Osteoporosis: A Silent Killer that’s Undertreated and Under-Detected

Osteoporosis is a disease that occurs when the body loses bone mass, causing bones to thin and break easily. Many who have this disease are not even aware that they do because, while the disease can cause aches and discomfort, the tendency is to dismiss it as old age.

The first real symptom of osteoporosis is often a broken bone. When the hip or spine are involved, some of the elderly are unable to recover. In some advanced osteoporosis cases, the spine curves and the rib cage drops against the pelvis, compressing the intestines and internal organs. Some patients report losing as much as four inches of height.

Prevention is possible, preferable

To help prevent the development of osteoporosis, young women should begin taking small doses of calcium and Vitamin D after the age of 25 to improve their bone health. Once a woman reaches menopause, her bone mass drops. Bone mass will also drop below a safe level for those who haven’t had enough calcium in their system. Men can also develop osteoporosis.

A healthy lifestyle is important to prevent the disease or help stop its progression. It’s important to stop smoking, cut down on caffeine, limit alcohol intake and eat a healthy diet.

Maintaining and building strength helps to build up bone – by doing nothing, you lose bone.


It is recommended that women 65 and older and men 70 and older undergo a non-invasive, painless DEXA bone density scan to detect how porous their bones are. Additional diagnostic tools include blood tests and visual examination including a balance check. Once it is diagnosed, patients should continue to take Calcium and Vitamin D, in addition to a pharmacological agent to treat osteoporosis.


There are two classes of medications for treating osteoporosis: antiresorptive and anabolic agents.

Antiresorptives slow down the bone destruction. A pill form has been traditionally used, but the newer subcutaneous injection every six months or annual IV injection is much simpler.

Anabolic agents build the bone and can reverse bone loss. They must be injected by the patient daily for 18 months. Patients who elect to use anabolic treatment should follow with an antiresorptive medication at the end of those 18 months. Unfortunately, the two can’t be taken together, however new and better medications are being developed.

It’s important to stick with the medications because they are effective and problems will arise otherwise. Patients should take them for life, but their doctor may advise a “drug holiday” for one or even two years, carefully monitoring the condition to determine when to return.

Raising awareness

There is a critical need to raise awareness of osteoporosis. The Spine Center at Methodist Hospitals offers an Osteoporosis Program to educate, diagnose, advise and treat patients who are at risk for or who already have osteoporosis.

As part of our program, patients who have osteoporosis are referred to a Physical Therapist who will instruct them about proper exercises and tell them what not to do. Our nutritionist provides diet advice and can recommend the proper amount of supplemental Calcium and Vitamin D to take for prevention or maintenance.

Elian M. Shepherd, MD, FACS, the Director of the Methodist Hospitals Spine Care Center, is a Methodist Physician Group board-certified orthopedic surgeon.

Dr. Elian M. Shepherd As a 1970 graduate from the University of Damascus Faculty of Medicine, Dr. Elian Shepherd, MD with the Methodist Physician Group Orthopedic and Spine Center in Merrillville, Indiana has been providing top-notch orthopedic care to patients for almost half a century. He’s fellowship-trained at Northwestern University and a board-certified specialist in spinal surgery. Dr. Shepherd is the current medical director of the Spine Care Center and a member of the Scoliosis Research Society and American Academy of Orthopedic Surgeons.

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