OSTEOPOROSIS – WHAT IS IT?

Osteoporosis is one of the most common conditions I encounter in my clinic. Osteoporosis literally mean “porous bone” and is defined as “A metabolic bone disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and a consequent increase in fracture risk”.  This condition is often overlooked and unfortunately many patients will not know they have the disease until a fracture occurs.  People at most risk for osteoporosis include women, peri-menopausal, and Caucasian. The World Health Organization (WHO) recommends routine screen for all women over 65 years old with Bone Densometry, or DEXA, Scan.  Screening may be indicated for younger women who have other risk factors.  The DEXA evaluates the density (or quality) or your bone. I recommend DEXA from at least 3 sites – usually the hip, lumbar spine, and wrist.  Results of the DEXA are reported as a T-score.  This value compares your bone density to the “peak bone mass/density” of someone who is 30 years old.  Osteoporosis is defined as a T-score of less than -2.5.  Regardless of your DEXA results, you may also be diagnosed with osteoporosis if you experience a fragility facture.  A fragility fracture is defined a fracture resulting from a low-energy mechanism, like a fall from standing height.

OSTEOPOROSIS – FRAGILITY FRACTURES

A fragility fracture is defined as a fracture caused by a low-energy mechanism, such as a fall from standing height. A person who experiences a fragility fracture is automatically diagnosed with osteoporosis, regardless of their DEXA score. People with normal bone density have bones that are strong enough to not fracture from a slip-and-fall and require much higher-energy to cause a fracture. Many times, people are unaware of their underlying osteoporosis until they experience a fragility fracture. Additionally, only 15% of fragility fractures receive treatment for underlying osteoporosis.  Fragility fractures are very common in patients over 65 years old – they are 4 times more common than stroke.  The most common sites of fragility fractures include your spine (vertebral compression fractures), hip, wrist, and shoulder. Prior fragility fracture increases your risk for subsequent fracture by 50%.

OSTEOPOROSIS – TREATMENT

Osteoporosis is often overlooked and unfortunately many patients will not know they have the disease until a fracture occurs. People at most risk for osteoporosis include women, peri-menopausal, and Caucasian.  Many times, people are unaware of their underlying osteoporosis until they experience a fragility fracture.  Additionally, only 15% of fragility fractures receive treatment for underlying osteoporosis.  There are many important treatment options to help strengthen your bone.

  • Diet
    • High Protein
    • Calcium (1200mg daily) & Vitamin D (800 IU daily)
  • Exercise (low impact, weight bearing exercises)
    • Stationary bike, elliptical machine
    • Tai Chi (strength & balance à fall prevention)
  • Medical Treatment (requires evaluation and prescription from your doctor)
    • Bisphosphonates
    • Parathyroid analogues (Forteo, Tymlos)
    • RANK-L inhibitor (Prolia)
    • Selective Estrogen Receptor Modulators (SERMs)

 

The Spine Team at Plymouth Bay Orthopedic Associates consists of Physical Therapists, Physical Medicine & Rehabilitation Specialists and Board Certified Orthopedic Spine Surgeons. Our goal is to design a treatment plan customized to your lifestyle and goals and we use the latest advancements in both non-surgical and minimally invasive spine care. We have offices located in Plymouth, Duxbury and Sandwich, MA. Contact us today to schedule a consult!