Osteoporosis – Causes, Symptoms, Treatment & Exercise – Sit and Be Fit

What is Osteoporosis?

Osteoporosis (Greek term for porous bones) is a disease of the skeleton in which bone health is compromised due to low bone density. Decreased bone mass leads to a thinning and weakening of the bone, making it brittle. In this state, the risk of fracture is greatly increased.

On a microscopic level, healthy bone looks like a sponge or honeycomb. Low bone mass of the osteoporotic bone causes gaps and holes to form between the honeycomb cells, breaking down the structural integrity.

What are the Symptoms of Osteoporosis?

Osteoporosis is called a silent disease because it does not manifest symptoms. It is not possible to evaluate your bone health based on how you feel or look. Often, one finds out they have osteoporosis when a bone breaks. According to the U.S. Department of Health and Human Services Osteoporosis Workgroup, 10 million people in the United States, age 50 and over, have osteoporosis with an additional 43 million people reported with low bone mass putting them at risk for developing the condition. Frequent bone fractures or fractures that occur under conditions that healthy bones could withstand are potential symptoms. The Mayo Clinic adds these additional warning signs: stooped posture, back pain caused by collapsed vertebrae, loss of height over time.

What Causes Osteoporosis?

Some bone loss is normal with advancing age, but if inadequate bone was developed during youth, or if bone loss is excessive, osteoporosis results. Bone is made up of living tissues that are constantly breaking down (via bone cells called osteoclasts) and building itself up (by way of bone cells called osteoblasts). When the rebuilding is no longer keeping up with the tearing down process the bone becomes thin. Causes of bone loss are varied. See the risk factors below.

Osteoporosis Risk Factors

Because osteoporosis exists without symptoms, you can have the disease and not know it. An awareness of risk factors will help determine if you are in jeopardy of developing the disease. Risk factors for osteoporosis include; family history of osteoporosis, female gender, increased age, low testosterone levels in men, low estrogen levels in women, low weight, history of prior fracture, excessive thyroid hormone therapy, Caucasian descent, inactive lifestyle, medical history of malabsorbtion, late onset of menstruation, inadequate Vitamin D, low calcium intake, excessive use of alcohol, early menopause, excessive caffeine use and cigarette smoking.

Certain medications such as steroids, Heparin and proton pump inhibitors as well as health conditions including cancer, liver disease and thyroid disease, can also contribute to the onset of osteoporosis. For a more complete list of medications and health conditions that put you at risk for developing osteoporosis, visit the Bone Health and Osteoporosis Foundation website at bonehealthandosteoporosis.org/patients/what-is-osteoporosis.

Osteoporosis Diagnosis and Treatment

If you think you might be at risk for osteoporosis, check with your doctor. Your doctor may refer you to an endrocrinologist who can prescribe a special low dose x-ray bone density test to called a DEXA scan to examine bone tissue and determine if you have low bone density. It is a simple test and takes only a few minutes to complete. The National Institute of Health recommends women age 65 and older and men age 70 and older be screened for osteoporosis. All post-metapausal women over the age of 50, with risk factors, should receive a DEXA scan to establish a baseline for their bone health.

Results of Osteoporosis

Osteoporosis often results in multiple painful and disabling fractures. Weakened bones can fracture with normal activities, such as picking up a bag of groceries or a grandchild, rolling over in bed, stepping off a curb, or even sneezing. Falls cause many osteoporotic fractures.

Fractures of the bones of the spine (vertebrae) are the most common type of osteoporotic fracture. They result in decreased height, stooped posture, limited mobility, and disabling pain. The spine curves forward, and the lower ribs may even come to rest on the pelvis. Hip fractures are the most serious and expensive type of fracture. Nearly 25% of individuals who break a hip die within one year of their injury, and approximately 25% of survivors require expensive long-term care. Other commonly fractured sites are the wrist, the ribs, and the shoulder.

Exercise and Osteoporosis Prevention

The Surgeon General’s Report posted on the National Institute of Arthritis and Musculoskeletal and Skin Diseases website states that many types of physical activity can contribute (positively) to bone health but most people aren’t active enough. Bones lose their strength if they are not used, just as muscles do. Bone tissue is living and responds to the stresses placed upon it. Therefore, an active lifestyle that stresses bone health is important throughout life.

Exercise Precautions for Osteoporosis

Not all exercises are appropriate for those who have been diagnosed with osteoporosis. Here are some exercise safety tips and precautions to follow:
• Avoid forward bending of the spine. Do not perform sit-ups, abdominal crunches, or toe touches. Forward bending of the spine increases the compressive forces on the bones of the spine and may cause fracture.
• Avoid bringing the knee up forcefully or excessively toward the chest while seated or while lying down. Osteoporotic ribs or vertebrae can be injured with this movement.
• Avoid forceful high impact movements such as stomping and pounding of the feet.

Develop an awareness of the position of your spine during exercises and everyday activities. Ask yourself, “Can I maintain a straight back with this exercise/activity, or does my spine curve forward?” A forward curved spine increases the risk of fracture as osteoporosis worsens.

If you have osteoporosis or at risk for developing the disease, emphasize weight bearing, strengthening, posture, and balance exercises.

Posture and Osteoporosis

Low bone density associated with osteoporosis puts the 33 individual bones (called vertebrae) that make up the spinal column at risk for spine fractures, also called vertebral compression fractures. This makes it especially important for those managing osteoporosis to protect the spine by maintaining good posture through a practice called neutral spine alignment.

The spine is a column of vertebrae balanced with a series of normal curves. These curves not only provide balance but also add increased strength to tolerate compressive forces imposed on the spine. Engineers have estimated that the spine is able to bear compressive forces ten times greater because of these curves (than it would be able to without the curves). The body works most efficiently when these normal curves are maintained in all positions.

When the body is properly aligned:

the weight of the body is balanced on all the vertebrae in the spinal column
muscle energy is conserved
fatigue is limited
muscles are in optimal position thereby eliminating or reducing muscle pain and decreasing the chances of certain muscles becoming tight and creating muscle imbalances
lungs are in a position to properly expand and work to capacity
balance is optimized
movement is most efficient
the vertebrae that make up the spinal column are protected