Bones, mostly made of collagen and calcium, provide a rigid framework that protects soft organs (kidneys, liver, lungs and spleen) and protects the body. Just like any other body part, bones are living tissue, offering strength and stability.
Certain conditions, however, can affect bone strength and flexibility, resulting in health complications. These include osteopenia and osteoporosis. According to the Bone Health and Osteoporosis Foundation, 54 million Americans have osteoporosis. Women are more likely than men to develop bone disease.
- Osteopenia is a decrease in bone mineral density (a measure of how dense and strong bones are) belo a normal level, but not low enough for a diagnosis of osteoporosis. This condition can be a precursor to osteoporosis.
- Osteoporosis is a decrease in bone mass and mineral density. The condition affects people of all ethnic groups, rises with age, and increases the risk of fracture.
Bone density determines which condition a patient has. Measured by a T-score, -1—2.5 indicates osteopenia, with a score lower than –2.5 as osteoporosis. Osteoporosis is also diagnosed with a fracture. So, one can have a normal bone density but a fracture is a red flag that something else is going on.
Symptoms and diagnosis of bone disease
“Osteoporosis is silent until a person breaks a bone. That is often the first indication that someone has osteoporosis, unless they are appropriately screened,” said Jeannee “Jae” Sanders, APRN, FNP-C, CCD, Orthopedics with CommonSpirit Health. “A DXA scan is the gold standard. Importantly, the tech and provider should be ISCD (International Society of Clinical Densitometry) certified, and patients should always have a spine x-ray or lateral vertebral assessment as part of the DXA as well.”
Sanders has the ability to measure Trabecular Bone Score, a measurement of the microarchitecture of the bone, on iDXA by GE.
Osteopenia and osteoporosis can be caused by the normal aging process (especially after menopause), family history, low calcium and/or Vitamin D, a sedentary lifestyle, lack of weight-bearing exercise, heavy smoking or alcohol use, thyroid disease, diabetes, autoimmune disorders, long-term steroid use and more.
Early detection is important to slow or stop progression of bone disease. Over time, weakening bones can cause height loss, a bent-over posture or curved upper back, back pain, or fracture (often in the hips or spine).
The first line of defense: Diet and exercise
It is important to get the right nutrients to keep bone disease at bay. Calcium rich foods include dairy products, sardines, and leafy greens. Protein can help build strong bones; poultry, fish, lean meats and legumes are good sources.
You may have heard the phrase, “move it or lose it,” and this is especially true for bone health. Weight-bearing exercises, like walking, jogging, running, and lifting small weights can have a positive impact for those with bone diseases. At least 30 minutes of weight-bearing exercise most days of the week is recommended. Additionally, aerobic and balance exercises may help reduce the risk of falling. Yoga, tai chi and Pilates are good lower-impact activities. Be sure to speak with your doctor before starting a new exercise routine!
Sometimes diet and exercise may not be enough, and medication may be prescribed. Lifestyle changes that can benefit patients include:
- Limiting salt and caffeine
- Quitting smoking
- Reducing alcohol use
- Using corticosteroids, and anticonvulsants sparingly, if possible
Sanders wants you to know that bones are always changing, growing and reshaping themselves, so know that osteopenia and osteoporosis can be reversed — with time and treatment.
Reduce your risk of fracture
- Loose carpets or items on the floor at home can be fall hazards.
- If you have corrective lenses, be sure to wear your glasses to prevent tripping.
- Minimize the impact on weakened bones with soft furniture, bedding and floors.
- Apply nonskid decals or tape to the floor of your shower or bathtub, along with grab bars.
Medical intervention
“Screening for bone disease should start at age 50, or earlier if indicated by medical history. All patients who have had a fracture should have a screening DXA and evaluation,” said Sanders. “Ask about Vitamin D levels, dietary support, types of exercises that are important and fall prevention.”
To learn more and schedule a screening, contact Anna Brown, RN, Bone Health Navigator and Fracture Liaison Service Coordinator at CommonSpirit Orthopedics and Bone Health at 719-776-2663 (BONE).
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