Blog ~ Osteoporosis

Here's wIn the UK alone Osteoporosis affects over 3 million people. With more than half a million people each year receiving treatment for fractures as a direct result of the condition.

There's not a week goes by in my clinic where I don't see someone who suffers with some form of Osteoporosis, this week alone I had two patients with vertebrae collapses in the spine caused by it.

Lowering of our bone density is a normal part of ageing, however the condition makes bone loss take place much faster, creating a weakness to our bones, with the bones becoming susceptible to fracture. In most cases it develops slowly over several years, often being identified after a fracture has been found.

When a women goes through Menapause her hormones change, due to this her oestrogen levels fall, therefore increasing the risk of Osteoporosis making women more at risk than men, particularly if the menopause begins early or their ovaries have been removed. However it does affect men, younger women and children. The word broken down Osteo (bone) porosis (porus) meaning the bones density becoming less compact.

Homeostasis is our bodies internal mechanism working in balance, constantly connecting and communicating its systems with each other, always constantly changing. Part of this physiological process takes place in our skeletal system where Osteoblasts (bone builders) work in synergy with Osteoclasts (bone clearers) constantly restructuring and creating new bone, until something occurs to disturb the balance and our bone builders reduce. Think of the scenario whereby you put food on a plate for someone to eat, through their craving they eat all the food.. everyones happy and this process continues. Then you stop providing the food, but the person still wants the same amount and starts to eat into the plate itself..

You may have heard the word Osteopenia, this is the stage of
bone loss before osteoporosis. There are many other factors that can increase the risk of developing osteoporosis, these include;
• Heavy or constant drinking of alcohol and smoking
• Not exercising regularly
• Family history, particularly a hip fracture in a parent
• Long-term use of certain medicines that can affect bone strength or hormone levels, such as anti-oestrogen tablets that many women take after breast cancer.
• Taking high-dose steroid tablets for more than 3 months
• Other medical conditions – such as inflammatory conditions, hormone-related conditions, or malabsorption problems
• Having or having had an eating disorder such as anorexia or bulimia
• Having a low body mass index (BMI)

If you're worried visit your GP and if they suspect Osteoporosis or Osteopenia they can work out your future risk of breaking a bone using an online programme, such as FRAX or Q-Fracture. They might also send you for a bone density scan (DEXA scan) to measure your bone strength.
Its calculated as a standard deviation (SD) and is called a T score.
• A T score of -1.0 or obove is normal bone density.
• A T score between -1.0 and -2.5 shows low bone density, and is defined as osteopenia.
• A T score of -2.5 or below shows bone loss and is defined as osteoporosis.
As a treatment your doctor can prescribe bone strengthening treatment and medications, this will depend on your bone density results.

Treatment for osteoporosis is based around what i call the 4 P's precautions - prevent - preserve - promote: Where possible you can take precautions through life style choices to lower the risk of the condition taking place. When your diagnosed you can create a treatment plan to live a life that prevents your condition deteriorating and preserves the bone condition you have, to promote bone stability and strength by adjusting what happens to your bodies internal environment and reducing risk from factors of your external environment. Whilst treating and preventing broken bones, and taking medicine to strengthen your bones, through the NHS and your GP.

If you're at risk of developing Osteoporosis, or you've been diagnosed, you can take steps to help keep your bones healthy such as;

• Making lifestyle changes – such as giving up smoking and reducing your alcohol consumption
• Healthy eating, including foods rich in calcium and vitamin D
• Taking a daily supplement containing vitamin D and C.
• Taking regular exercise little and often, to keep your bones as strong as possible
• Avoid high impact activity, and focus on regular low impact and weight bearing activity.
• Strengthening your muscles at the major joints.
• Educate yourself and read more about prevention and treatment
• Speak to your GP
• Contact professional organisation such as the NHS and the Royal Osteoporosis Society.
• You may find it helpful to talk to a trained counsellor.

Physiotherapy can play a major part in giving advice, treatment and rehabilitation for the condition and I would recommend both sufferers and medical practitioners to look up Wolff's Law related to Osteoporosis, I use the theory when treating the condition and it works very effectively.