A brief history of osteoporosis.

Osteoporosis has always been with us. The effect of what we now know to be osteoporosis has been observed in many patients across the centuries. For example, remains of many ancient Egyptians show the unmistakable curvature of the spine associated with osteoporosis. Hip fractures have long been recognised as a complication of old age, but it was always assumed that they were an inevitable consequence of growing old.

The journey to understanding the true cause begins in the 1770s, English surgeon John Hunter discovered that as new bone is laid down in the body, old bone is destroyed. This process is known as remodelling, and as long as the amount of new bone being grown is greater than the amount of old bone being destroyed then bones remain healthy. But where the old bone is disappearing faster than the new bone can be grown, this is osteoporosis. Hunter couldn’t have known this but his discovery of the dynamic nature of our bones was key in opening up new research opportunities to further expand our understanding of the skeletal system.

Osteoporosis was finally named by the French pathologist Jean Lobstein when he noticed bones that were riddled with larger than normal holes. He coined the term osteoporosis which literally means “porous bone” to describe this deterioration. We were still unable to isolate a diagnosis of osteoporosis from other bone diseases in living patients though. It took Gustav Pommer in 1885 to clearly demonstrate that rickets and osteomalacia were caused by the newly grown bone failing to calcify, whereas osteoporosis was a reduction in the amount of bone. This distinction was a key part in the journey towards understanding osteoporosis.

So we now understood what separated osteoporosis from other bone diseases but the extent of the effect of osteoporosis on menopausal women was still not properly understood. Fuller Albright, who worked at Massachusetts general hospital in the 1940s, observed that post-menopausal women were more likely to develop frail bones. He proposed that oestrogen deficiency was the cause of this postmenopausal osteoporosis. Albright’s work was the first step in our full understanding of the many different causes of osteoporosis.

We are now in the fortunate position to have advanced detection and diagnostic equipment and a much more complete understanding of our skeletal system. There are a selection of drugs and therapies available to treat the condition and people are able to live with and in some cases reverse the effects of osteoporosis, sometimes returning bone health to normal. GOF believe that the next step is using all this acquired knowledge and expertise to prevent osteoporosis from occurring at all. We know that by building up bone density and strength while we are young, we can offset the effects of ageing and hormonal deficiency. Lifestyle changes are the next frontier to enable us to eradicate osteoporosis once and for all.