Osteoporosis is a condition that causes bones to weaken and lose strength and making them easier to break as compared to normal bones. It is a common problem for people above the age of 50.

The risk of getting the disease increases as the person gets older because bone mass is lost faster than it is created. Nowadays, the disease is getting prevalent in children also due to sedentary lifestyle.

Osteoporosis is a serious problem in children because it occurs at the time when children’s body is building up most of their bone mass. By the age of 18 to 20, this bone mass builds about 90 percent in an individual.

Therefore, osteoporosis is a serious problem as it strikes the child when the body is still building up their bone strength. The greater the bone mass in children, the lower their risk of osteoporosis in later life.

While most people associate osteoporosis, a condition characterised by low bone density and fracture susceptibility, mainly occurring with women in midlife or older, it is surprisingly common in children too. Osteoporosis can occur in children due to underlying causes such as:

• Osteogenesis imperfecta

•  Inflammatory conditions such as juvenile arthritis or Crohn’s disease

•  Type 1 diabetes

•  Type 2 diabetes

•  Hyperthyroidism

•  Calcium and Vitamin D deficiency

•  Chronic disease and its treatment

Other than this, children who are bedridden or with prolonged periods of immobility are at an increased risk for the disease because they are unable to participate in weight-promoting activities that promote bone density.

The cause of osteoporosis is sometimes referred to as a 'silent condition' because there are no signs or symptoms of a broken bone.

Osteoporosis is a serious problem. Any signs and symptoms should not be ignored and an early consultation with the doctor is recommended. The common signs and symptoms of osteoporosis in children may include:

• Pain in lower back, hips, knees, ankles and feet

• Trouble in walking

• Frequent fractures of lower extremities like feet, ankles and leg

• Easily broken bone, particularly the long bones of skeleton

• Loss of height or curvature of spine

• Sudden weight loss

• Shortness of Breath

Early diagnosis of this disease is an important step in protecting children's bones from other fractures before remission.

The diagnosis of osteoporosis in children requires a history of fractures and, in most cases, the detection of a low bone mineral density (DXA) on a scan.

Based on the diagnosis, treatment can be given. The goal of pediatric osteoporosis management is to reduce bone mineral density in the center to optimize maximal bone mass; prevent pain, bone fractures and scoliosis, and increase function and mobility. Treatment can include:

• Consumption of diet rich in calcium, vitamin D and protein

• Safe physical activity practice

• Some osteoporosis medication as prescribed by the doctor

Osteoporosis is a progressive bone disease in children. Generally, an earlier consultation with a doctor can lead to early treatment.

Bone density measurements are the most accurate way to determine lower bone mass and should be performed by your doctor for suspected juvenile osteoporosis.

Other than that, attaining a healthy lifestyle can help a child grow bones. This can be ensured by making them eat a balanced and calcium-rich diet and by providing them safe exposure to the sun and vitamin D.

If still the condition doesn’t get better with the diet and sunlight exposure, the doctor may also consider prescribing some medications to strengthen their bones and reduce risk of fractures.

(Author: Dr Yash Gulati, Senior Consultant Orthopaedics, Joint Replacement & Spine, Indraprastha Apollo Hospitals, New Delhi)