Osteoporosis and Your Bone Health

Chiropractic helps active seniors

When you hear the word osteoporosis, do you think of your hunched over grandma who broke a hip from missing a step?

If so, you already have an idea of what osteoporosis may look like. Although normal aging can cause bones to weaken, there are things you can do to reduce your chances of getting osteoporosis and things you can do to reduce the risks if you already have osteoporosis.

What is osteoporosis?

What is osteoporosis
BruceBlaus, CC BY-SA 4.0, via Wikimedia Commons
Our bones are constantly breaking down old bone and building new bone. As children, we are growing lots of bone tissue, which is why kids have growing pains and outgrow their shoes and clothes so quickly. By ages 25-30, we eventually reach peak bone mass. As we continue to age, the cycle of breaking down old bone and building new bone continues, but at a slower rate and we gradually lose bone density. Around age 50, the rate of bone density loss speeds up and continues on a downward trend. If this bone density loss is too much and too fast, then your bones become weak and brittle. Osteoporosis is the term for this bone disease that causes weak, brittle bones and results in higher risk for fracture.

Who Can Get Osteoporosis?

Osteoporosis can happen to anyone, even some kids, but usually occurs after age 50. There are some risk factors for osteoporosis that you can change and some that you cannot change.
Age and Bone Mass
Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013., CC BY 3.0, via Wikimedia Commons


Risks That You CANNOT Change:
  • Age: It’s all downhill after age 30 for bone density. Between 30-50’s, bone remodeling slows. Between the ages of 50-70’s, rapid bone loss occurs. After age 70, bone loss continues and risk for fractures increases.
  • Women: Women are twice as likely to develop osteoporosis than men. Because hormones affect bone growth, menopause is a chief culprit for osteoporosis in women due to the reduced estrogen. Women also tend to have smaller frames, which mean smaller bones. Bigger bones are stronger bones.
  • Race & Ethnicity: White women are the most likely to have osteoporosis than any other group. Asain and Hispanics groups are also at greater risk. Black people have the lowest risk.
  • Genetics & Family History: Your DNA determines so much of what makes you you. If your parent had a hip fracture due to osteoporosis, then you are more likely to break a bone yourself.
Risks That You CAN Change:
  • Lower Body Weight: Your bones are the frame of your body and have to support your body weight. The more you weigh, the stronger your bones need to be and the bones will accommodate by becoming denser and stronger. Regardless if the extra weight you are carrying around is in the form of muscle or fat, your bones will still be stronger.
  • Smoking: Smoking reduces blood supply to bones, slows bone forming cells, decreases the body’s ability to absorb calcium and affects hormone balance.
  • Chronic Heavy Drinking: Heavy alcohol consumption guidelines vary, but according to NIAAA drinking more than 4 drinks a day for men, and more than 3 drinks a day for women is considered heavy drinking. It is not fully understood how alcohol affects bone health, but it is clear that chronic heavy drinking compromises bone health and increases risk for osteoporosis.
  • Drinking Cola: Studies have shown that drinking 3 or more cola or diet cola soft drinks a day can lower your bone density, which increases your risk for hip fracture. Cola drinks include Coca-Cola, Diet Coke, Pepsi, Diet Pepsi, RC Cola, etc. There is not a correlation between other carbonated drinks like seltzer water, Dr. Pepper, Sprite or Mountain Dew.
  • Nutrition: Calcium, vitamin D and magnesium are key nutrients for bone health. The best source for these nutrients is in foods that naturally have them or in foods fortified with these nutrients. Several foods like dairy, green leafy vegetables, seafood and nuts are great sources for these nutrients. Supplements like calcium citrate and vitamin D3 can be taken to fill in any gaps with these nutrients. Note: Our daily requirements for calcium increases as we get older.
  • Exercise: Weight-bearing exercise and resistance exercises are vital for strong bones and strong muscles. Higher impact activities like jogging or jumping make our bones stronger. If you already have osteoporosis, modifying high impact exercises is important to avoid worsening weak bones, but there are still exercises that can be done safely and to boost your bone strength. Having strong muscles are also important for strength, balance and fall prevention.

Risks of Osteoporosis

The biggest risk if you have osteoporosis is fracture or broken bones. According to recent statistics from the International Osteoporosis Foundation, worldwide, 1 in 3 women over the age of 50 years and 1 in 5 men will experience osteoporotic fractures in their lifetime. The most common areas of osteoporotic fractures are the forearm (80%), the lower arm bone called the humerus (75%), hip (70%) and spine (58%). One you have had one osteoporotic fracture, your likelihood of another fracture increases. With every fracture you increase your likelihood of having chronic pain, disability or even death. Because of these potentially serious complications, it is important to prevent further bone weakening and to have a fall prevention plan.

Preventing Osteoporosis

Creating strong bones starts when we are kids and continues as we grow older. The two most important components that you can affect are nutrition and exercise. Even if you already have osteoporosis, you can still help your bones with proper nutrition and exercise.

Nutrition

Our requirements for bone health nutrients like calcium, magnesium and vitamin D change during our lives. In general, as adults we need 1000-1200mg/day of calcium, 310-420mg/day for magnesium and at least 600 IU/day of vitamin D.

Exercise

Exercise is important to strengthen bones and keep our muscles strong. High impact exercise stresses our bones, which in turn makes them put down more bone. Exercise is also key in preventing falls.

DEXA Scan

A DEXA scan is a specialized imaging test that measures your bone density. These scans are the best way to determine your risk for osteoporosis and are recommended to have your first scan at age 65 for women and age 70 for men if no other risk factors.

Medication

Bone building medications like Reclast and Fosamax work to either slow the rate of bone breaking down or some speed up the rate of bone growth.

Chiropractic Care and Exercises for Osteoporosis Patients

If you are at a high risk for osteoporosis or are already diagnosed with osteoporosis, preventing fractures is vital.

Chiropractic

Traditional chiropractic care involves the doctor adjusting with her hands. In an osteoporotic patient, this manual adjustment may be too intense and result in unintended fractures. But do not fret, you can still get the benefits of chiropractic care with different techniques. Instrument chiropractic adjustments with the Arthrostim are very effective and much gentler than traditional chiropractic treatments. Low-velocity mobilization of the joints and soft tissue mobilization can also be beneficial.

Exercises

The goal of an osteoporosis exercise program is to maintain strength and stability in order to reduce fall risk. Your exercise program should consist of two components: weight-bearing aerobic exercises and strength and resistance exercises. Weight-bearing aerobic exercises like walking, stair climbing, jogging and Tai Chi are great for general health maintenance and can be helpful with bone density. Strength and resistance exercises are used to promote bone density increase, strengthen muscles and help with balance.

Fall Prevention

Since tripping and falling is the number one way to end up with an osteoporotic fracture, working on balance and proprioception is essential. Proprioception is your body’s ability to determine where it is in the world (think your body’s own GPS) and most of these receptors are in your muscles, tendons and joints. Chiropractic and exercise work well together to promote good proprioception by stimulating these receptors. Reducing your chances of tripping are equally important – Wear well-fitting shoes that have good tread, use handrails, keep clutter off the floors, have good lighting, be cautious of medications and alcohol that may make you woozy, disoriented or dizzy, and use more caution in adverse weather like rain or ice.