Ageing brings about many changes, and a variety of physical transformations take place as we advance in age. These signs are most apparent in the elderly, with bone, joint and muscle pain being among the most common complaints. Decreased bone density, muscle loss and the deterioration of joints are some of the reasons many seniors suffer from musculoskeletal issues. As a study by Oxford Academic suggests, while some of these changes are inevitable, they represent a public health problem that can largely be prevented, thus reducing their risk and severity.
The first, basic step in managing musculoskeletal diseases is to stay informed of them. This article talks about five common bone conditions that frequently affect older adults, often sneaking up on us gradually. These conditions include osteoporosis, osteoarthritis, rheumatoid arthritis, spinal stenosis, and fractures—here’s what you need to know.
Osteoporosis
Osteoporosis is a bone disease characterised by the weakening of bones, making them more vulnerable to fractures. It is caused by a decrease in bone mass and mineral density, leading to changes in the quality and structure of the bone. Studies from 2017 to 2018 show that about 12.6% of adults aged 50 and over have osteoporosis in the hip, spine or both. Weak and brittle bones caused by osteoporosis can make even something as minor as a cough lead to fractures.
While the main cause of osteoporosis is often linked to ageing, certain factors play a major role too. As people age, bone mass becomes harder to sustain. Risk factors such as low insufficient calcium intake and eating disorders can increase the likelihood of developing osteoporosis. Women are also more predisposed to the condition, and long-term use of steroids can disrupt bone-building, making osteoporosis more likely.
Osteoporosis often presents no symptoms until a fracture occurs.
Osteoarthritis
Osteoarthritis is the most common degenerative joint disorder, meaning it progressively worsens over time. It happens when the cartilage that cushions your joints wears down and disintegrates, causing your bones to rub against each other, consequently leading to damage. According to the World Health Organization, about 73% of people living with osteoarthritis are over 55 years old, and 60% are female. The knee is the most commonly affected area.
There is no single definitive cause of osteoarthritis. However, wear and tear remains an undeniable factor. Accidents such as sports injuries and falls, as well as existing health conditions, can gradually contribute to or worsen osteoarthritis.
In osteoarthritis, friction between joint surfaces causes pain, swelling and stiffness. Sometimes, a piece of bone may break off and float inside the joint space. This is called a loose body.
Rheumatoid Arthritis
A portion of people who develop rheumatoid arthritis are elderly, and this subset is known as elderly-onset rheumatoid arthritis (EORA). This group accounts for about one-third of all cases, with diagnoses occurring in people aged 60 to 65 and above. In rheumatoid arthritis, the immune system attacks the lining of the joints, making it an autoimmune condition that triggers widespread inflammation.
Like osteoarthritis, the exact cause of rheumatoid arthritis cannot be pinpointed. It is usually attributed to a combination of factors, including genetics, hormones, and lifestyle.
In rheumatoid arthritis, inflammation is often accompanied by pain, swelling, stiffness, and loss of mobility in the joints. Symptoms of elderly-onset rheumatoid arthritis usually appear suddenly, also known as acute onset. It usually affects larger joints like the shoulders and knees. Some people may also experience general symptoms like fatigue, fever and loss of appetite.
Spinal Stenosis
The narrowing of tunnels in the spine that contain the nerves or spinal cord is called spinal stenosis. Although this narrowing is a natural part of the ageing process, it can sometimes cause irritation or compression, leading to pain and numbness in the limbs. This occurs because reduced space within the spinal canal puts pressure on the nerves. Spinal stenosis is most common in people over 50 years old and primarily affects the lower back and neck.
Despite its prevalence, the outlook for spinal stenosis is generally favourable. Among approximately 20% of adults over the age of 60 who show signs of spinal stenosis, more than 80% do not experience symptoms, making treatment unnecessary. However, it is worth noting that spinal stenosis can stem from other causes, such as bone spurs resulting from arthritis and herniated discs.
Spinal stenosis usually develops gradually, and symptoms can come and go. Beyond pain and numbness, some individuals may also experience tingling and weakness in the neck, back, limbs and feet.
Fractures
Fractures refer to a break or crack in the bone. The risk of fractures naturally rises with age. These are known as geriatric fractures and happen due to skeletal fragility in the elderly, most often as a result of falls. Women are significantly more likely to experience fractures, with nearly half suffering an osteoporotic fracture in their lifetime. The risk is also considerable for men, though lower, at nearly one-third.
Fractures are injuries that can be considered a bone condition, but they can also be a sign of an underlying bone disease. Weakened bones from age and other existing conditions, such as osteoporosis and osteomalacia, increase the risk of fractures, especially when induced by a fall. Individuals who lead a sedentary lifestyle or are frequent drinkers are also liable to heightened risk.
As there are different types of fractures—ranging in severity from hairline fractures to transverse fractures—symptoms may vary. However, common symptoms include pain, swelling, tenderness, bruising, as well as the inability to move the affected body part and the presence of a bump.
Conclusion
Ageing often comes hand in hand with the fear of developing bone-related conditions that affect daily life, such as osteoporosis, osteoarthritis, rheumatoid arthritis, spinal stenosis and fractures. While a number of these conditions are considered “natural”, early diagnosis can slow down their development or reduce their debilitating impact. Staying aware and being proactive about bone health can keep us resilient, active and independent as we age.
Hip and Knee Orthopaedics believes in timely intervention. We are an orthopaedic clinic in Singapore with experience in treating various types of bone and muscle conditions, led by two double fellowship knee specialists. Whether you are recovering from an injury, managing an existing condition, or want to protect yourself from damage or wear and tear, our team is here to help. Schedule an appointment with our specialists today.
