Osteoporosis is a progressive disease affecting the bones which leads to reduced bone mass and structural changes. Our bones have cells which are producing new bone while other cells take away old bone. This bone remodeling process is normally in balance. With osteoporosis, there is an increase in bone resorption. The end result is weakening and thinning of the bones and increased risk of fracture. Indeed, people with a diagnosis of a vertebral fracture have four times greater risk of fracture.
Certain risk factors are associated with osteoporosis. These include age: (being over the age of 50 years), a family history, vertebral fracture, long term use of pregnisone or another glucocorticord medication, smoking, and excessive alcohol (more than 2 drinks per day) or caffeine (greater than 4 cups of coffee or cola per day). Women are more susceptible at menopause due to the reduction in estrogen. Estrogen functions to suppress bone resorption. Women tend to lose up to15% of their bone mass at menopause. Indeed, 25% of women and approximately 12% of men over the age of 50 have osteoporosis.
Exercise has been shown to help improve bone density (BMD). Most people believe walking is sufficient exercise to maintain their BMD. Studies have shown that in fact walking does not improve BMD as it does not load the bone enough. The best exercise involves mixed loading i.e., walking with jogging or resistance exercise (weights). Obviously, people who have other health issues might not be able to jog or jump to effectively stress the bone but light weights or theraband might be incorporated. Furthermore, fall prevention through specific balance exercises becomes a major focus in physiotherapy treatment of older osteoporotic adults.
There appears to be a lot of literature aimed at pre and postmenopausal women with regards to osteoporosis. Perhaps children should be included with respect to providing education on bone health. We reach our peak bone mass at 20 years of age. Diet and lifestyle greatly influence bone health in the young. This will be the focus of next months’ article.
Written by Susan Reive, Owner of Kilborn Physiotherapy Clinic