strength and flexibility and result in health
complications.
List of conditions
 Osteoporosis
Osteoporosis is a disease that results in a decrease in bone mass and mineral density. The quality
and structure of the bone may also change. Osteoporosis can decrease bone strength and increase
the risk of fracturing.
The risk of osteoporosis increases with age and affects people of all ethnic groups
 Osteopenia
Osteopenia refers to a decrease in bone mineral density below a normal level but not low enough
for a doctor to classify it as osteoporosis.
A T-score is a measure of bone density. A person with a T-score between -1 and -2.5 will receive
a diagnosis of osteopenia, whereas a doctor would classify a T-score lower than -2.5 as
osteoporosis. The prevalence of osteopenia is 4 times higher in females compared with males.
 Paget’s disease
Paget’s disease is a condition that affects the bone remodeling process. This refers to the action
by which the body breaks down old bone tissue and replaces it with new bone tissue.
In people with this chronic condition, the process of rebuilding bones takes place at a faster rate,
resulting in an unusual bone structure. This can either cause the bones to become softer or larger,
making them more susceptible to complications such as bending or fractures.
 Osteogenesis imperfecta
Osteogenesis imperfecta (OI) is a disorder that causes the bones to fracture easily. Some people
may also refer to OI as brittle bone disease. The condition results from a change or mutation in
the genes that carry information for making a protein known as type I collagen. This protein is
necessary for strong bones.
People with a family history of OI have a higher risk of having the disease as a person can inherit
the gene mutation through one or both of their parents. There are different types of OI. The most
common and mildest type is type I, while type II is the most severe.
 Osteonecrosis
Osteonecrosis, also known as avascular necrosis or aseptic necrosis, occurs when there is a
disruption to a bone’s blood flow, leading to bone tissue death. This can cause the bone to break
down and the joint to collapse.
While osteonecrosis may occur in any bone in the body, it commonly affects the shoulders, hips,
and knees. The condition occurs most often in people aged 20–50 years. These individuals also
often have a history of trauma, corticosteroid use, or excessive alcohol intake.
 Osteoarthritis
Osteoarthritis is the most common form of arthritis. This condition affects the body’s joints by
degrading cartilage, the tissue that covers the surface of joints. Osteoarthritis can also change the
shape of bones. Osteoarthritis most frequently affects the hands, hips, and knees.
 Osteomyelitis
Osteomyelitis describes an infection or inflammation of the bone, with myelitis referring to
inflammation of the fatty tissues within the bone. It typically occurs when a bacterial or fungal
infection enters a bone from the bloodstream or surrounding tissue. It can happen at any age but
is more common in young children.
 Fibrous dysplasia
Fibrous dysplasia occurs when abnormal fibrous tissue replaces healthy bone tissue. The unusual
scar-like tissue makes the bone weaker. This can cause the bone to change shape and increase the
risk of fractures.
Fibrous dysplasia typically occurs due to a gene mutation that results in bone cells producing an
abnormal type of fibrous bone. While it can develop in any bone, it occurs most often in the
thigh bone, shin bone, ribs, skull, humerus, and pelvis.
 Bone cancer and tumors
Bone cancer is an uncommon type of cancer that begins when cells in a bone start to grow out of
control. Any of the cells in the bone can develop into cancer.
Primary bone cancers are cancers that start in the bone. The most common types of primary
bone cancers include osteosarcoma and Ewing sarcoma. Cancer cells can also spread to the bone
from other areas of the body. Doctors refer to these as bone metastases. The most common site
for bone metastases is the spine.
  Osteomalacia
Osteomalacia, also known as bone softening, refers to a condition where the bone does not
harden the way it should after forming. This metabolic bone disease occurs when there is
incomplete mineralization of the bone. Mineralization refers to the process where minerals coat
the inner layer of the bone, forming a hard outer shell. The incomplete formation of this shell
leaves the collagen soft and vulnerable.
 Rickets
Rickets is a childhood bone condition similar to osteomalacia, but it occurs due to imperfect
mineralization.
It results in soft, weak bones, typically due to a vitamin D deficiency. Without sufficient vitamin
D, the body cannot metabolize calcium and phosphorous, which are essential for proper bone
development and growth. Vitamin D deficiency may result from inadequate nutrition, lack of sun
exposure, or malabsorption.
 Autoimmune conditions
An autoimmune condition occurs when the immune system attacks the body’s own cells, tissue,
and organs. Bone diseases can develop secondary to some autoimmune diseases, increasing the
risk of complications such as bone loss and fractures.
Rheumatoid arthritis (RA): This condition causes the body’s immune system to attack the
membranes around the joints and causes the cartilage to degrade. There is an increased risk of
bone loss and fractures in people with RA.
Causes and risk factors
A number of factors can cause bone disease. Some may be specific to a certain type of bone
disease. Causes include:
Genetics: A person may have a higher risk of developing a type of bone disease due to a
mutation or change in a gene or a history of bone disease in their family. A person may inherit a
gene mutation from one or both parents.
Aging: As people age, the mineral content of their bones begins to decrease, resulting in the
bones becoming less dense and more fragile.
Nutrition: A balanced diet is essential for healthy, strong bones. In particular, people need to
consume sufficient levels of calcium and vitamin D.
Problems with bone remodeling: After age 20, a person may experience an imbalance where the
body breaks down old bone tissue quicker than it can replace it. This can result in a loss of bone
strength and quality.
Hormonal changes: Imbalances of certain hormones may increase the risk of developing
osteoporosis. For example, low estrogen levels during menopause or low levels of testosterone
can increase a person’s risk of osteoporosis.
Medications: Certain medications can increase the risk of bone disease development. For
example, corticosteroids, thyroid medicines.
Lifestyle factors: Lifestyle factors including low physical activity levels, smoking, and excessive
alcohol consumption can predispose a person to osteoporosis
Treatments
The most appropriate treatment option will depend on the type of bone disease and how serious
the condition is.
For example, with osteoporosis and osteopenia, the goal of treatment is to stop further bone loss
and prevent fractures from occurring. Therefore, treatment may include:
recommending nutritional guidance, making lifestyle changes such as performing more physical
activity and quitting smoking, putting measures in place to reduce the risk of falls to prevent
fractures, prescribing medication
Some conditions, such as OI, do not currently have effective treatments. Therefore, the goal of
treatment is to prevent or control symptoms and improve muscle strength and bone mass. In
addition to taking medication, a person with OI may have physical therapy to improve muscle
strength and mobility.