What is osteoporosis?
Although your bones may seem inanimate, they are made of living tissue just like the rest of you. Old bone tissue is constantly being replaced, but as you age, you can lose too much bone mass—this is called osteoporosis. It occurs when the rate of replacement is too low, or the rate of loss is too high (or both).
Children and teens have the highest rate of bone production, and bone mass usually peaks in the early 20s. The higher your bone density is at this age, the lower your risk of developing osteoporosis later. After age 30, you lose approximately 1% bone mass every year. The National Osteoporosis Foundation estimates that one in two women and one in four men above the age of 50 will break a bone due to osteoporosis.
Know the risk factors
52 million Americans have low bone mass, which increases their risk for osteoporosis.
Other risk factors include:
- Gender—women are four times more likely than men to develop osteoporosis
- Age—people over age 50 are at the highest risk
- Race—an increased prevalence of osteoporosis is found among people of Caucasian or Asian descent
- Family history—having a close family member who has suffered a hip or spinal collapse fracture increases the risk for osteoporosis
- Personal history—a past fracture increases the risk for future fractures
- Body type—men and women who are small and thin face an increased risk for osteoporosis. Weight loss after age 50 can increase the risk of hip fractures, while weight gain can decrease the risk
- Hormones—decreased estrogen (women) or testosterone (men) can decrease bone density
- Lack of exercise—sedentary lifestyle is associated with an increased risk for osteoporosis, while weight-bearing exercise is associated with a decreased risk
- Eating disorders/gastrointestinal surgery—poor nutrition and hormone imbalances can contribute to bone loss
- Low calcium and Vitamin D—calcium and vitamin D are essential to building strong, dense bones. Deficiencies in either can increase osteoporosis risk. The recommended calcium dose for women aged 50 and younger is 1,000 mg/day, and 1,200 mg/day for women aged 51 and older. For men aged 70 and younger the recommended calcium dose is 1,000 mg/day and 1,200 mg./day for men aged 71 and older. The recommended dose of Vitamin D for women and men younger than 50 is 400-800 international units (IU) daily, and 800-1,000 IUs daily over age 50
- Smoking—smoking is associated with decreased bone density, and smoking can trigger early menopause in women (before age 40)
- Alcohol—excessive consumption can reduce bone density
- Medications—long-term use of corticosteroids, thyroid drugs, anticonvulsants, antacids, and medications for treating or preventing cancer, depression, or transplant rejection can increase osteoporosis risk
- Menopause—a decline in estrogen production leads to a lower rate of bone replacement and to rapid bone loss. Postmenopausal women––especially those who go through early menopause–have a greater risk of fracture and osteoporosis
Diagnosis & treatment
Osteoporosis develops over many years, and symptoms may not be obvious. Possible signs of low bone density or osteoporosis can be a loss of height, stooped posture, pain in the spine, or fractures that seem to happen more easily than they should.
Occupational and physical therapists are key members of the team to help prevent and treat osteoporosis and related fractures. Our team members include those that use and have been trained in the Meeks Method. We educate individuals with osteopenia or osteoporosis on how to complete everyday activities, such as carrying groceries and housekeeping, while exercising and protecting joints at risk for fracture. Additionally, we treat injuries through posture management, education on body mechanics, flexibility and impact training and exercise programs.
We use the following tools to diagnose osteoporosis or low bone density:
- Medical and personal history—previous fractures, drinking and smoking habits, diet, physical activity, medication, or menopause
- Physical exam—visual examination of the spine, changes in height measurement
- Laboratory tests—blood calcium, thyroid function, hormone levels, biochemical marker tests
- DEXA scan—a bone density test that uses low-level X-rays to measure mineral content in the bones; usually done on the hip and spine, and recommended for women over 64 and men over 69
- FRAX® tool—used to evaluate fracture risk in the next 10 years, using results of a DEXA scan in combination with assessment of other risk factors; useful for postmenopausal women, patients over 50, and people with low bone density
There are a variety of treatment options for the management of osteoporosis. While prevention is the best first line of defense, you can still slow bone loss by eating a bone-healthy diet, doing regular weight-bearing exercise and following our prevention guidelines.
Other osteoporosis treatment options include medication (antiresorptive medicines to slow bone loss), physical medicine evaluation (for posture), nutrition counseling, pain management, group education programs and support groups.
Free educational classes
At Phelps, we host monthly education, nutrition and exercise programs to help you keep your bones healthy or manage bone loss. You can join by coming to the Board Room on the second Thursday of every month, from 10:45am to 11:30am.
Preventing osteoporosis starts early. The stronger your bones are when you are young, the stronger they will be when you are older. Eating a balanced diet is the best way to ensure that you are getting the nutrients you need to keep your bones strong.
Some important points in our prevention plan are:
Eat foods that are high in calcium—sources of calcium include milk, cheese, yogurt, canned sardines, salmon (with bones), dark green vegetables and calcium fortified breads and juices. You may also want to consider supplements if you can't get an adequate amount of calcium through diet alone.
Get enough vitamin D—this vitamin helps the body absorb calcium, and adequate amounts can usually be obtained through 20 minutes of sun exposure per day, or by eating foods like eggs, salmon, fortified milk and cereal, or vitamin D supplements.
Cut down on caffeine and alcohol—caffeine decreases calcium absorption, and excessive alcohol consumption has been shown to have a negative effect on bone health.
Make sure you exercise—regular exercise can help keep your muscles strong and prevent bone loss. Weight-bearing exercise should be done three to four times per week, and can include walking, running, aerobics, jumping rope, hiking, stair-climbing and elliptical machines. Muscle-strengthening exercise should be done two to three times per week, and can help rebuild bone and increase density. This includes weight lifting and use of exercise bands.
Tai chi—this practice is good for preventing osteoporosis because it improves balance and prevents falls and the risk of breaking brittle bones. You may also want to consult your doctor or physical therapist about beginning yoga or Pilates.