Bone up on bone health


By Amy Wall

Osteoporosis and osteoarthritis are terms that we hear a lot, especially as we get older, but few of us know exactly what they refer to. As we age, it’s essential for us to become aware of our bone health and, more importantly, the steps we can take to protect it. We spoke to Professor Stephen Eustace, Consultant Radiologist at the Cappagh National Orthoapedic Hospital, to learn more.

A lot of people tend to confuse osteoarthritis and osteoporosis but what is the difference between the two conditions?

“Osteoarthritis is a degenerative disorder of joints where the articular surfaces become worn, resulting in pain due to bone articulating on bone. Being degenerative and resulting from joint overloading, osteoarthritis tends to become considerably more common as we age,” says Professor Eustace.

“Osteoporosis is a disorder of ageing characterised by loss of bone mass and strength and the development of ‘soft’ bones. From the age of 20, normal individuals begin to lose bone mass. This loss of bone mass is accelerated at the time of menopause due to a fall in anabolic sex hormone, progesterone and estrogen levels in females and a fall in testosterone levels in males.

“Loss of bone mass is therefore a normal feature of ageing. However, in some individuals this loss of mass and development of soft bones is accelerated and more marked than identified in similar age and sex matched populations.”

It is estimated that 300,000 people in Ireland are living with osteoporosis. Professor Eustace explains that unfortunately osteoporosis can be a “silent” disease and women who experience a premature menopause are at a higher risk of developing it.

“Osteoporosis is a silent disease without any symptoms. However, being characterised by bone softening, affected individuals are prone to fracture following minor trauma as following a fall with fracture of the wrist of an outstretched hand, fracture of the hip bone or compression fractures in the lower back,” says Professor Eustace.

“Typically females who undergo a premature menopause are the most likely to develop and are at risk of osteoporosis. Less commonly patients with chronic medical disorders, liver disease or on long term steroid therapy are also at risk.”

When it comes to prevention, it’s important to have a balanced diet and if you are one of the 300,000 people affected by osteoporosis, there are things you can do to help ease symptoms.

“A balanced diet with dairy products, milk and cheese and regular exercise are the best ways to prevent osteoporosis. Modest alcohol intake and cessation of smoking are also important issues. In patients with premature menopause, consideration should be given to hormone replacement therapy,” says Professor Eustace.

“In those with osteoporosis, dietary modifications, exercise and a range of medical therapies including bisphosphonates and parathyroid hormone supplements can prevent progression of the disorder.”

Turning to osteoarthritis, Professor Eustace says that the main signs and symptoms usually include “joint pain, swelling and restriction of motion.”

“Pain is typically worse after exercise and becomes worse as a day progresses, often awakening affected individuals at night.”

Osteoarthritis is usually treated with physiotherapy, medication, steroids, joint lubricants and injections and, in serious cases, surgery.

“When damage to a joint is advanced, surgical intervention is generally required with options including joint washout, cartilage transplants (regeneration of the articular surfaces), joint realignment called osteotomy and, ultimately, joint replacement,” explains Professor Eustace.

“Hip and knee replacements are the most common surgical joint replacements. The surgery is now relatively routine with patients being discharged frequently on the second day post-surgery and returning to full mobility at six weeks.”

So if you’re suffering from osteoarthritis when is it a good idea to begin considering joint replacement surgery?

“All attempts are made to avoid joint replacement. Generally, when conservative treatments fail to treat joint pain and the pain becomes intolerable, limiting sleep and stopping the activities of daily living, it is generally time to consider surgery, in consultation with an appropriate doctor.”



If you’re concerned about your bone health or worried about developing osteoporosis or osteoarthritis it is essential for you to consult your doctor. Upon listening to your concerns and getting your medical history, your doctor may recommend you for a bone density test. This will help to determine how healthy your bones are. Your doctor can also advise you on any further tests that may be needed.



·      The adult human body has 206 bones

·      There are 26 bones in the foot alone, while the hand contains 54 bones

·      The femur is the longest and strongest bone in the body. It is stronger than concrete and as strong as granite

·      Your bone strength and density will change as you go through life

·      Bones stop growing when you reach puberty

·      The skull is made up of 22 different bones which fuse together during childhood

Catherine Devane