Understanding Osteoporosis Causes, Risk Factors and Treatment Options

 

Osteoporosis is a bone condition that affects millions of individuals worldwide. In the UK alone it is estimated to affect 3.5 million people. Often referred to as the "silent disease," it progresses without symptoms until a fracture occurs. Fractures associated with osteoporosis can have serious consequences, affecting mobility and overall quality of life. In this blog post, we'll explore the causes, risk factors, and available treatments for osteoporosis, helping you to understand how you can take proactive steps to maintain bone health.

Causes of Osteoporosis:

Osteoporosis arises from an imbalance in the natural bone remodelling process. The human skeleton is in a constant state of renewal, with old bone being continually replaced by new. When the creation of new bone lags behind the removal of old bone, bones become porous and more prone to fractures. The term "osteoporosis" literally translates to "porous bones”, meaning they are fragile and more susceptible to fractures, particularly in the spine, hip, and wrist.

It's important here to distinguish between osteoporosis and osteopenia. Osteopenia is also a condition characterised by lower than normal bone mineral density, however osteopenia is considered a precursor to osteoporosis. With Osteopenia, an individual’s bones are not as dense as those with normal bone density but are not yet at the level of significant bone loss seen in osteoporosis. The good news here is that early detection and the right intervention during the osteopenic stage can be crucial in preventing the progression to osteoporosis and reducing the risk of fractures.

Common Risk Factors:

Several factors contribute to the development of osteoporosis. Understanding them is crucial for early detection and proactive management:

• Age: Bone density tends to decrease with age, making older adults more susceptible to osteoporosis.

• Gender: Women, particularly postmenopausal women, are at a higher risk due to the decline in oestrogen levels. Women lose up to 20% of their bone density in the 5-7 years following menopause.

• Family History: A family history of osteoporosis increases the likelihood of developing the condition.

• Hormonal Changes: Conditions leading to hormonal imbalances, such as menopause or certain medical treatments, can contribute to bone loss.

• Low Body Weight: Individuals with a small body frame or low body weight may have less bone mass, increasing their risk.

• Dietary Factors: Inadequate intake of calcium and vitamin D, essential for bone health, can contribute to osteoporosis.

• Sedentary Lifestyle: Lack of weight-bearing exercise can lead to weaker bones over time. What we do when we are young really matters as your bone health reaches its peak at around age 25.

• Certain Medications: Long-term use of medications like corticosteroids and some anticonvulsants can increase the risk.

• Medical Conditions: Conditions such as rheumatoid arthritis, celiac disease, and hormonal disorders can contribute to bone loss.

Diagnosing Osteoporosis:

The diagnosis of osteoporosis involves assessing bone density and evaluating the risk of fractures.  A DEXA is the most widely used and accurate method for measuring bone density. It uses low-dose X-rays to assess the amount of mineral in bone, usually at the hip and spine. The machine measures the amount of X-rays that pass through the bones, providing a Bone Measurement Density (BMD) score. The BMD score is reported as a T-score, which compares the patient's bone density to that of a healthy young adult of the same gender. A T-score of -1.0 or higher is considered normal, while scores between -1.0 and -2.5 indicate osteopenia (low bone density), and scores of -2.5 or lower suggest osteoporosis.

Treatment Options:

While osteoporosis cannot be cured, several treatment options aim to slow down bone loss, reduce fracture risk, and enhance overall bone health:

• Medications: Bisphosphonates, hormone therapy, and other medications can be prescribed to help maintain bone density.

• Calcium and Vitamin D Supplements: Ensuring an adequate intake of calcium and vitamin D is crucial for bone health.

• Weight-Bearing Exercise: Regular physical activity, especially weight-bearing exercises like walking, jogging, and strength training, helps maintain bone density.

• Balanced Diet: A diet rich in calcium, vitamin D, and other essential nutrients supports bone health.

• Lifestyle Modifications: Avoiding smoking and excessive alcohol consumption is beneficial for bone health.

• Fall Prevention Measures: Taking precautions to prevent falls, such as maintaining a clutter-free environment and improving home safety, can reduce the risk of fractures.

How Can Physiotherapy Help?

Physiotherapy plays a valuable role in the management and prevention of osteoporosis. While it cannot cure osteoporosis, it can help improve bone health, enhance overall strength and flexibility, and reduce the risk of falls and fractures. Here are several ways in which physiotherapy can be beneficial for individuals with osteoporosis:

Weight-Bearing and Resistance Exercises: Physiotherapists design exercise programs that include weight-bearing activities (such as marching, jogging or and dancing) and resistance exercises (using bands or light weights). These exercises help stimulate bone formation and increase bone density.

​Balance and Stability Training: Focus on exercises that improve balance and stability to reduce the risk of falls. This includes activities like standing on one leg, heel-to-toe walking, and specific balance exercises.

​Posture Correction: A physio can assess and address poor posture, which is common in individuals with osteoporosis. Proper posture can help prevent vertebral compression fractures and improve overall spinal health.

​Core Strengthening: Strengthening the core muscles helps support the spine and maintain stability. Physio programs often include exercises to strengthen the abdominal and back muscles, contributing to better posture and reduced strain on the spine.

​Fall Prevention Strategies: A Physio can assess the risk of falls and implement strategies to minimise that risk. This may include home safety assessments, education on fall prevention techniques, and specific exercises to improve reaction time and coordination.

​Pain Management: People suffering from osteoporosis may experience pain, especially if they have suffered fractures. A Physio can provide pain management strategies, including gentle exercises, stretching, and manual therapy techniques to alleviate discomfort.

​Education and Lifestyle Guidance: Educating individuals about lifestyle modifications that can positively impact bone health, such as maintaining a healthy diet rich in calcium and vitamin D, avoiding smoking and excessive alcohol consumption, and engaging in regular weight-bearing exercises.

​Adaptations for Daily Activities: A Physio can also recommend modifications to daily activities to reduce the risk of injury. This may include techniques for safe bending, lifting, and reaching, as well as suggestions for appropriate footwear.

It's important for individuals with osteoporosis to consult with their healthcare team, including a physiotherapist, to develop a personalised plan tailored to their specific needs and condition. This collaborative approach helps optimize bone health, reduce the risk of fractures, and enhance overall well-being.

Balanced can help! 

At Balanced, our new Osteoporosis screening assessments are for anyone who has already been diagnosed with Osetoporosis or Osteopenia or those who are at risk of developing these conditions due to their family history, medical conditions, or being post-menopause.

Led by our physio, Enya, the sessions will include FRAX assessment, a questionnaire that uses information about your bone density and other risk factors to determine your risk of sustaining a fracture in the next 10 years. The appointment will also include a tailored home exercise programme and advice on improving your bone density. For those who wish a more detailed assessment, we can also refer you to a Radiologist for a DEXA bone density scan.

Enya is also running osteoporosis-specific exercise classes, which are a combination of impact and resistance training designed to improve and maintain bone density. The classes are small group and suitable for those who are at higher risk of low bone density or have been diagnosed with Osteopenia or Osteoporosis. You should take part in the physio screening before participating to make sure the class is tailored to your needs and capabilities.

Get in touch to find out more! Contact us on info@balancededinburgh.co.uk or call on 0131 315 3105.