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  • Writer's pictureRobin R Varghese, PT.

Osteoporosis!!! YES, you CAN prevent it.

Updated: Jan 9, 2023

  • The word ‘osteoporosis’ means ‘porous bone.

  • It is a disease that weakens bones, and puts one at a greater risk for sudden and unexpected bone fractures.

  • Osteoporosis means less bone mass and strength.

  • Low bone density that puts them at risk of developing osteoporosis. This condition is called osteopenia.

  • Osteoporosis weakens bones, making them more susceptible to sudden and unexpected fractures. The disease often progresses without any symptoms or pain, and is not found until bones fracture.

  • Osteoporosis is responsible for more than two million fractures each year, and this number continues to grow.


What exactly happens?


  • Bones are made of living, growing tissue. The inside of healthy bone looks like a sponge. This area is called trabecular bone. An outer shell of dense bone wraps around the spongy bone. This hard shell 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 remodeling, 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.


Primary osteoporosis

​Secondary Osteoporosis

​has no known definite cause

​caused by prolonged use of medications or secondary to another disease or condition which inhibits the absorption of calcium or impedes the body's ability to produce bone

​there are many contributing factors LIKE prolonged negative calcium balance, impaired gonadal and adrenal function, estrogen deficiency, or sedentary lifestyle.


Types of Primary Osteoporosis

Types of Secondary Osteoporosis

Post menopausal Osteoporosis

​Endocrinal

Senile Osteoporosis

​Gastrointestinal

Idiopathic Juvenile Osteoporosis

​Rheumatological

​Hematological

​Inflammatory

​Medications

Immobilization

Symptoms

Many times Osteoporosis does not show any symptoms. That is why it is also called as a silent disease. Nevertheless, the following symptoms must not be overlooked.

  • Loss of height (getting shorter by an inch or more).

  • Change in posture (stooping or bending forward).

  • Shortness of breath (smaller lung capacity due to compressed disks).

  • Bone fractures.

  • Pain in the lower back.

Risk factors

​Increasing age

a) Postmenopausal: Women over the age of 50 are prone. Estrogen is a hormone that protects against excessive bone loss Menopause slows the production of estrogen In the first 10 years of Menopause, women undergo rapid bone loss . b) Senile Osteoporosis men over the age of 50 are more likely to have an osteoporosis-induced bone break.

Bone structure and body weight.

​Petite and thin people have a greater risk of developing osteoporosis because they have less bone to lose than people with more body weight and larger frames.

Family history

​Those with family history are more prone

​Medical conditions and medications

​Certain medical conditions and medications can increase the risk.

Other

​ethnicity, alcohol and tobacco use.

Treatment

  • Medications

  • Hormone Replacement Therapy

  • Selective estrogen receptor modulators (SERMS)

  • Diet and supplementation



Physical Therapy Management


1. Weight-bearing exercises

  • Exercises such as walking or hopping, has been shown to maintain or improve bone density in this population

  • Strengthening exercises, using weights or resistance bands, have also been shown to maintain or improve bone density at the location of the targeted muscle attachments

  • Maintaining bone health in this population is extremely important, especially in the elderly as there is typically has a decline in bone mass with age.

2. Flexibility and strengthening exercise

  • These can help improve the individual's overall physical function and postural control.

  • Improving postural control is important to reduce the risk of falls

  • Falls often result in fractures in frail individuals

  • Balance exercises are also important to incorporate to further reduce the risk of falls.

3. Postural exercise

  • These are crucial to prevent structural changes that often accompany osteoporosis, such as thoracic kyphosis

  • Every osteoporosis program should include extension exercises; chin tucks, scapular retractions, thoracic extensions, and hip extensions

  • Strengthening the extensor muscles will promote improved posture and improved balance

Flexion exercises are CONTRAINDICATED especially in patients with a risk of a spinal fracture. Anterior compressive forces to the vertebra can contribute to compression fractures Flexion and twisting place a high compressive load on the vertebral bodies, these high levels should be avoided.


4. Balance exercise


5. Education - top tips easily given to clients

  • Follow a healthy diet that includes enough calcium and Vitamin D

  • Wear sensible, well-fitting shoes to avoid falls

  • Avoid rugs and sloppy slippers – both can cause trips

  • Have good lighting on stairs

  • Get eyesight checked regularly

  • Try to avoid heavy lifting – consider home delivery grocery shopping

6. Back pain

  • Physiotherapists may treat patients with osteoporosis for back pain

  • Agility training, resistance training, and stretching have all been shown to decrease back pain and its related disabilities in this population.

7. High-intensity training - Research highly supports high-intensity training in the prevention of bone loss for women in menopausal years and the early post-menopausal period

High-intensity training would include body-weight and resistive exercises at a high-intensity, similar to circuit training. This type of training is often contraindicated for individuals with low bone mass

8. Dynamic weight-bearing, high force exercise

  • These exercises results with the greatest improvements at the femoral neck and moderate results at the femoral trochanter

  • Dynamic weight-bearing, low force exercise had moderate positive effects on the spine

How can we prevent it?

​Dietary management : The most important nutrients for people with osteoporosis are calcium and vitamin D. Calcium is a key building block for bones. Vitamin D helps the body to absorb calcium. Calcium can be from diet, supplements, or both (it is best to get these nutrients from food, rather than supplements) For adults aged 50 and older, the National Osteoporosis Foundation of the USA has recommended intake is 1000–1200 mg/day of elemental calcium.

Optimal vitamin D can be acquired 3 ways: Eating food that naturally contain vitamin D or are fortified with vitamin D Sensible sun exposure A few minutes, regularly, with good skin exposure, no sun cream and your shadow should be shorter than you. If it is longer than you are, you are not producing any vitamin D· Taking a vitamin D supplement too helps. For adults aged 50 and older, the National Osteoporosis Foundation of the USA has recommended intake is 700–800 IU/day


Exercise and supplementation are often suggested to help you prevent osteoporosis.

Lifestyle

Maintaining a healthy lifestyle can reduce the degree of bone loss. Begin a regular exercise program. Exercises that make your muscles work against gravity (such as walking, jogging, aerobics, and weightlifting) are best for strengthening bones.

Do not drink too much alcohol. Do not have excessive amounts of caffeine. Don’t use tobacco at all.


Precautions to be taken if one is living with Osteoporosis


Prevent falls inside your home

Keep your floors free of clutter, including throw rugs and loose wires and cords. Use only non-skid items if you have mats, carpets or area rugs. Make sure your lighting is bright enough so that you can see well. Do not use cleaners that leave your floors slippery. Clean up any spills that happen immediately. Use grab bars in the bathroom and railings on stairways.


Prevent falls outside your home

Make sure lighting is adequate in all areas outside your home. Use a backpack or other type of bag that leaves your hands free. Keep areas outside in good repair and free of clutter. Wear sensible shoes with non-slip bottoms.

Patient education is vital as many are unaware of the serious consequences of the disorder. Early prevention can help reduce the high morbidity

  • Attending physical therapy for exercise prescription and participation in a supervised exercise programme is recommended.

  • Patients should be urged to modify their lifestyle and remain compliant with the medications prescribed.

  • The patient should be urged to quit smoking and abstain from alcohol.

  • The dietitian should educate the patient on a calcium-rich diet and the need to take vitamin D supplements.

  • The pharmacist should assist the team by educating the patient about the benefits of medications and their adverse effects.

  • Women over the age of 65 should be urged to have a bone density scan.


Latest Cochrane review suggest that Exercise has the potential to be a safe and effective way to avert bone loss in postmenopausal women.


At Valley Healing Hands, Brownsville, Texas, we provide the best physical therapy treatment for Osteoporosis. Our Therapists are highly qualified and skilled to guide and help you in preventing as well as in treating Osteoporosis. Our patients are completely satisfied with our services. You may learn about us here by knowing what they have to say about us and get connected to us.Our patients love us and you too will!

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