Scary Skeletons: Osteoporosis

1.  What is osteoporosis?
Osteoporosis is a term many people are familiar with – it’s when one’s bones become weak and brittle from losing too much bone (becoming too “porous” – hence the term osteoporosis), or from making too little bone. It is dangerous because weak bones are more susceptible to breaking from falls, bumps, and accidents. Also, it can affect vertebrae and lead to hunched posture, often resulting in pain. Osteoporosis is especially prevalent in women and older populations.

There are MANY causes of osteoporosis, and it can occur in conjunction with dozens of different medical conditions and medications. This is an important conversation to have with your primary care physician to see if you are putting your bone health at risk.

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2.  How is it treated, and how is it prevented?

Half of women over 50 who have osteoporosis will break a bone. If you know you do have osteoporosis, is your condition hopeless or is there something you can do to take care of your bones?

Osteoporosis cannot be “cured”, but there are measures one can take to treat it. Doctors sometimes prescribe medications (bisphosphonates, prolia, forteo, estrogen-like drugs, fortical, and more) that work either by preventing the breaking down of bone or by increasing the building of bone, but all come with side effects. Depending on the severity of your osteoporosis, a medication treatment may be worth discussing with your doctor. Each person is unique, and a different treatment may work better for one person than another

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Nutrition is another key component of treating (and preventing) osteoporosis! Calcium is the “building block of bone”, and your body needs vitamin D to help absorb the calcium. Daily multi-vitamins are one way to ensure you’re getting enough calcium and vitamin D, but here are some foods that are calcium-rich and vitamin D-rich (and don’t forget good old sunshine!) Most adults should aim for 1000-1200 mg of calcium, and 400-1000 IU of vitamin D daily. 

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Lastly, exercise is key for keeping your bones strong. Proper and consistent exercise not only strengthen your bone density but also will strengthen the muscles and tendons that connect to and support your bones, relieving pressure from your joints. Exercise for treatment and prevention of osteoporosis should include two types of exercise: weight-bearing exercise, and muscle-strengthening exercise.
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Weight-bearing exercise puts stress on your bones - "good stress". This stress increases production of bone - increasing your bone density and mass or reducing the loss of bone mass. (If you want to learn more about how bone production and loss work check out this video on bone remodeling!) To exercise and use this "good stress" on your bones, do activities like running, walking, tennis, dancing, or anything repetitive on your feet. The impact on your bones actually makes them stronger. HOWEVER, if you suffer severe osteoporosis, you should consult your doctor about what exercises are safe for you to participate in. Running may not be the best exercise for someone with severe osteoporosis who is at a high risk of breaking a bone.

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Muscle-strengthening exercise (“resistance” exercise), should be done for the whole body. If you’re just going to do a little bit, focus on complex movements and large muscle groups. Strengthening the legs, hips, and glutes are going to give you the support you need and this lower body strength may help prevent falls! Core and upper body strengthening are also important. If you already have osteoporosis, consider adding some fall-prevention exercises to your day, like balancing on one foot.

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If you do not have osteoporosis now, remember that the best solution is prevention!

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By: Lisa Bartz, C-EP

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Sources:
National Osteoporosis Foundation: What is Osteoporosis and What Causes It? 2018;
The American Society for Bone and Mineral Research: Response to New England Journal of Medicine Study: “Biphosphonates: Where Do We Go From Here?” 2012;
Endocrine Web: The Role of Calcium and Vitamin D in Bone Health: Nutrients for Osteoporosis Prevention, P. Camacho, MD, D. Toft MD, PhD
WebMD: Osteoporosis: Diagnosis and Treatment, 2017