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The bare bones about osteoporosis

Angelo Pappas, P.T.

It is estimated 34 million people are at risk of developing osteoporosis. Each year in the U.S., nearly 1.5 million bone fractures occur related to osteoporosis. In 1999, approximately 320,000 people experienced hip fractures; this number is expected to increase to 440,000 by the year 2025. Unfortunately, only 20-percent of those who experience one of these fractures pursue follow-up treatment for osteoporosis.

Ninety-percent of women over the age of 75 have osteoporosis. Of those elderly patients who experience a hip fracture, as many as 40 percent die within one year of suffering the fracture. Post-menopausal women can lose up to 20 percent of their bone mass in the first five to seven years following menopause.

With these high statistics, osteoporosis needs to be taken seriously and prevention measures should be implemented.

What is osteoporosis?
Osteoporosis means "porous bones” and people with the condition have weak and brittle bones that can fracture with only a small amount of stress such as bending over or coughing. The most common fractures occur in the spine, hip and wrists. More than 10 million Americans have osteoporosis and approximately half of women age 50 and over will have at least one osteoporosis-related fracture in their lifetime. Women also are twice as likely as men to have osteoporosis after the age of 50.

Most people don’t know they have osteoporosis until they have a fracture. However, there are several subtle but serious warning signs to look out for. A stooped posture, loss of height and chronic back pain are all signs of bone loss and possible minor fractures that are related to osteoporosis.

Causes and Risk Factors
Our bones constantly are being rebuilt throughout our lifetime. Bones are made up of collagen, a protein that provides the basic framework, and calcium phosphate, a mineral that hardens the bone. Our bone mass peaks at age 30 and begins to slightly deteriorate and we lose more bone than we replace. Those with a high peak bone mass are less likely to develop osteoporosis than those with a lower peak bone mass. Low amounts of calcium also affect bone mass and density and can increase the chances of developing osteoporosis. There also are several other risk factors to consider:

  • Tobacco use – Smoking is linked to decreased bone density. Additionally, smokers typically are thinner than nonsmokers, tend to drink more alcohol and may be less physically active.
  • Eating disorders – Anorexia nervosa and bulimia both lead to lower bone density and can impact the amount of calcium and vitamin D the body receives.
  • Inactive lifestyle – Individuals who are less active have weaker bones than those who exercise regularly. Any weight-bearing exercise is beneficial for your bones. Walking, running, jumping, dancing and weightlifting seem particularly helpful for creating healthy bones.
  • Excess alcohol consumption – Having more than two alcoholic drinks a day on a regular basis increases the risk of osteoporosis because alcohol can interfere with the body's ability to absorb calcium.
  • Risk factors you can’t avoid – Being a woman, being Asian or white, having a thin frame and being over the age of 65 are all factors that put you at greater risk of developing osteoporosis. Luckily, there are several steps to help prevent osteoporosis and the fractures it causes.

Preventing Osteoporosis
There are several medications and hormones that can help treat osteoporosis but the best treatment is prevention. Try to eat foods that are rich in calcium and vitamin D – milk, fish and leafy greens are great sources. Exercising regularly with a combination of strength training and weight-bearing exercises helps keep bones strong and supports the important muscles around them. Finally, if you are a woman over the age of 65 or a man over the age of 70, be sure to visit a doctor to get a bone density test to make sure your bones are strong and healthy and catch any possible signs of osteoporosis.

Angelo Pappas, M.P.T., is licensed physical therapist with a master’s degree in physical therapy and is the program manager of FMC’s Geriatric Fracture Program.