Osteoporosis is something that can cause pain, heartache and severely limit your daily activities, especially if it becomes severe. The good news is that you can prevent it from becoming severe.
On this page we are explaining what osteoporosis is, the causes, treatments, risk factors and how you can prevent it from becoming a problem.
One good thing is that you can still receive chiropractic treatment despite having osteoporosis. We might have to modify the treatment but there is always a chiropractic treatment method that will suit you.
Osteoporosis (porous bone) is a condition where the bones become weak and thin. It is characterized by low bone mass and structural deterioration of bone tissue, causing bone fragility and an increased likelihood of fracture. Normal bone structure has the appearance of honeycomb - a thick outer shell and a strong inner mesh. The holes between the bony mesh become larger in osteoporosis meaning the bone structure is weakened and susceptible to breaking with the slightest knock or fall.
How common is Osteoporosis?In the UK, one in two women over the age of 50 will break a bone, predominantly due to osteoporosis. One in five men over 50 are also affected. It affects an estimated 75 million people in Europe, USA and Japan. In 2000, there was an estimated 9 million new osteoporosis fractures, 1.6 million being in the hip, 1.7 million in the forearm and 1.4 million in the vertebrae. Europe and the US accounted for 51% of these fractures. 30 – 50 % of women and 15 – 30 % of men will suffer a fracture related to osteoporosis in their lifetime. If there is a 10% loss of bone mass in the vertebrae, it will double the risk of vertebral fracture and a 10% loss of bone mass in the hip can result in a 2.5 times greater risk of hip fracture.
In females, the lifetime risk of hip fracture is 1 in 6, compared with a 1 in 9 risk of a diagnosis of breast cancer. In males, the estimated lifetime risk of experiencing an osteoporosis fracture over 50 years is 30%, similar to the lifetime risk of developing prostate cancer.
Unfortunately, if you have had a prior fracture due to osteoporosis, there is an 86% increased risk of another fracture. Also the great majority of individuals at high risk (80%) who have already had at least one osteoporosis fracture are neither identified nor treated. That is why osteoporosis screening is important.
Signs and Symptoms of OsteoporosisUnfortunately, you cannot feel your bones getting weaker. Often, osteoporosis is diagnosed in patients when x-rays are taken in our chiropractic clinics. Most people are unaware that they have osteoporosis until they fracture a bone. Osteoporosis sufferers can fracture a bone from a minor fall, or in serious cases, from a simple action such as a sneeze or even just spontaneously.
Vertebral fractures may initially present as back pain, loss of height or spinal deformity e.g. kyphosis, Dowager’s hump or stooped posture. In many cases, a vertebral fracture can occur without causing pain and is found on x-rays as an incidental finding without the patient being aware of previous fractures.
Women can lose up to 20% of their bone mass in the first 5 – 7 years after menopause, making them more likely to develop osteoporosis.
Risk factors for osteoporosisCertain people are more likely to develop osteoporosis than others. The risks for developing osteoporosis include:
This is one of the most serious complications of osteoporosis. A hip fracture unfortunately often results in increased dependency or even death. It is common to get pneumonia or deep vein thrombosis (DVT) as a complication.
Nearly 75% of all hip fractures occur in females over 50. They have a 2.8% risk of death related to hip fracture after the age of 50, which is equivalent to the risk of death from breast cancer and 4 times higher than from endometrial cancer.
Hip fractures cause the most morbidity with reported mortality rates up to 20 – 24 % in the first year after hip fracture and greater risk of dying may persist for at least 5 years afterwards. Loss of function and independence among is common with 40% of them being unable to walk independently and 60% requiring assistance even a year later. Due to this, a third of people are totally dependent or in a nursing home in the year following a hip fracture.
Vertebral fractureA 50-year old female has a 16% lifetime risk of having a vertebral fracture compared to 5% in a male. A 65-year old female with 1 previous vertebral fracture has a 1 in 4 risk of another fracture over 5 years; however this can be decreased to a 1 in 8 risk by treatment.
Vertebral fractures can cause back pain; loss of height; deformity; immobility, increased number of days in bed and even reduced lung function. The impact on quality of life can be huge as a result of loss of self-esteem, distorted body image and depression. Also there can be a significant effect on normal daily living activities.
Vertebral fractures are associated with an increased risk of both further vertebral and non-vertebral fractures. It is estimated that only a third of vertebral fractures come to clinical attention and non-diagnosis of vertebral fractures is a worldwide problem.
Vertebral compression fractures is one of the most common pathologies we see in the practice.
Specialised tests called bone mineral density scans (BMD) can measure density in various sites of the body, most commonly the heel. Experts recommend using a central DEXA scan (dual energy x-ray absorptiometry), combined with laser technology. This test is painless, safe and requires no preparation from you. The test will tell if you have low bone density and are at risk of having a fracture in the future. It compares your bone density with that of a healthy young adult. The result is given as a T-score.
Some bone density tests measure the strength of the hip, spine and/or wrist, the areas commonly fractured in osteoporotic patients. Although no test is 100% accurate, it is the single most important diagnostic test to predict whether a patient will have a fracture in the future.
Treatment of osteoporosisAlthough there is no cure for osteoporosis, it can be treated in a variety of ways. There is a range of drug treatments available for post-menopausal osteoporosis. Studies have shown that depending on the drug and patient population, treatment decreases the risk of vertebral fracture by between 30 – 65 % and of non-vertebral fracture by 16 – 53 %.
Treatment of established osteoporosis is cost effective irrespective of age. Identifying and treating patients at risk of fracture but who have not yet had a fracture, will substantially reduce the long term burden of osteoporosis, reduce the risk of first fracture from 8% to 2% which can reduce the 5 year fracture incidence from approximately 34% to 10%.
Sunlight exposure can increase the BMD in vitamin D deficient bone and aid prevention of non-vertebral fractures.
A balanced diet rich in calcium, adequate vitamin D, regular weight-bearing exercise programme and fall prevention are important in maintaining strong and healthy bone.
Medication for OsteoporosisThere are two types of cells in our bones, bone dissolving cells, osteoclasts (break down old bone) and construction cells, osteoblasts (build new bone). Some drugs work by slowing down the activity of the bone dissolving cells whilst others stimulate the construction cells. The aim of medication is to strengthen bones to prevent them from fracturing.
Types of medication that are used include:
Less commonly used medication includes:
Maintaining a healthy diet and active lifestyle will help prevent osteoporosis. Regular weight-bearing exercise is the best way and it is never too late to start. If you have already been diagnosed with osteoporosis, you will need to be careful of vigorous, high impact exercise. Here at the practice we have the facilities to help develop a suitable exercise programme for you. We recognize the need to keep exercise fun otherwise you will not continue.
Did you know that lifting weights is the most effective way to help you maintain and build your bone density, jumping on a trampoline is also a great way to help you.
Now, you might not like the idea of ‘pumping iron’ or trampolineing, so we have alternative exercise routines we can suggest. Dancing, walking, Tai Chi, gardening and golf are good forms of exercise for all ages. Leading an active lifestyle, whatever you decide to do, will ensure that you stay healthier in your old age.
Chiropractors are able to advise each patient on exercises, which will help improve core stability musculature and maintain bone density.
Calcium and vitamin D are important for bone health. A varied diet including milk, hard cheese, certain vegetables and fruits, oily fish and meat will help to ensure you are eating the correct amount. It is not necessary to eat dairy or meat products to get enough calcium in your diet. Supplements can help to boost your intake of the necessary nutrients to. It is important to reduce intake of salt, fizzy drinks, too much caffeine and alcohol.
MSM is known for its anti-inflammatory benefits because it helps reduce the rigidity of cells in soft tissues of the body.
We should all eat 5 servings of fruit and vegetables a day. Mega Greens plus MSM compares to 5 – 7 servings per day.
The body continuously regenerates new cells. Skin cells are regenerated on 30- day cycles, while bone cells are regenerated on 120-day cycles. If our cells do not receive proper nutrition, then they will fall into a state of degeneration. Proper nutrition means you provide your body with the necessary vitamins, minerals, amino acids and proteins. Mega Greens plus MSM are gluten free and suitable for all ages.
Genacol supplements help relieve painful symptoms of joint inflammation and degeneration. Using Genacol can significantly reduce use of NSAID’s (anti-inflammatory tablets) for people with osteoarthritis and joint problems, and is less likely to cause any stomach irritation. Smoking and being overweight will also have an effect on bone density so quitting smoking and losing weight will decrease your chances of bone fracture due to osteoporosis.
ConclusionChiropractors do not treat osteoporosis but we are able to reduce some of the symptoms, particularly relating to spinal compression fractures and we offer important advice to help prevent further fractures and loss of bone density. We often identify compression fractures and osteoporosis on x-rays and we are able to advise patients to have further tests to establish the severity of the problem. We can all be affected by osteoporosis but it pretty difficult to know if you are affected until you have a test.
We know that the higher your bone density is at the age of 30 the better it tend to be in later years, so it is important to tell our children to eat well, exercise and look after themselves.
We also know that if we do weight bearing exercise, eat well and have a good lifestyle in our later years we are less likely to suffer osteoporosis, so we need to tell our parents about it.
Remember, it is never too late to improve your bone density, so don’t delay telling the people you love and care for what they should do.