Inside osteoporosis
2009
Osteoporosis is a very common condition and can be one of the underlying conditions that lead to back pain.
Our colleagues at the National Osteoporosis Society have kindly offered to explain this condition to us and give some tips on what you can do to fight off osteoporosis.
Almost one in two women and one in five men will break a bone, mainly due to osteoporosis, but what exactly is the condition and what effect can it have on the day to day lives of those living with it?
Case study
 After a year of pain, Pat Chalk was eventually diagnosed with osteoporosis 14 years ago. She was originally diagnosed with acute rheumatoid arthritis in 1993 and began taking steroids to treat the condition. Doctors initially believed her incredible pain was due to the rheumatoid arthritis but, after physiotherapy and hydrotherapy did not seem to help, she was sent for an x-ray of her spine.
The x-ray showed three severely affected vertebrae and, as a result of pain from the fractures and her arthritis, Pat was forced to use a wheelchair for three years. Pat believes that her osteoporosis has probably been caused by an early menopause; however, her sister has just been diagnosed with osteoporosis at 63. She also has rheumatoid arthritis and has been taking steroids to treat it for the past three years, although she doesn’t take them now. Pat believes that they may have been the cause of her sister’s osteoporosis. “I had an early menopause at 39 and began missing periods when I was 32,” Pat says. “I began to notice something wasn’t right when my waist line was getting nearer to my hips. My body shape had lost definition, I had no waist. I also lost six inches in height and gone from being five foot three inches to four foot nine.” As her condition got worse, it began to affect every area of her life – leading eventually to early retirement from her job as a nurse. In terms of treatment for her osteoporosis, Pat was initially prescribed hormone replacement therapy (HRT), a treatment she took for four years until her specialist advised her to try something different. Although she says she has been “through every type of treatment for osteoporosis” Pat has settled on a combination approach and currently takes risendronate and calcium supplements along with a combination of 13 different types of medication to treat her rheumatoid arthritis. Pat says she also does her best to have a diet high in calcium, but finds exercise demanding due to the pain from her rheumatoid arthritis and osteoporosis. “I find exercise difficult,” she says, “even walking half a mile to the shops is a struggle.” |
Pat’s story is a fairly typical one and goes a long way to highlight the problems caused by the condition.
What is osteoporosis?
The bones in our skeleton are made of a thick outer shell and a strong inner mesh which looks like honeycomb made up of bony struts. Osteoporosis means some of these struts become thin or break, making the bone more fragile and prone to fracture.
Bone loss occurs naturally in everyone as they get older but broken bones because of osteoporosis are not an inevitable part of ageing and there is much that can be done to prevent and treat them.
Both men and women have an increased risk of osteoporosis if they have low body weight (women who are under weight or have developed an eating disorder); drink excessive amounts of alcohol; smoke heavily or take high dose of corticosteroid tablets (taken for conditions such as asthma and arthritis). They are also at risk if they have a family history of osteoporosis or have a medical condition which affects the absorption of foods such as Crohn’s disease and coeliac disease.
If you think you are at risk then you need to discuss it further with your GP. The GP will assess your medical history, including whether you have broken any bones or lost height, and may decide to send you for a special bone scan to measure your bone density.
If you have already broken a bone after a minor bump or fall you may already have osteoporosis. Other warning signs include height loss and kyphosis (curvature of the spine).
Dual Energy X-ray Absorptiometry (DXA) scans measure the density of bones. This test is currently the most accurate and reliable way to find out the strength of bones and your risk of breaking a bone. It is a simple, painless procedure that uses very low doses of radiation. You will be asked to lie down for 10-15 minutes while an x-ray arm passes over you to take an image of your hip or spine. These scanners are usually in hospitals and not all hospitals have one, which can mean long waiting times.
Prevention
The good news is there is a lot you can do to try to build and maintain a strong skeleton that will help to prevent osteoporosis.
Calcium
Adults should aim to eat 700mg of calcium every day. Calcium is the most abundant mineral found in bones and helps to give them strength and rigidity. Excellent sources of calcium are milk and dairy products including the low fat varieties.
You can also find calcium in a wide range of other foods such as
- green leafy vegetables (watercress, okra)
- dried fruit (dried figs, apricots and currants; five figs provide 250mg of calcium)
- tinned fish like tinned salmon, sardines, pilchards (provided you eat the bones)
- tofu (a type of vegetable protein made from soya beans)
- fried whitebait, sesame seeds and tahini are all high in calcium
Vitamin D
You also need vitamin D to help your body absorb calcium. The best source is sunlight. About 15-20 minutes of sun exposure to the face and arms every day between May and October should provide you with enough vitamin D throughout the year, but be careful not to allow your skin to burn.
Weight-bearing exercise
Bone is a living tissue and needs to be exercised just like muscle. Your skeleton grows stronger if you do weight-bearing exercise. This is any kind of physical activity where you are supporting the weight of your own body such as
- jogging
- dancing
- aerobics
- tennis
- squash
- badminton
- netball
- volleyball
- football
- skipping
- brisk walking
- running up and down the stairs
Try to exercise at least three times a week for a minimum of 20 minutes.
If you have experienced a fracture due to osteoporosis you should always consult your GP before starting any new exercise.
You can also help your bones by giving up smoking and watching how much alcohol you drink. You should aim not to exceed the government’s recommended limit. It is always good to have alcohol free days.
The National Osteoporosis Society is the only UK wide charity dedicated to improving the prevention, diagnosis, and treatment of osteoporosis. The charity provides a wide range of services to help people learn how to prevent osteoporosis or to manage living with the disease and the fractures it causes.
If you would like to find out more about joining the National Osteoprosis Society for just £15, please call us on 01761 473119. Our members play a key part in the charity, supporting our efforts to improve treatment and adding their voice to our countrywide campaign. If you would like to make a donation call us today on 01761 471771.
For osteoporosis information and support, please call our Helpline on 0845 450 0230. Our Helpline service is open every weekday between 9 am and 5 pm and is staffed by a team of nurses who have specialist knowledge of osteoporosis. You can also visit our website at www.nos.org.uk