Osteoporosis is a condition which affects bone strength and increases the sufferer’s risk of sustaining a fracture (broken bone). In osteoporosis bone strength decreases due to a reduction in bone mass. Bone tissue in our body is always being reabsorbed and at the same time new bone is being laid down. In osteoporosis, bone reabsorption is greater than bone formation, resulting in bone loss. Depletion of calcium is a key factor, as when calcium levels decrease, the rate of bone reabsorption increases. Vitamin D is also important as it is required for calcium absorption into the body.
Osteoporosis may be classed as either primary or secondary. Primary osteoporosis may occur at any age in either sex, however often occurs later in life and following menopause in women. This occurs because oestrogen levels decrease following menopause, causing bone reabsorption to exceed bone formation. Women are more likely to suffer from osteoporosis than men because their bones are generally smaller. Secondary osteoporosis is caused by medications (e.g. corticosteroids), diseases (e.g. celiac disease) or other medical conditions. Other factors which increase the chances of developing osteoporosis are smoking and excessive alcohol intake.
Osteoporosis is a very common condition, in Australia 30-50% of women and 15-30% of men will sustain a fracture due to osteoporosis during their lifetime. It is a largely preventable disorder, so important to improve and optimise bone health throughout our lives to avoid this.
Signs and symptoms
It is often not until someone has suffered a fracture that they find out that they have osteoporosis. Symptoms following a fracture can be quite severe. Vertebral fractures in particular can cause chronic and disabling pain.
Prevention of osteoporosis is ideal, rather than treating the condition once it has developed. The way to prevent osteoporosis is to gain the highest bone mass possible when young, and then to reduce the rate at which bone mass is lost in later life. A greater bone mass protects against osteoporosis as the person can withstand some loss of bone mass before it severely affects bone strength. There is strong evidence supporting exercise and physical activity for increasing peak bone mass. Exercise should involve weight-bearing activities and resistance training.
Physical activity is required to maintain bone mass. In later life, adequate intake of calcium and vitamin D as well as exercise can work to slow the decline in bone mass. Exercise needs to be of moderate impact in order to assist in reducing the rate of loss of bone mass. Recently, the benefits of exercise have been suggested to reduce the incidence of fracture by up to 50%. Regular exercise can increase muscle mass and strength, improve function, increase independence, improve quality of life, improve balance and significantly reduce the risk of falls. As falls are the major mechanism for causing osteoporotic fractures, reducing the risk of them occurring is extremely beneficial. Physiotherapists are aware of the pathology behind osteoporosis and are trained in exercise prescription. Thus, Physiotherapists can tailor a safe and specific exercise program to the individual to work towards achieving these positive outcomes. Some Physiotherapy clinics have specific exercise classes for the older population to participate in which include all the elements needed to achieve the aforementioned outcomes. Physiotherapists are also able to assist patients in areas such as pain management, mobility, and injury assessment and treatment.
For more information, see your LifeCare practitioner.
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