How to Reduce your Osteoporosis Risk and Stay Out of the Nursing Home

Hey Team!

I was thinking about when I first moved to Colville, and I worked as a Physical Therapist in the Garden Homes Medical Clinic basement. Working in this setting when I arrived in Colville was a fantastic experience. For example, I met some of the best healthcare providers and people I still call friends today. Sometimes I reflect on the experience I had and the relationships I shared. As I walked down memory lane… I thought about my time with Jane and Dr. Ball. Every Friday, these two wonderful people would perform Dexa Scans in one of the rooms in the lower basement. Inevitably, we would bump into each other and talk about the day's events, but also, it was an excellent opportunity for me to understand scans for osteoporosis. Many individuals have poor bone mineral density, and this scan was a great way to evaluate their risk for osteoporosis.

Thank you to Jane and Dr. Ball regarding my time learning at Garden Homes and for being so kind. This backstory is an excellent lead-in to today's topic on osteoporosis.

DO I HAVE OSTEOPOROSIS, AND IS IT CONTAGIOUS?

Osteoporosis is defined as the lack of bone mineral density over 2.5 times normal levels, meaning the density of your bones is becoming "less thick," and the incredible interwoven structure of the bone is weak. Some people would describe this as brittle. Brittle is a good word because we can easily picture the lack of density, creating an easier chance of a fracture. But what about Osteopenia? What is this? Osteopenia is similar to osteoporosis and is best described as Pre-osteoporosis. If you have lost some bone mineral density… but are not up to the 2.5 x normal… then you are in the osteopenia stage. Why is this important to know? Because this is a significant sign, you must start making steps to correct your bone mineral density immediately. Also... no, it's not contagious!

A GROWING CONCERN

People with osteoporosis can still walk, talk, enjoy the day, and live without everyone knowing about their diagnosis. Many individuals who have osteoporosis are unaffected in their lives. So why is this a concern at all? A lack of bone mineral density has led to many factors affecting mobility. For example, the most significant problem regarding osteoporosis is a fracture. Many picture a fracture occurring during a fall to the ground, a considerable concern. Still, too many times, we do not realize the postural changes occurring. For example, people with osteoporosis will develop compression fractures to the thoracic spine due to the force of gravity on these structures. Forces from gravity, lifting objects with our arms, and the poor mineral density of the vertebra bodies lead to a fracture of the vertebra itself. Essentially, the vertebrae compress on themselves. Pain begins as a consequence but also changes in posture. People with compression fractures lose height and start to slump forward due to the altered anatomy of the vertebra… preventing standing erect.

5 CAUSES OF OSTEOPOROSIS

Fractures are a significant concern for individuals as they age. We examined "5 Reasons You Will Be Placed in a Nursing Home" a few weeks back, and one of the primary reasons is a fall at home. But falling is not the most significant concern… but the fracture occurring from a fall. Sometimes, however, osteoporosis is so substantial a person will fracture a hip and then fall as a result. Let's look at some causes of osteoporosis.

#1. Age: Our bones are in a constant state of renewal. New bone is created, and old bone is recycled. Up to the age of 20, our bones are cycling at a rate of building new bone faster than the body replaces old bone; essentially, we are developing greater bone density. In our 30's, this begins to slow down, and as we age, we will start to lose bone faster than what the body can replace.

#2. Hormones: A decrease in estrogen in women and testosterone in men will accelerate the rate of bone loss overall. Estrogen levels are decreased dramatically after menopause in women. Men tend to experience a gradual decline in testosterone after age 45, with a dramatic drop-off after age 55.

#3. Diet: People need calcium to develop bone. A diet severely lacking calcium will create challenges in maintaining bone density. Also, individuals with eating disorders or severely restricting nutrients will lack the development of new bone.

#4. Medications: Certain medications, such as long-term steroid use, will disrupt bone mineral density formation. Steroid drugs such as cortisone or prednisone will interfere with the bone formation process.

#5. Lifestyle factors: As we create more of a demand on our bodies from the force of gravity, or the activity we perform, our bones will increase or decrease the amount of bone density to meet this demand. Our activity significantly affects our bone mineral density overall. If we perform a more weight-bearing activity, the body will stimulate the bone to create more density, but the opposite is true. If we spend a great deal of time in a sedentary position… bone density will ultimately shrink.

Ok Team, what do we know? We know we want to stay in our homes and not be temporarily or permanently placed in a nursing home (reference the previous article on why). We know bone mineral density directly correlates to how easily our bones will break. If we can prevent some of the causes of osteoporosis, reduce our risk of falling and be aware of our surroundings… we have a great chance of living without limitations. Remember, our posture can be affected by compression fractures in the mid-back. Prevention of osteoporosis is essential to allow us to keep our independence as we age. Thanks again Team, for reading and also for reaching out.

I look forward to your emails or calls. Keep Moving!

• The author, Rob Sumner, is a Doctor of Physical Therapy and owner of Sumner Specialized Physical Therapy. He's happy to answer any questions about this article, wellness, fitness, or physical therapy overall by phone at (509) 684-5621 or by email at Rob@SumnerPT.com