Osteoporosis: There IS Something You Can Do About It!

Reprinted with permission from TRIAD PUBLISHING CO.

Osteoporosis--porous, fragile bones that break easily--is occurring in epidemic proportions in the U.S. For those who are affected, it can be painful, disfiguring, and debilitating.

There is much information available on osteoporosis, but not all of it is correct. To reduce your risk of fracture you must become an informed consumer. Taking a little time to learn about the condition is well worth the effort and much less painful than a vertebral compression or hip fracture.

The information given here is from two prominent authorities: Morris Notelovitz, M.D., Ph.D., noted clinician and researcher who founded the first women's clinic in the U.S., and Sara Meeks, P.T., a physical therapist who specializes in the treatment of osteoporosis, postural problems, back pain, the frail elderly and the mature athlete.

I. Preventing Osteoporosis

Are you at risk?

It is important to find out. Osteoporosis is not just a problem for postmenopausal women, as many believe; it is a lifelong concern for everyone. Although some people are more at risk than others, this life threatening condition affects both men and women and crosses all ages (including children), ethnic groups, and lifestyle considerations.

Because there are no symptoms, almost three-fourths of those with fragile bones are not aware of it. Do not assume that you do not have, or cannot get, this life-threatening condition.

According to Sara Meeks, "I recently gave a seminar at which a 28-year-old, well-built, healthy looking man stood up and volunteered the information that he had recently been diagnosed with osteoporosis by bone density scan. To look at him, it was impossible to tell." Meeks also describes a 15-year-old boy, an athlete, a wrestler, who had osteoporosis.

Should you be concerned?

Absolutely! Everyone should take osteoporosis seriously. Do you think that any of the following statements pertain to you?

1. I am a man; therefore I cannot have osteoporosis.
2. I am a teenager; therefore I cannot have osteoporosis.
3. I am taking estrogen; therefore I cannot have osteoporosis.
4. I take calcium; therefore I cannot have osteoporosis.
5. I exercise regularly; therefore I cannot have osteoporosis.
6. I don't smoke or drink; therefore I cannot have osteoporosis.
7. There is no history of osteoporosis in my family; therefore I cannot have it.
8. I do not have back pain; therefore I do not have osteoporosis.

These statements are all NOT TRUE. No matter who you are, your family history, your dietary or lifestyle habits, you can't ever assume that you can't get osteoporosis.

How can you tell if your bones are getting thinner and weaker?

Osteoporosis has no symptoms. You have no warning that a bone is weak enough to fracture. But there is a sure way to know if you are at risk of a fracture. Get a bone density test. If your doctor does not suggest one, ask for it.

In the past doctors depended on risk factors alone to decide who should be offered preventive therapy. But information from the medical and family history, including an assessment of lifestyle and other risk factors, identifies only about 30% of those who have osteopenia.

One of the most accurate tests is called a DEXA. It's painless, takes just a few minutes, and has virtually 100% accuracy. You will learn whether your bone mass is normal or below normal. If it is low, you must take steps to stop bone loss and build new bone as soon as possible, before a weakened bone breaks. If you are losing bone, your doctor may order certain blood and urine lab tests that provide more information.

What is osteopenia?

Osteopenia refers to the condition in which some bone has been lost, but probably not enough to be a threat to your bones. It is like a "mild case of osteoporosis." It means the bones have started losing mass but so far the risk of breaking is very small. Osteopenia is a warning that bone is being depleted. If you don't stop the bone loss, it will get worse, until actual osteoporosis results.

How can you prevent osteoporosis?

Prevention requires a combination of nutrition, exercise, and possibly hormones and/or medication.

Nutrition: Proper nutrition is vital. You must have enough calcium, which builds bones, and vitamin D, which helps absorption of calcium. As we get older, we need more of both of these. Calcium supplements can provide the levels you need, but continue to strive to get as many nutrients as you can from food sources. Calcium supplements are absorbed most efficiently when taken in individual doses of 500 mg or less, which means you need to take supplements more than once a day.

Exercise: Exercise should be part of your daily routine for osteoporosis prevention. The best exercises are those that work the muscles harder than they would work normally. Activities such as weight lifting, walking, dancing, stair climbing, step aerobics, jogging, hiking and tennis are all effective at building bone. Exercise also affects the hormones that control bone remodeling, shifting the balance toward new bone formation.

Why should certain exercises be avoided? Everyone needs exercise. But for preventing osteoporosis, there's more to the story; some exercises can actually do harm if you have low bone mass. (If you do not know your bone status, it is safest to assume that you have osteoporosis unless a bone density test has shown you do not).

Any twisting or flexion of the spine can cause a compression fracture. When you do flexion exercises, the back flexes, or bends forward, and the spinal vertebrae compress, thereby increasing the risk of crushing or breaking a bone if the spine has been weakened from osteoporosis. Avoid crunches, sit-ups, straight leg raises, toe touches, and knee-to-chest movements.

Be especially careful if you or someone you know is a senior, participating in seated exercise classes. Sitting is the position of greatest compression on the spine, and the risk of a compression fracture is increased by bending forward or bringing the knees up to the chest.

Medication: Most of the available drugs - as well as estrogen replacement therapy for postmenopausal women - help prevent bone loss. When bone mass is increased, it happens as a result of this slowing down or stopping further bone loss. Calcium, vitamin D, and exercise must also be part of your osteoporosis prevention program.

When should prevention begin?

The prevention of osteoporosis should begin early. Physical activity in childhood is an important determinant of peak bone mass. Studies have shown that exercise habits started before the age of 10 continue throughout life.

If you are a teenager or young adult, it may be difficult for you to imagine that today's poor nutrition, exercise and lifestyle habits could lead to disability in your later years.

If you are menopausal, and you haven't already started a program of prevention, it's not too late to begin. Don't wait until you have a symptom--the only symptom is a fracture.

If you are in your 30s or older, or have any reason to think you are at risk, ask your doctor for a bone density test.

II. Advanced Osteoporosis: What Can You Do?

If your bone density test shows you have osteoporosis, you can take steps to stop the bone-depleting process and even add bone mass. Follow the suggestions in the section "How can you prevent osteoporosis?" and "What risks are there with certain exercises?"

If you have had one or more fractures . . . if you are in pain . . . if you have trouble with breathing or digestion . . . if you have become shorter . . . if you are stooped over ("dowager's hump") you can be helped. Here's how:

1. Develop good posture with body alignment exercises. When you straighten your body alignment, back pain is relieved, breathing and digestion improves, and you will be less likely to fall. If you have a dowagers hump, it will lessen somewhat. You will become a little taller and look better.

2. Make sure you are getting enough calcium and vitamin D.

3. Find out about the new therapies that are being developed to halt bone loss and build bone mass. In addition to new drugs, scientists are looking into the benefits of combining treatments that are known to be effective. Learn what you can on your own, and see your doctor right away!

4. Exercise. No matter how frail you may be, there are safe exercises starting at a low level that can help build up specific bones.

References:

The information on these pages is excerpted and adapted from two books (click on the title to learn more about them and how they can help you):

1. Stand Tall! Every Woman's Guide to Preventing and Treating Osteoprosis, by Morris Notelovitz, M.D., Ph.D. with Marsha Ware, M.D. and Diana Tonnessen

2. Walk Tall! An Exercise Program for the Prevention & Treatment of Osteoporosis, by Sara Meeks, P.T., G.C.S.