From the Scriptures

" Give thanks to the Lord for He is good:
for His mercy endures for ever."

Psalms 136:1

What is Osteoporosis?
Osteoporosis is a skeletal disease in which bones become thinner and more porous, and more prone to fracture. Osteoporotic fractures most commonly occur in the hip, spine, and wrist. The disease is usually painless until a bone breaks or fractures. In order to diagnose osteoporosis, a person's bone density, or bone mineral content, must be measured.
Bones provide the strength and support people need to move. They also store calcium, magnesium, phosphorus and other substances that are important for the body's health. Throughout our lives, the cells in our bones constantly break down old bone mass and build new bone to replace it. As we age, however, the body's ability to rebuild bone lessens, which can lead to increased risk for fracture in older adults. In early middle age, our bones naturally become thinner. This happens in both men and women, and continues throughout the rest of life. During menopause, the sudden loss of the female hormone estrogen increases the rate at which a woman's bones thin. As men age, decreased hormone levels can also cause bone thinning. Moderate thinning of the bones is called "osteopenia," and thinning that is severe enough to raise the risk of fracture is called "osteoporosis."

Who is affected?
Osteoporosis is very common among older women. It is estimated that 9.4 million women in the United States have osteoporosis. Another 16.8 million women have a bone density that is below normal. Although advanced age is a well-known risk factor for both men and women, the disease is far more prevalent in post-menopausal women due to the loss of the hormone estrogen. Other risk factors for women include an early or premature menopause, either naturally or by surgical removal of the ovaries, with no hormone replacement therapy; exercising so strenuously that one's menstrual period stops; having a small body frame; excessive use of alcohol; cigarette smoking; low dietary intake of calcium; and a high dietary intake of protein. For men, low levels of the male hormone testosterone increase risk. More often, however, the cause of osteoporosis in men is chronic alcoholism. Certain medications, such as glucocorticoids (e.g., prednisone), heparin, and phenytoin (Dilantin©); primary hyperparathyroidism; and a positive family history also increase the risk for osteoporosis in both men and women.

How can it be diagnosed?
For persons with no obvious signs of osteoporosis, the only way to diagnosis the disease is to measure one's bone density using bone densitometry. This is a simple test, much like an x-ray, which uses a very low dose of radiation to measure bone density in the spine, hip, wrist, or heel. The test may also need to be repeated every two to four years, particularly if the patient is taking medications that can increase bone density.

How can Osteoporosis be prevented?
Risk for developing osteoporosis can be reduced by doing weight bearing exercise such as walking, jogging, weight lifting or playing a sport such as tennis; and making sure the patient gets enough calcium and vitamin D through diet and supplements. Postmenopausal women should consume 1,200 mg of calcium each day. Persons 51 to 70 years should consume 400 IU of vitamin D daily, and those 71 and older should consume 600 IU daily. Hormone replacement therapy such as estrogen or other medications designed to prevent bone loss are also effective ways to reduce the risk of osteoporosis in postmenopausal women. Several medications are available that can either maintain or even increase bone density when taken in combination with calcium and vitamin D. These medications include hormone therapies such as conjugated estrogens or the combination estrogen/progesterone pill, which can be taken as a nasal spray or by subcutaneous injection. However, before starting these therapies it is important to consult your family physician. Stopping smoking improves bone health, in addition to many other benefits to the body and overall health. It is also important to remove hazards in the home that might cause the patient to trip and fall, and possibly fracture a bone.

How does Physiotherapy help?
The physiotherapist may prescribe an exercise routine which will include weight bearing activities for the lower limbs such as walking, jogging, running or any sport. Weight training using small weights for the upper limbs is invaluable in maintaining bone health. Brisk walking and other weight bearing exercises not only slow down bone thinning, but also may lower the risk for a fracture because exercise also improves balance and muscle strength. Other measures can be taken to prevent fractures or falls including gait and strength training to improve balance, and learning new ways to safely perform everyday activities.