Physicians and Patients Can Both Join in the Fight Against Osteoporosis
Physical Therapy in St. Louis West County for Osteoporosis
Breakthrough Performance & Wellness came across this article that outlines treatment options for those with osteoporosis, and how assistance from a Physical Therapist can make your home and regular activities safer
If you were born between 1946 and 1964, then you are one of the 75 million Baby Boomers in the United States. And most likely when you look in the mirror you see a few wrinkles and gray hair you didn’t have 20 years ago. But there’s something else there that you might not see and that’s osteoporosis. Osteoporosis is a loss of bone density that can cause weak, brittle bones that tend to break easily. And think about this: 50 per cent of the women in this group and 30 per cent of the men will develop an osteoporosis-related fracture sometime during their older years.
Hang on — there’s a bit more you need to know. Disability and death are close companions of these fragility fractures. If you break a hip, you could end up in a nursing home, you most likely won’t get back to normal, and death is a reality for one out of every four patients with fragility hip fractures.
So where’s the good news in all this? If you have osteoporosis, if you are at risk for osteoporosis, or if you have already had an osteoporosis-related fracture, there are steps you can take for a better outcome. And even better than that — doctors are receiving training specific to this problem so they can help you avoid such problems. What can you expect from your physician? As the authors of this article point out, understanding who is at risk, why osteoporosis develops, and what to do to prevent (or treat) this disease is the orthopedic surgeon’s highest priority for this age group.
First, physicians recognize that menopausal women are affected most often but men should not be neglected. Men develop osteoporosis later in life than women but the effects can be just as devastating. Osteoporosis occurs when more bone cells die than are replaced by new, healthy bone cells. This process of tearing down old bone cells and building up new ones is called bone remodeling. Unfortunately, with age (and for women, a loss of the hormone estrogen), bone remodeling slows down or becomes lopsided with too many old cells and not enough new ones.
That’s where a prevention plan of vitamin and mineral supplementation along with exercise and lifestyle changes come in. Taking calcium with vitamin D, getting some sun exposure (an excellent source of vitamin D), and quitting smoking (or other tobacco use) is a good place to start. A lifestyle of daily exercise to challenge balance, build strength, and stimulate bone growth is essential starting from childhood when bone is forming and continuing throughout the lifespan.
Your physician will check for any hormonal abnormalities that can affect bone and prescribe medications that can restore a correct chemical balance within your body. Usually some blood tests are needed to check this out. If you are a candidate for one of the antiresorptive drugs called bisphosphonates like Boniva or Fosamax, then your doctor will prescribe those for you. Your doctor will also do a risk factor assessment to look for any other risk factors that might increase your chances for developing osteoporosis.
Getting older, having a family history of osteoporosis, being of the Caucasian (white) race, and having a previous history of fracture yourself are nonmodifiable risks. Nothing you can do to change any of those. What you really want to focus on are those modifiable risk factors (things you can do something about). Tobacco use was already mentioned. Other modifiable risk factors include being underweight, drinking too much alcohol, being a couch potato or otherwise inactive, and not taking your calcium and vitamins.
Your physician can also measure your bone density in order to calculate your risk of a fracture using special X-ray tests called Dual X-ray Absorptiometry (DXA scan). Another useful test is the FRAX Risk Assessment Tool put out by the World Health Organization (WHO). This tool calculates your 10-year risk of fracture. You can even access this tool on-line yourself, but you’ll need the results of your DXA scan to complete the calculations (http://www.shef.ac.uk/FRAX). These tests are recommended for women aged 65 and older, men 70 and older, and anyone over 50 who has significant risk factors for osteoporosis.
A Physical Therapist can also help you. The therapist can prescribe a specific exercise program proven to help improve bone strength. All exercise is good for your health, but not all exercise targets the bones. The therapist can also conduct a falls assessment to find out what your risk is for a fall and then develop a falls prevention plan designed for your unique risk factors.
You can help yourself. Don’t wait until you fall and break a bone. Studies show that preventive measures do make a significant difference. Ask your physician now to measure your bone density and to calculate your risk of falls and fractures. If your physician prescribes calcium and vitamin D, take them as directed! If your physician refers you to an endocrinologist (specialist in hormones and bones), make the appointment and go! Don’t put it off.
Ask your Physical Therapist to inspect your home for any safety tips and ideas on how to prevent falls. And if you have already had a fragility fracture and you haven’t been told any of these things about vitamins and exercise and home fall prevention programs, then walk (don’t run) to the phone right now and make yourself an appointment for some proactive help today. See your primary care physician or orthopedic surgeon for the kind of comprehensive care you’ll need to keep your bones health and strong and avoid osteoporosis, fractures, and falls that can change your life forever.
Reference: Richard M. Dell, MD, CCD, et al. Osteoporosis Disease Management: What Every Orthopaedic Surgeon Should Know. In Journal of Bone and Joint Surgery. November 2009. Vol. 91-A. Suppl. 6. Pp. 79-86.
Breakthrough Performance & Wellness provides services for Physical Therapy in St. Louis West County.