Osteoporosis and Arthritis
Osteoporosis is a disease of the skeleton which reduces bone strength and increases the risk of fracture.
WHAT IS OSTEOPOROSIS?
Osteoporosis is a disease of the skeleton which reduces bone strength and increases the risk of fracture. Most bones apart from the face and head can be affected by osteoporosis, but the most common sites of fracture are the hips, spine, wrists and ribs. Osteoporosis, or bone loss, is often called the silent disease because it arises without symptoms. The first sign we get of the disease is often a fracture.
Osteoporosis happens when bone loses mineral, like calcium, at a faster rate than the body can replace them (increased bone turnover) leading to a loss of bone thickness (bone mass or bone density). As a result, bones become thinner and less solid, so that even a minor bump or accident can cause serious fractures.
In Malaysia, osteoporosis related fractures have been recognised as a major health problem, particularly in the elderly. Common sites of fracture are the spine, wrist and hip. Hip fractures, in particular, are worrying, as they are associated with an increased risk of death within the first year of injury.
Even if they do survive the initial injury, the majority of the fracture patients will be disabled, with only 25 % resuming normal activities.
A study undertaken on the incidence of hip fracture among Malaysian individuals aged 50 and above in 1997 showed a rate of 90 per 100,000, and the number increased with age, and a higher rate of fracture in women.
Among Malaysians, the Chinese had the highest incidence of hip fractures compared to Malays and Indians. Chinese women accounted for 44.8% of hip fractures that year.
HOW TO PREVENT IT?
Building strong bones, especially before the age of 30, can be the best defense against developing osteoporosis, and a healthy lifestyle can be critically important for keeping bones strong.
Osteoporosis is preventable, and anyone can help themselves and lower their risk of osteoporosis by having a healthy lifestyle. In particular, young girls who take sufficient calcium and undertake sufficient exercise in their growing years are much less likely to become candidates for osteoporosis later in life.
In the first 20 years of life, it is important to build bone mass, through diet and exercise. After the age of 20, the emphasis shifts to preserving and maintaining bone mass.
Keeping a healthy lifestyle means not smoking, limiting your alcohol intake and remaining active by indulging in weight-bearing and resistance exercise like walking and jogging; playing games like tennis, basketball and football and other such activities.
Getting enough calcium and vitamin D each day is also important to keep bones healthy. You can get enough calcium by eating 3-4 servings of dairy foods such as milk, yoghurt and cheese daily or by taking calcium tablets. Vitamin D can be taken in tablets or absorbed through sunlight.
Bone loss can be prevented from getting worse if osteoporosis is diagnosed early and effective treatments are used.
DO YOU HAVE IT?
Osteoporosis is diagnosed by examining a person’s medical history, taking down details such as one’s height, and conducting specific tests, such as a DXA: Dual-energy X-ray Absorptiometry, commonly known as the bone density test. This measures the density of a person’s bones compared with the bone density of an average young adult of the same gender and ethnicity. The scan measures the density of the bones in the spine and hip and gives a ‘T score’, which tells the doctor whether or not bone loss has happened.
Getting a T score of -2.5 or lower indicates that a person has osteoporosis and is at high risk of getting a bone fracture, and should proceed to treatment for osteoporosis. A score between -1.0 and -2.5 shows osteopenia or low bone density, and in this case, some lifestyle changes are needed to reduce the risk of developing further bone loss and to limit the risk of fracture.
Osteoporosis can be treated by a variety of medications to stop further bone loss or even improve bone mass, and also prevent further spinal fractures. The most common medication used to treat osteoporosis is a bisphosphonate, a non-hormonal drug, which can help increase bone mass and reduce the risk of fractures. In cases where the osteoporosis is severe, and has not responded to first line treatments like bisphosphonates, a drug known as teriparatide (parathyroid hormone), that helps new bone to grow and increases bone mass, can also be given by daily injections.
IT’S NOT THE SAME AS…..
Osteoporosis is a separate disease from osteoarthritis. Confusion between the two is common, possibly because of the similarity in the diseases’ names.
Although a separate disease, osteoporosis has been known to occur alongside some forms of arthritis, in particular, rheumatoid arthritis (RA), as well as Systemic Lupus Erythematosus (SLE), or lupus.
In addition, there have been instances where prescribed medication for arthritis, for example, prednisone, which is used to treat RA, lupus, and some other non-arthritis inflammatory conditions, have caused the bone to lose mineral, and bring on the onset of osteoporosis.
DEALING WITH OSTEOPOROSIS AND ARTHRITIS
However, osteoporosis and arthritis do share many coping strategies. With either or both conditions, people benefit from arthritis-friendly exercise programs that may include physical therapy and rehabilitation. In general, exercises that emphasize stretching, strengthening, posture, and range of motion are appropriate, such as:
low impact aerobics
swimming and water exercise
low stress yoga
People with osteoporosis must take care to avoid activities that include bending forward from the waist, twisting the spine, or lifting heavy weights. People with arthritis must compensate for limited movement in arthritic joints. Always check with your physician to determine if a certain exercise or exercise program is safe for your specific medical situation.
Everyone with arthritis will use pain relief strategies at some time. This is not always true for people with osteoporosis. Usually, people with osteoporosis need pain relief when they are recovering from a fracture. In cases of severe osteoporosis with multiple spine fractures, pain control also may become part of daily life.
Regardless of the cause, pain relief strategies are similar for people with osteoporosis, osteoarthritis, and rheumatoid arthritis.
PREVENTING OSTEOPOROSIS AND ARTHRITIS
Just like with osteoarthritis, there are many things that we can do to try and reduce our chances of developing osteoporosis.
And just as there are similarities between coping with osteoarthritis and osteoporosis, both diseases have some preventive measures in common.
Things that one has to do to lower one’s risk of getting osteoporosis, like keeping active with weight bearing activities, refraining from smoking and excessive alcohol – also helps one to lower the risk of getting osteoarthritis and rheumatoid arthritis.
So, if there wasn’t enough good reasons before, surely, now, the attraction of keeping yet another preventable, and potentially dangerous disease at bay, through a healthy diet and lifestyle, should set us all on a path of good living habits for a better quality of life!