What is Osteoporosis?
Osteoporosis is a bone disease characterized by low-bone density (thickness of the bone), decreased bone strength, and a change in the bone structure, which can lead to an increased risk of fracture. The normal bone structure becomes thinned out and porous, lessening the ability of the bone to withstand the typical forces that are applied in everyday living. Fractures from osteoporosis and low-bone density can be serious, causing pain and affecting your quality of life.
Bone is living tissue. Normally, one type of cell removes bone and another type of cell adds bone in a balanced, ongoing process. In osteoporosis, bones weaken when not enough new bone is formed and/or too much bone is lost. This imbalance commonly begins in women during the first 5 years of menopause. However, it can also occur in men and in children, often due to diseases that affect bone development, such as Celiac disease, inflammatory bowel disease, rheumatoid arthritis, spina bifida, cystic fibrosis, or kidney disease. Some medicines, such as steroids, may increase your risk for developing osteoporosis. Athletes who are underweight during the time of peak bone development are also susceptible.
There are many factors that can cause a person to be at risk for developing the disease. It is important to know your risks so that you can be diagnosed and proactive in your treatment.
Risk Factors for Osteoporosis
Noncontrollable Risks
- Female gender
- Small frame
- Advanced age
- Hormone levels
- Genetics
- Predisposing medical conditions
Controllable Risks
- Cigarette smoking
- Excessive alcohol intake
- Inactive lifestyle
- Excessive caffeine intake
- Lack of weight-bearing exercise
- Drugs (eg, steroids, heparin)
- Poor health
- Low weight
- Calcium-poor diet
- Low vitamin D levels
How Does it Feel?
Osteoporosis is a disease that can be “silent,” and there may be no outward symptoms until a fracture occurs. If you are middle-aged or older, you may notice a loss of height or the appearance of a humpback, although this is not a diagnosis for osteoporosis in and of itself. Fractures may occur in situations that would not occur in persons with healthy bones, such as breaking an ankle after stepping off a curb, breaking a hip with a fall, or breaking a rib when opening a window. These are calledfragility fractures and are a red flag for bone disease. Spinal compression fractures, particularly those in the upper back or thoracic spine (area between the neck and the lower back), are the most common fractures, followed by hip and wrist fractures.
How Can a Physical Therapist Help?
Your physical therapist can develop a specific program based on your individual needs to help improve your overall bone health, keep your bones healthy, and help you avoid fracture. Your physical therapist may teach you:
- Specific exercises to build bone or decrease the amount of bone loss
- Proper posture
- How to improve your balance so as to reduce your risk of falling
- How to adjust your environment to protect your bone health
Healthy bone is built and maintained through a healthy lifestyle. Your physical therapist will teach specific exercises to meet your particular needs.
The exercise component for bone building or slowing bone loss is very specific and similar for all ages. Bone grows when it is sufficiently and properly stressed, just as muscle grows when challenged by more than usual weight. Two types of exercise are optimal for bone health, weight-bearing and resistance.
It is best for a physical therapist to provide your individual bone-building prescription to ensure that you are neither over- or under-exercising. Typically, exercises are performed 2 to 3 times a week as part of an overall fitness program.
Weight-bearing exercises
- Dancing
- Jogging
- Racquet sports
- Heel drops
- Stomping