World Osteoporosis Day (WOD), on October 20 each year, marks a campaign dedicated to raising global awareness of the prevention, diagnosis and treatment of osteoporosis. As such, Rebecca, will give you the low down on what osteoporosis is, what causes it, how to prevent or slow down the loss of bone density. Finally, she will go through the chiropractic and osteopathic implications.
What is osteoporosis:
The term osteoporosis is used only when the bones become quite fragile (more than what we would think of as the normal process of ageing). When bone is affected by osteoporosis, the holes in the honeycomb structure become larger and the overall density is lower, which is why the bone is more likely to fracture.
What is osteopenia:
Most of us have heard of osteoporosis, which is a disorder that causes the bones to lose tissue and become weak and brittle. However, not many are aware of this similar disorder that is often confused with osteoporosis. Osteopenia is similar to osteoporosis in that the person suffering from the disorder will experience a loss in bone density. However, it’s not to the same extent. While not everyone requires treatment with medication, certain risk factors could make your condition more severe.
Normal bone health:
Our bone matrix is made from osteoclasts and osteoblasts. Bone turnover happens in two steps: cells called osteoblasts build new bone and other cells, called osteoclasts, remove old bone and return the calcium to the blood stream. Within our bones are special cells that constantly break down bone and build new bone. Osteoclasts break down bone, and osteoblasts make new bone. Over our lifetime these processes should be in balance, and are constantly being utilised. Having strong bones in childhood lays a foundation for bone health throughout life. We build almost all our bone density when we’re children and teens. The bone-building process is mostly finished around age 20. As adults, we still replace old bone with new bone, but more slowly. Over time, our bones get weaker, but there are many ways to help slow this down. It is imperative that we maximise our bone health when we are younger.
Osteoporosis often has no symptoms. The first sign that you may have it is when you break a bone in a relatively minor fall or accident (known as a low-impact fracture). Fractures are most likely in the hip, spine or wrist.
It happens most commonly when are women over age of 50yoa (primarily due to the hormone profile changing around menopause). History of several low impact fractures are typical. e.g. my uncle horse riding (didn’t fall off a horse), but was diagnosed with a fracture of his vertebra. I advised him to seek a DEXA scan which did then show up osteoporosis.
Risk factors for developing osteoporosis:
- low body weight
- drinking too much alcohol
- many trips, falls and slips
- certain medications
- certain conditions
- hormonal changes
- poor childhood nutrition especially lack of vitamin D and calcium
- lack of impact exercise
How to diagnose it:
There are several ways to diagnose osteoporosis. As chiropractors and osteopaths, we have access to X-ray facilities, and we do often spot loss of bone density on the film. We then refer the client out to their GP for possible further imaging, most commonly a DEXA scan.
DEXA (DEXA stands for dual energy X-ray absorptiometry) and is one of the most common ways to measure bone density by using a type of X-ray. the results come out as T scores. Typically the ranges are as below, although age does play a factor in the conclusion.
+1 to -1 Your bone density is in the normal range for a young and healthy person.
-1 to -2.5 Your bone density is slightly below the normal range for a young and healthy person, also known as osteopenia.
-2.5 and below Your bone density is in the osteoporosis range.
Implications for us as chiropractors and osteopaths:
- we can often see bone density loss if we take x-rays to help with our diagnosis. Often if we see this on x-ray then we already know the person has got significant bone loss. We then refer out for possible further testing.
- if there is the presence of bone density loss, then we modify our techniques appropriately. We lower the force of our adjustments, and add gentle forms of care. For example the activator, dry needling, mobilisation, and the drops. The drops are great as any force applied to the spinal joints gets dissipated through the couch rather than through your body.
- fractured vertebra can change the shape and posture of your spine and we can often help with some of the aches and pains that can be caused from this.
- nutritional advice to support good bone health, advice on foods and supplements that can help slow the bone loss. My grandmother actually has reversed her diagnosis of osteoporosis over 20 years by using a certain supplement protocol including magnesium, vitamin D and potassium supplementation. Never start these without consulting a qualified health practitioner.
- to encourage our young people to look after their bones, with nutrition and with specific exercise, and to avoid certain things like fizzy drinks.
If you have osteoporosis or osteopenia, and are wanting to seek some physical therapy, please do call us on 01273 206868 or email firstname.lastname@example.org to speak to one of our clinicians. They are all qualified in using specific techniques that are gentle, safe and effective.