OSTEOPOROSIS – DEFINITION AND PREVENTION
The word ‘osteoporosis’ means ‘porous bone.’ It is a disease that weakens bones, and if you have it, you are at a greater risk for sudden and unexpected bone fractures. Osteoporosis means that you have less bone mass and strength. The disease often develops without any symptoms or pain, and it is usually not discovered until the weakened bones cause painful fractures. Most of these are fractures of the hip, wrist and spine.
What causes osteoporosis?
Researchers understand how osteoporosis develops even without knowing the exact cause of why it develops. Your bones are made of living, growing tissue. The inside of a healthy bone looks like a sponge. This area is called trabecular bone. An outer shell of dense bone wraps around the spongy bone. This hardshell is called cortical bone.
When osteoporosis occurs, the “holes” in the “sponge” grow larger and more numerous, which weakens the inside of the bone. Bones support the body and protect vital organs. Bones also store calcium and other minerals. When the body needs calcium, it breaks down and rebuilds bone. This process, called bone remodelling, supplies the body with needed calcium while keeping the bones strong.
Up until about age 30, you normally build more bone than you lose. After age 35, bone breakdown occurs faster than bone buildup, which causes a gradual loss of bone mass. If you have osteoporosis, you lose bone mass at a greater rate. After menopause, the rate of bone breakdown occurs even more quickly.
Signs and symptoms
Osteoporosis develops slowly, and a person may not know they have it until they experience a fracture or break after a minor incident, such as a fall. Even a cough or sneeze can cause a break in osteoporotic bones.
Breaks will often occur in the hip, wrists, or spinal vertebrae for people who have osteoporosis.
If a break occurs in the spinal vertebrae, it can lead to changes in posture, a stoop, and curvature of the spine. People might also notice a decrease in height or their clothes may not fit as well as they did previously.
Treatment aims to:
- slow or prevent the development of osteoporosis
- maintain healthy bone mineral density and bone mass
- prevent fractures
- reduce pain
- maximize the person’s ability to continue with their daily life
People at risk of osteoporosis and fractures can use preventive lifestyle measures, supplements, and certain medications to achieve these goals.
Causes and risk factors
Doctors have identified several risk factors for osteoporosis. Some are modifiable, but it is not possible to avoid others.
The body continually absorbs old bone tissue and generates new bone to maintain bone density, strength, and structural integrity.
Bone density peaks when a person is in their late 20s, and it starts to weaken at around 35 years of age, As a person grows older, bone breaks down faster than it rebuilds. Osteoporosis may develop if this breakdown occurs excessively.
It can affect both males and females, but it is most likely to occur in women after menopause because of the sudden decrease in estrogen. Estrogen normally protects women against osteoporosis.
The IOF advises that once people reach 50 years of age, 1 in 3 women and 1 in 5 men will experience fractures due to osteoporosis.
Unavoidable risk factors include:
- Age: Risk increases after the mid-30s and especially after menopause.
- Reduced sex hormones: Lower estrogen levels appear to make it harder for the bone to regenerate.
- Ethnicity: White people and Asian people have a higher risk than other ethnic groups.
- Height and weight: Being over 5 feet 7 inches tall or weighing under 125 pounds increases the risk.
- Genetic factors: Having a close family member with a diagnosis of hip fracture or osteoporosis makes osteoporosis more likely.
- Fracture history: A person over 50 years of age with previous fractures after a low-level injury is more likely to receive a diagnosis of osteoporosis.
Diet and lifestyle choices
Modifiable risk factors include:
Calcium and vitamin D intake
Calcium is essential for bones. People should make sure they consume enough calcium daily.
Adults aged 19 years and above should consume 1,000 milligrams
(mg) of calcium a day. Women who are over 51 years of age and all adults from 71 years onward should have a daily intake of 1,200 mg.
Dietary sources include:
- dairy foods, such as milk, cheese, and yoghurt
- green leafy vegetables, such as kale and broccoli
- fish with soft bones, such as tinned salmon and tuna
- fortified breakfast cereals
Other ways to minimize the risk are:
- avoiding smoking, as this can reduce the growth of new bone and decrease estrogen levels in women
- limiting alcohol intake to encourage healthy bones and prevent falls
- getting regular weight-bearing exercise, such as walking, as this promotes healthy bones and strengthens their support from muscles
- exercises to promote flexibility and balance, such as yoga, which can reduce the risk of falls and fractures
For people who already have osteoporosis, nutrition, exercise, and fall prevention techniques play a key role in reducing the risk of fracture and the rate of bone loss.
Tips for fall prevention include:
- removing trip hazards, such as throw rugs and clutter
- having regular vision screenings and keeping eyewear up to date
- installing grab bars, for example, in the bathroom
- ensuring there is plenty of light in the home
- practising exercise that helps with balance, such as tai chi
- asking the doctor to review medications, to reduce the risk of dizziness
IMPORTANCE OF PHYSIOTHERAPY
The goal of physiotherapy is to make daily activities easier and to promote independence. All of these can not be achieved if they remain in pain or discomfort, if they lack confidence or if they have weak muscles. The most important concerns a physiotherapist will address are;
- Reducing the risk of a fall. One of the most common reasons an elderly person will seek physiotherapy is to recover from or prevent a fall. Falls are the leading cause of accidents among this population and tend to lead to very serious health complications, including a significantly higher mortality rate in the year following the fall.
- Reducing pain from chronic conditions. Physiotherapy helps to alleviate discomfort from conditions like arthritis, osteoporosis, long-standing back pain, etc. through the use of exercises and other modalities.
- Regaining and maintaining independence: A well-tailored exercise program is applied towards specific functional goals and helps maximize strength without overloading the muscles, which allows them to lead an active, independent lifestyle for a longer period of time.
At PCA your physiotherapist will guide and individualize your program to meet your needs and achieve your goals.
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PCA today on 0813 028 0496.