Osteoporosis – You ARE AT RISK unless you KNOW YOU AREN’T

Osteoporosis is really not a fun subject. But it is REALLY important that you think about it now. This has been driven home to me this year in both a personal and a professional capacity.

In 2016, the Institute of Osteopathy has teamed up with the National Osteoporosis Society to raise awareness of this very serious condition. Osteoporosis can be painless until you fall and have a fracture. If you have fragile bones and weak muscles, the recovery from fractures can be very difficult.

Half of women and a fifth of men over 50 years old are affected by bone thinning.

One in three people have undiagnosed spinal fractures that may cause no pain but will eventually lead to bone loss and spinal curvature.

My story

A beloved relative fell over in September 2016, for the first time, at the age of 78. Her balance is usually excellent, but on this occasion a large dog jumped up in excitement when she went to pat it and she stepped back and lost her balance.

She had been taking alendronic acid (a bone density drug) for several years but this didn’t prevent her from badly fracturing her pelvis and requiring pins through her femur to pull it out of her crushed hip socket (I agree its grim, but I don’t want us to shy away from the facts).

The first two weeks following her fall were excruciatingly painful and she required assistance for every single move and manoeuvre. She has now been in hospital for over six weeks, simply waiting for the fractures to slowly knit — her bones are just too fragile to stabilise surgically.

This situation breaks my heart because I know it was completely avoidable if she’d taken measures earlier in her life to improve her musculoskeletal health.

She is lucky to have a very strong community and family around her and visiting her in hospital but she is of course bored, frustrated and scared. I’m scared too. When she is allowed home she will be much more vulnerable to further falls and further fractures. We are taking serious measures to make sure she has plenty of rehabilitation from physiotherapists and physical therapists to reduce the chance she’ll lose her balance, or be too weak to prevent herself from falling.

My own wonderful grandmother died of complications related to osteoporosis. She had an increasingly hunched posture, and eventually fell, broke several ribs and died several weeks later. My mother has been reminding me for years that I have a family history of osteoporosis. This has somehow always been filed in my ‘mother banging on about medical problems’ category and therefore essentially ignorable.

As a direct consequence of her mother’s terrible death, my mother exercises frequently, is careful about her diet and has really fantastic posture. This has made it all too easy for me to ignore my own immediate family history of osteoporosis!

First, try to establish that you ARE NOT AT RISK

Here is a link to an online tool that will help you assess your fracture risk. Follow this link then select Calculation Tool tab and put in your stats.

http://http://www.shef.ac.uk/FRAX/

If you’re worried you may have thinning bones, the most conclusive way of finding out is by having a Bone Density Scan. This assesses your bone density at different sites in your skeleton and can establish the risk of incurring into a stress fracture.

This is why is so important to get it done if you are peri- or post-menopausal or if you identify with the risk factors for osteoporosis. The stage before becoming osteoporotic is called osteopaenia and shows a small reduction in bone density which is also visible on a bone density scan.

Being aware of it as early as possible will increase the chances for you not to even get to an osteoporotic state and to start working on it successfully addressing your diet and physical activity.

Here are some signs that you may already have osteoporosis

You may have noticed a loss of height (a sign of slow vertebral collapse caused by compression fracture), or a dowager’s hump accompanied by a bulging tummy, or breathlessness, and needing the loo frequently all caused by a change in your spinal shape.

You may have a relative with a history of osteoporosis. Long-term use of steroids can weaken bone. Poor digestion can reduce your capacity to absorb calcium and Vitamin D so inflammatory bowel disease, long term gut dysfunction, and coeliac disease can all predispose to thinning bones.

If you have established risk from a family history, or know you have osteoporosis here are the best ways to reduce your risk of fracture.

Osteoporosis – 9 ways to prevent or treat it

Load bearing exercise
Nutrition – lots of calcium (tinned fish and green veg)
Aerobic exercise
Vitamin D – to absorb the calcium (egg yolk, supplements and sunshine)
Resistance exercise
Maintaining a consistent weight (slim not skinny)
Improving your balance with stabilisation exercise
Osteopathy to treat functional anatomy of bladder / bowel
Drugs – bisphosphonates (alendronic acid)/ raloxifene / teriparatide

How can Kennington Osteopaths and Physiotherapy help?

Our new physical therapist, Mr Andrea Bartolini, has a number of treatment package options to strengthen, condition, stretch and stabilise. He is also a trained nutritionist and sports and public health so can advise you about diet as well as prescribing appropriate exercise to improve your posture and increase your bone density and reduce your risk of falling in the first place.

If you’ve already had a fall or a fracture and have been injured our phsyiotherapists and osteopaths are brilliant at rehabilitation and pain relief. You don’t have to live in pain and you don’t have to live with dysfunction. We all also offer treatment packages that offer a really cost effective way of helping you to look after yourself.

Osteoporosis – 5 signs you might have it

Loss of height
‘Dowager’s hump’
Heartburn or vomiting
Weak bladder (urge incontinence)
Family members who have (had) it

Osteoporosis – 4 symptoms that might indicate you have it

Bulging tummy (spinal fractures can reduce space in the abdomen)
Breathlessness (spinal curvature reduces lung capacity)
Back pain (spinal fractures may be extremely painful – but are sometimes painless)
Worrying about your balance (weak muscles make balancing harder)