What is happening to your bones?
You’ve probably seen in television commercials how elderly people are at increased risk for broken bones if they fall. Typically, this is caused by osteoporosis. What is this? Why does it happen? Can you prevent it?
Definition
Osteoporosis is when bones become weak and brittle to the point that the chance of fracturing (breaking) a bone while doing simple everyday tasks, like coughing or bending over, is significantly high. We need to look at bones further in-depth to understand why this happens. Your bones aren’t just rigid structures but living tissue that is constantly being renewed. Your body continually breaks down old bone tissue and replaces it with new bone tissue. When you are younger, the growth of new bone tissue exceeds the removal of old bone tissue resulting in increased bone mass. Once you become an adult, this process evens out until you become elderly. Then, the creation of new bone tissue slows down to the point that it no longer keeps up with the removal of old bone tissue. This is what leads to your bones becoming brittle and weak.
It can affect people of either gender and any race; however, it most often is seen in white or Asian women who are past menopause. People who have a smaller body frame, are underweight, or have a diet low in calcium are at increased risk for developing osteoporosis. Certain medical conditions (ex. celiac disease, inflammatory bowel disease, cancer) and medications (ex. long-term use of steroids) can also contribute to bone tissue loss. Lifestyle choices, such as smoking, excessive alcohol consumption, and not being active, can increase your risk. Symptoms do not appear in the early stages of bone tissue loss. Once osteoporosis has weakened your bones, you may notice back pain, usually resulting from a fracture or collapsed vertebra (the small bones that form your backbone). You might also have a loss of height over time, stooped posture, and broken bones that occur more easily than expected.
Treatment
Osteoporosis treatment is based on your risk of breaking a bone in the next ten years. This is determined by doing a bone density test, which is when you lie on a table, and low-level X-rays are used to take pictures of your bones to determine the density (amount of minerals in them). Usually, only a few bones are checked to limit the amount of radiation you receive. Since the hip, wrist, and spine are the most commonly broken bones for those with osteoporosis, these are the ones that are frequently checked.
If you are at increased risk, your doctor will prescribe a medication that helps improve your bone density. Some examples are alendronate, risedronate, ibandronate, and zoledronic acid. They typically come in a pill form, taken either once a week or once a month. An intravenous (IV) injection can be done quarterly or yearly, but it is more expensive than the pills. Some individuals benefit from taking hormone-replacement therapy medications that help maintain bone density. It is vital to stop smoking and reduce the amount of alcohol intake to no more than two alcoholic drinks a day. Preventing falls is an excellent way to decrease the chances of a fracture. Some tips for doing this include wearing shoes with non-slip soles, keeping electrical cords/slippery area rugs out of the way, making sure your house has adequate lighting, installing grab bars in the bathroom near the shower/toilet, and using assistive devices to get in and out of bed.
Prevention
Osteoporosis is best prevented through good nutrition and regular exercise. It’s vital to get enough protein, calcium, and vitamin D. Protein is considered the building block of bones. If your diet doesn’t have an appropriate amount throughout your life, it can impact the density of your bones as you age. Also, as you age, you need more calcium in your diet. Your body’s needs increase from 1000 milligrams a day to 1200 milligrams a day for women over 50 and men over 70. Besides low-fat dairy products, some other sources of calcium include dark green leafy vegetables, canned salmon/sardines with bones, soy products (tofu), and calcium-fortified foods (cereals and orange juice). Vitamin D plays an essential role in your body’s ability to absorb calcium. Most people get an adequate amount of vitamin D from sunlight. If you are housebound or use sunscreen/avoid sun exposure due to the risk of skin cancer, you may need to take a vitamin D supplement.
Exercise is vital to good bone health. By combining strength training with weight-bearing and balance exercises, you will help your body build strong bones and slow the rate of bone loss. Strength training focuses on the muscles and bones in your upper body, whereas weight-bearing (walking, running, stair climbing) focuses on your lower body. Balance exercises (tai chi, yoga) help decrease your risk of falling as you age. Good nutrition and exercise also help you maintain an appropriate weight, which is critical since being underweight has been proven to raise the risk of osteoporosis. Also, don’t smoke and drink alcohol sparingly, as these decrease your bone density.
Unfortunately, we don’t think about osteoporosis until we start feeling its effects. By doing what you can before and maintaining healthy habits after it’s noticeable, you’ll prevent your bone density from declining quicker. If you have any questions or concerns about osteoporosis, please speak with your doctor. If you would like more information, please visit the National Osteoporosis Foundation at https://www.nof.org/patients/