Osteoporosis means porous bones. It is a progressive bone disease in which a loss of bone mass and density may potentially lead to fracture. It can affect all age groups and both males and females. Women are at greater risk of developing osteoporosis than men, mainly due to the rapid decline in oestrogen levels after the menopause.
Bone is a living tissue that is constantly being absorbed and rebuilt. As we get older more bone is naturally lost than is replaced. However In osteoporosis the bone mineral density is reduced even further. The structure of bone begins to deteriorate and the amount and variety of proteins in bone are altered. This causes bone to become more fragile and more at risk of fracture through a minor fall or bump. The spine, hip and wrist are most commonly involved.
Osteoporosis is often referred to as the silent disease as it may not be diagnosed until a fracture has occurred. Fractures due to osteoporosis can lead to changes in posture (such as developing a stoop in your back), muscle weakness, loss of height and bone deformity of the spine.
Some people may experience pain in their bones and muscles, particularly in their backs. If you do experience any such symptoms and have some of the risk factors of osteoporosis it is important to talk to your GP.
The list of risk factors is extensive. Here are some of the more commonly associated risk factors:
Osteoporosis can be treated through drug therapy. Bisphosphonates are the most commonly prescribed medications for osteoporosis and have been approved for the treatment of steroid induced osteoporosis. Depending on the cause of your osteoporosis the most appropriate medication will be prescribed for you.
Taking the daily recommended dose of calcium and Vitamin D are also important in both the prevention and treatment of osteoporosis. Weight bearing exercises are also vitally important to encourage bone growth.
While 90% of bone growth has occurred by age 17 it will continue to grow in strength until the mid-30’s. As we age we naturally lose a small amount of bone each year. A good diet, regular exercise and a healthy lifestyle will help to maintain our bone strength and prevent the occurrence of osteoporosis.
It is important to maximise bone growth in children and teens through a variety of high impact activities. In the adults ages small bone growth can be encouraged through weight training and weight bearing exercises.
The intake of calcium and vitamin D in our diet is particularly important for the continual growth of bone and slowing down of bone loss.
Physiotherapists have a large role to play in the treatment and prevention of osteoporosis through exercise prescription, therapeutic modalities, education and advice. Those who suffer from osteopenia (low bone density, precursor to osteoporosis) and osteoporosis may be fearful of injuring themselves.
From personal experience I have noticed that those with osteoporosis and especially those who have suffered from a fracture due to the condition can be afraid to partake in exercise as they are fearful of injury. Physiotherapists can reassure them, help them to set goals and educate them on the most appropriate exercise therapy for them
We typically will not see a large volume of patients referred specifically for osteoporosis. However they may be referred due to back pain or post fracture as a direct effect of the condition. It is important when asked about your past medical history to always inform your physiotherapist if you have been diagnosed with osteopenia or osteoporosis. Our treatment may then be adapted slightly as a precautionary measure if needed. I have worked with patients to help them become more confident in themselves and more comfortable with exercise that will inevitably help improve their bone and muscle strength and overall function.
The Irish Osteoporosis Society have an excellent website with extensive information on all you need to know about osteoporosis www. Irishosteoporosis.ie
by Paula Morgan.