Osteoporosis--porous, fragile bones that break easily--is occurring in
epidemic proportions in the U.S. For those who are affected, it can be painful, disfiguring, and debilitating.
There is much information available on osteoporosis, but not all
of it is correct. To reduce your risk of fracture you must become an informed consumer. Taking a little time to
learn about the condition is well worth the effort and much less painful than a vertebral compression or hip fracture.
The information given here is from two prominent authorities: Morris
Notelovitz, M.D., Ph.D., noted clinician and researcher who founded the first women's clinic in the U.S., and Sara
Meeks, P.T., a physical therapist who specializes in the treatment of osteoporosis, postural problems, back pain,
the frail elderly and the mature athlete.
I. Preventing Osteoporosis
Are you at risk?
It is important to find out. Osteoporosis is not just a problem for postmenopausal women, as many believe; it is
a lifelong concern for everyone. Although some people are more at risk than others, this life threatening condition
affects both men and women and crosses all ages (including children), ethnic groups, and lifestyle considerations.
Because there are no symptoms, almost three-fourths of those with fragile bones are not aware of it. Do not assume
that you do not have, or cannot get, this life-threatening condition.
According to Sara Meeks, "I recently gave a seminar at which a 28-year-old, well-built, healthy looking man
stood up and volunteered the information that he had recently been diagnosed with osteoporosis by bone density
scan. To look at him, it was impossible to tell." Meeks also describes a 15-year-old boy, an athlete, a wrestler,
who had osteoporosis.
Should you be concerned?
Absolutely! Everyone should take osteoporosis seriously. Do you think that any of the following statements pertain
to you?
1. I am a man;
therefore I cannot have osteoporosis.
2. I am a teenager;
therefore I cannot have osteoporosis.
3. I am taking
estrogen; therefore I cannot have osteoporosis.
4. I take calcium;
therefore I cannot have osteoporosis.
5. I exercise
regularly; therefore I cannot have osteoporosis.
6. I don't smoke
or drink; therefore I cannot have osteoporosis.
7. There is no
history of osteoporosis in my family; therefore I cannot have it.
8. I do not have
back pain; therefore I do not have osteoporosis.
These statements are all NOT TRUE.
No matter who you are, your family history, your dietary or lifestyle habits, you can't ever assume that you can't
get osteoporosis.
How can you tell if your bones are getting thinner and
weaker?
Osteoporosis has no symptoms. You have no warning that a bone is weak enough to fracture. But there is a sure way
to know if you are at risk of a fracture. Get a bone density test. If your doctor does not suggest one, ask for
it.
In the past doctors depended on risk factors alone to decide who should be offered preventive therapy. But information
from the medical and family history, including an assessment of lifestyle and other risk factors, identifies only
about 30% of those who have osteopenia.
One of the most accurate tests is called a DEXA. It's painless, takes just a few minutes, and has virtually 100%
accuracy. You will learn whether your bone mass is normal or below normal. If it is low, you must take steps to
stop bone loss and build new bone as soon as possible, before a weakened bone breaks. If you are losing bone, your
doctor may order certain blood and urine lab tests that provide more information.
What is osteopenia?
Osteopenia refers to the condition in which some bone has been lost, but probably not enough to be a threat to
your bones. It is like a "mild case of osteoporosis." It means the bones have started losing mass but
so far the risk of breaking is very small. Osteopenia is a warning that bone is being depleted. If you don't stop
the bone loss, it will get worse, until actual osteoporosis results.
How can you prevent osteoporosis?
Prevention requires a combination of nutrition, exercise, and possibly hormones and/or medication.
Nutrition: Proper nutrition is vital. You must have enough calcium, which builds bones, and vitamin D, which helps
absorption of calcium. As we get older, we need more of both of these. Calcium supplements can provide the levels
you need, but continue to strive to get as many nutrients as you can from food sources. Calcium supplements are
absorbed most efficiently when taken in individual doses of 500 mg or less, which means you need to take supplements
more than once a day.
Exercise: Exercise should be part of your daily routine for osteoporosis prevention. The best exercises are those
that work the muscles harder than they would work normally. Activities such as weight lifting, walking, dancing,
stair climbing, step aerobics, jogging, hiking and tennis are all effective at building bone. Exercise also affects
the hormones that control bone remodeling, shifting the balance toward new bone formation.
Why should certain exercises be avoided? Everyone needs exercise. But for preventing osteoporosis, there's more
to the story; some exercises can actually do harm if you have low bone mass. (If you do not know your bone status,
it is safest to assume that you have osteoporosis unless a bone density test has shown you do not).
Any twisting or flexion of the spine can cause a compression fracture. When you do flexion exercises, the back
flexes, or bends forward, and the spinal vertebrae compress, thereby increasing the risk of crushing or breaking
a bone if the spine has been weakened from osteoporosis. Avoid crunches, sit-ups, straight leg raises, toe touches,
and knee-to-chest movements.
Be especially careful if you or someone you know is a senior, participating in seated exercise classes. Sitting
is the position of greatest compression on the spine, and the risk of a compression fracture is increased by bending
forward or bringing the knees up to the chest.
Medication: Most of the available drugs - as well as estrogen replacement therapy for postmenopausal women - help
prevent bone loss. When bone mass is increased, it happens as a result of this slowing down or stopping further
bone loss. Calcium, vitamin D, and exercise must also be part of your osteoporosis prevention program.
When should prevention begin?
The prevention of osteoporosis should begin early. Physical activity in childhood is an important determinant of
peak bone mass. Studies have shown that exercise habits started before the age of 10 continue throughout life.
If you are a teenager or young adult, it may be difficult for you to imagine that today's poor nutrition, exercise
and lifestyle habits could lead to disability in your later years.
If you are menopausal, and you haven't already started a program of prevention, it's not too late to begin. Don't
wait until you have a symptom--the only symptom is a fracture.
If you are in your 30s or older, or have any reason to think you are at risk, ask your doctor for a bone density
test.
II. Advanced Osteoporosis: What Can You Do?
If your bone density test shows you have osteoporosis, you can take steps to stop the bone-depleting process and
even add bone mass. Follow the suggestions in the section "How can you prevent osteoporosis?" and "What
risks are there with certain exercises?"
If you have had one or more fractures . . . if you are in pain . . . if you have trouble with breathing or digestion
. . . if you have become shorter . . . if you are stooped over ("dowager's hump") you can be helped.
Here's how:
1. Develop good
posture with body alignment exercises. When you straighten your body alignment, back pain is relieved, breathing
and digestion improves, and you will be less likely to fall. If you have a dowagers hump, it will lessen somewhat.
You will become a little taller and look better.
2. Make sure you
are getting enough calcium and vitamin D.
3. Find out about
the new therapies that are being developed to halt bone loss and build bone mass. In addition to new drugs, scientists
are looking into the benefits of combining treatments that are known to be effective. Learn what you can on your
own, and see your doctor right away!
4. Exercise. No
matter how frail you may be, there are safe exercises starting at a low level that can help build up specific bones.
The information on these pages is excerpted and adapted from two
books (click on the title to learn more about them and how they can help you):
Stand
Tall! Every Woman's Guide to Preventing and Treating Osteoprosis,
by Morris Notelovitz, M.D., Ph.D. with Marsha Ware, M.D. and Diana Tonnessen
Walk
Tall! An Exercise Program for the Prevention & Treatment of Osteoporosis,
by Sara Meeks, P.T., G.C.S.