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A Silent Disease


Submitted by Shannon Laesch, APN, and Elizabeth Madlem, APN, The Bone Health Clinic at Millennium Pain Center

Osteoporosis is often called a silent disease because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a hip or the spine to fracture. It’s important to realize that once you’ve lost bone, it’s gone! This is why it is vital to keep bones healthy and strong and to take action to minimize loss of bone as you get older.

Oftentimes, osteoporosis is thought to only plague women, especially those post-menopausal; however, men can be affected as well. Risk factors include sex, age (prevalent in people over 50), race (prevalent in Caucasians), ethnicity (prevalent in Asians), family history of osteoporosis, and having a smaller body frame. Other risk factors include thyroid problems, low calcium intake, low testosterone, early menopause, excessive alcohol use, and long-term steroid use.

Osteoporosis is diagnosed by a medical evaluation by your healthcare provider. It often entails reviewing medical history, completing a physical exam, ordering specific lab tests, and a bone density test, also known as a DEXA scan.

If you’ve been diagnosed with osteoporosis, treatment focuses on slowing down or stopping further bone loss. In some cases, a bone-growing medication is used. A comprehensive osteoporosis treatment program includes a focus on lifestyle changes, such as proper nutrition and exercise; safety measures to prevent falls that may result in fractures; and medication if appropriate for the patient. Following are steps you can take to lower your risk of developing this potentially crippling disease and to keep it from getting worse.

A healthy, balanced diet is essential for minimizing bone loss and maintaining overall health. Calcium and vitamin D are especially important for bone health. As you age, your body becomes less efficient at absorbing calcium and other nutrients. Older adults are also more likely to have chronic medical problems and to use medications that may impair calcium absorption.

Vitamin D is required for proper absorption of calcium. It is made in the skin after exposure to sunlight, but there are only a few foods, including fatty fish and fish oils, that naturally contain significant amounts of vitamin D. Milk, cereals, and other dairy products are often fortified with vitamin D and are another good dietary source. Although many people obtain enough vitamin D naturally, studies show that vitamin D production decreases in older adults, in people who are housebound, and during the winter.

While vitamin D and calcium will not completely stop bone loss, they will guarantee that a supply of the materials the body uses for bone formation and maintenance is available. Supplemental calcium and/or vitamin D should be taken as recommended by your physician.

Exercise: Like muscle, bone is living tissue that responds to exercise by becoming stronger. Physical activity is needed to build and maintain bone throughout adulthood. The evidence suggests that the most beneficial physical activities for bone health include strength training or resistance training. A properly designed exercise program that builds muscles and improves balance and coordination provides other benefits for older people, including helping to prevent falls and maintaining overall health and independence. Exercise should not put any sudden or excessive strain on your bones, and if you have osteoporosis, you should avoid high-impact exercise. To help ensure against fractures, a physical therapist or rehabilitation medicine specialist can recommend specific exercises to strengthen and support your back, teach you safe ways of moving and carrying out daily activities, and recommend an exercise program that is tailored to your circumstances.

Stop unhealthy habits: Smoking is bad for your bones as well as your heart and lungs. Smokers may also absorb less calcium from their diets. Limit alcohol intake, as too much alcohol can damage your bones and put you at risk for falling and breaking a bone.

Prevent falls: Preventing falls is a special concern for men and women with osteoporosis. Falls can increase the likelihood of fracturing a bone in the hip, wrist, spine, or other part of the skeleton. Falls can be caused by environmental factors such as throw rugs, cords on the floor, or slippery floors. Physical factors such as impaired vision or balance, chronic diseases that affect mental or physical functioning, and certain medications such as sedatives and antidepressants can also put one at risk for falls. It is important that individuals with osteoporosis be aware of any physical changes that affect their balance or gait and that they discuss these changes with their healthcare provider.

Medications: Some medications that are prescribed for other conditions can contribute to bone loss, so be sure to discuss all medications with your healthcare provider. There are a number of medications that are used to prevent osteoporosis by slowing down the rate of bone loss and increasing bone density. Supplements of calcium and vitamin D are often added to these regimens as well. There is one FDA-approved medicine, Forteo (teriparatide), which can actually rebuild bone. As with all medication, everyone responds differently, so a drug that may be right for one person may not be right for you.

Preventing osteoporosis is a lifelong endeavor. Talk to your healthcare provider about osteoporosis, and ask if a bone density test is right for you. A bone density test is safe, simple, and painless. It involves no injections and takes only minutes to complete.

Stay tuned for future articles that will provide education concerning the signs and symptoms of osteoporotic fractures, what treatment options are available for patients when they do have a fracture, and care after the fracture.

For more information on osteoporosis or to schedule a bone density screening, you may contact The Bone Health Clinic at Millennium Pain Center, 309-662-4321. They are located at 1015 Mercer Ave. in Bloomington. Shannon Laesch and Elizabeth Madlem are fracture liaison specialists and bone health consultants. The clinic provides screening, diagnosis, and a comprehensive treatment plan for people who have or are at risk of developing osteoporosis.

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