Osteoporosis. What is it? Osteoporosis is a bone disease/disorder, whereby there is a loss of the density in your bones. Bones are essentially made up of two layers – a hard solid outer layer, called cortical bone, and a more open network of bone at the centre, called medullary bone. Medullary bone is sometimes called “spongy bone”, due to its appearance. Cortical bone is solid bone, and typically what we think of when we imagine a bone. Its solid structure stands up well when forces are applied to it – allowing us to withstand bumps or impacts without any skeletal damage. Osteoporosis means that this cortical section of the bone becomes more like the medullary section – meaning there is less solid covering to our bones, and more of the spongey bone inside. This means the bone is weaker and brittle, making is more susceptible to fracture. But what does it mean for me? A loss of the density in your bones puts you at risk of fracture. Not just from trauma or a large impact, but from minor incidents. Patients who suffer with Osteoporosis can commonly fracture their hip when landing from a small fall, fracturing their wrist or shoulder when putting their arms out to steady or catch themselves, or even suffer vertebral (spinal) fractures from simply rolling over in bed. But this only affects old ladies– right? Wrong. Whilst Osteoporosis most commonly affects women after they have been through the menopause it is also beginning to affect younger and younger people. Why? There is no stand-alone answer to the development of Osteoporosis, however, some lifestyles can make you more susceptible. Bone is a living tissue, and therefore responds to forces applied through it. This is called Wolffs Law, whereby the bones lay down more dense and solid tissue in response to greater forces being applied through them, in turn making them stronger and less vulnerable to damage. So, If you spend most of your time sitting down, i.e. have a desk job then go home and watch TV all night, there aren’t many high forces being transmitted through your bones. Therefore, you may be more susceptible to your bones decreasing in density.
“But I don’t sit down all day!” Unfortunately, there are many factors that play a role in the development of osteoporosis. For example, as previously stated it is more common in females who have been through the menopause but elderly men can also develop osteoporosis. Also, if you have a blood relative i.e. Mother or Sister who was diagnosed with the disease – you are more likely to develop osteoporosis. Those who have used steroids for a prolonged period of time (prescribed or recreational) are also at risk of developing the disease. It can be treated though? Osteoporosis is hard to reverse – it is much easier to prevent the disease, or slow down it’s progression. Medication prescribed by the GP will help your body to take more of what it needs to build bone from your diet – therefore if you aren’t eating the correct diet whilst taking these, they are not able to work optimally. It’s much easier to adopt an Osteoporosis prevention-style diet. “Osteoporosis prevention diet?” is this just another fad? No – this is not a set diet, and neither does it entail any prescribed or expensive foods. An osteoporosis prevention-style diet essentially means that you should be incorporating into your diet foods that your body can use to build bone. Your body lays down new bone by using Vitamin D and Calcium together – therefore a diet lacking in either one of these can mean a risk of developing Osteoporosis. Foods that contain Vitamin D and Calcium include mostly dairy foods and coloured fruits and vegetables – taking supplements simply isn’t the same, as these bypass our body’s natural way of building. How do I know if I am at risk?
Common Risk Factors for Osteoporosis include:
Physical inactivity and a sedentary lifestyle as well as impaired neuromuscular function (e.g., reduced muscle strength, impaired gait and balance) are risk factors for developing fragility fractures.
Smoking can lead to lower bone density and higher risk of fracture and this risk increases with age.
A high intake of alcohol confers a significant risk of future fracture (e.g., over 4 units of alcohol/day can double the risk of hip fracture) The risk of vertebral and hip fractures in men increases greatly with heavy alcohol intake, particularly with long term intake.
Prolonged use of corticosteroids is the most common cause of secondary osteoporosis. It is estimated that 30-50% of patients on long term corticosteroid therapy will experience fractures, with an increased in risk of hip fracture by 2-fold in women and 2.6-fold in men.
Proton pump inhibiting drugs can reduce the absorption of calcium from the stomach and long term use of these drugs can significantly increase the risk of an osteoporosis-related fracture
Low body weight and weight loss is associated with greater bone loss and increased risk of fracture.
There are some simple questions to answer to find out if you are susceptible to the condition, alternatively, you can ask one of our chiropractors more about the condition, or speak to your GP. What can I do to decrease my chances of suffering? Having an Osteoporosis prevention-style diet is not enough to rely on. As you know – bone is a living tissue, and responds to forces applied to it. Resistance training (with proper form) is a brilliant way to encourage solid bone growth. Resistance training doesn’t just mean lifting heavy weights at the gym either – a great way to incorporate resistance training is swimming, or aqua aerobics. These don’t have to be high impact sports – simply walking a few lengths of waist or chest deep water is a brilliant place to start. Resistance bands are also a good way to train, and also offer an aspect of progression, as they increase in difficulty. Remember though – if you are suffering from Osteoporosis use extreme caution when attempting to do heavy or high intensity resistance training! As this can have the opposite effect, as brittle bones are weak, so applying high forces to the bones can cause fracture. Can you tell if I have Osteoporosis before I suffer a fracture? If you feel you, a friend or relative could be suffering with osteoporosis we encourage you to speak to a professional – either ourselves or your GP, as the effects of a fracture can be devastating. But there are ways to test for the condition before suffering! We can refer you for a DXA scan – a non-invasive full body scan to determine your bone density throughout your body, and to even show any potential areas of concern.
We have attached a link which will take you to the National Osteoporosis Society’s test which will be able to tell you if you are at risk for osteoporosis.
image attribution: By BruceBlaus [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons