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Osteoporosis is a common medical condition characterized by reduced bone density within the skeleton. Osteoporosis tends to develop as people age; bone density peaks in the 20s and gradually decreases after that point, with loss accelerating as time goes on. Our bones are continually remodeling themselves, breaking down old bone and replacing it with new bone. This is a good thing as this keeps the skeleton strong and healthy by retaining bone mass. At a certain point, however, the rate at which bone loss occurs outpaces replacement of bone and bone density decreases. Low bone density is problematic because the skeleton becomes more susceptible to fracture, especially in the spine, hips, and forearms. Fractures often occur due to a traumatic event, such as a fall, and can lead to significant disability. Studies have shown that hip fracture is associated with increased risk of death within one year after injury.
A study completed in 2010 found that about 15% of women over age 50 had osteoporosis compared to 4% of men. In both genders, the prevalence of osteoporosis continued to increase as age increased. While it affects all ethnicities, osteoporosis is more common in Caucasian and Asian demographics. Additionally, genetics play a role in osteoporosis development and progression.
People often want to know what they can do to reduce their risk for osteoporosis. Excessive alcohol consumption and smoking are associated with increased risk for osteoporosis and subsequent fracture, and discontinuing these habits is beneficial for overall health. Because bone density is related to calcium and vitamin D levels in the body, maintaining a healthy BMI and eating nutritious meals help ensure adequate nutrient levels. Exercise, especially including weight bearing activities, helps to preserve bone density. Increasing the activity level of sedentary adults can further promote bone density.
Osteoporosis is formally diagnosed by using a special imaging study called a DEXA scan. This study measures the density of a person’s bones and compares this to a benchmark healthy adult bone density level. Based on this comparison, a person may be diagnosed with osteoporosis if his/her density deviates from the benchmark more than a set amount. If density is reduced, but not yet at the level diagnostic of osteoporosis, a patient may be diagnosed with osteopenia, a precursor to osteoporosis. From a clinical standpoint, this is like the relationship between “pre-diabetes” and diabetes; you do not have osteoporosis yet, but you should probably do something to limit the progression of the condition.
Typically, patients with osteoporosis or osteopenia are instructed by their physicians to increase calcium and vitamin D intake via supplements to help preserve bone density. In more advanced cases, a physician may prescribe medications that aim to slow the rate of bone loss or promote increased density. Exercise may also be suggested to help maintain bone density and reduce risk for falls.
This is where physical therapy may help. As noted earlier, weight bearing exercise helps improve bone health and starting an exercise program under the supervision of a therapist may be beneficial, especially with individuals who are new to exercise in general. In patients with a history of falling or impaired balance, exercises to strengthen the muscles in the legs and trunk may be prescribed to help improve safety and avoid fracture. Education regarding safe completion of daily activities, often to minimize bending or twisting movements of the spine, can help prevent compression fractures in the back. Finally, postural education can reduce pain and improve function in patients with osteoporotic changes in the back.
Ultimately, while there is no cure for osteoporosis, it is a manageable condition. Working with your physician and a physical therapist can help promote optimal bone health and reduce the risk for fracture by promoting safety during your daily activities. If you have questions regarding osteoporosis and how physical therapy may help you manage this condition, please contact an Access physical therapist today!