What is osteoporosis?
Osteoporosis is a condition impacting the bones of your skeleton, resulting in reduced bone mass and an increased risk of fracture. This condition impacts 1 in 3 women and 1 in 5 men in their lifetime, leading to decreased quality of life, functional limitations, and increased mortality. More than 2.3 million Canadians live with this disease.
What causes osteoporosis?
Although researchers have been unable to identify one known cause of osteoporosis, there are many risk factors to help identify if you may potentially develop this condition in the future.
Risk factors include:
- Sex: Women are more likely to develop osteoporosis than men
- Age: Estrogen plays an important role in the maintenance of bone density. As women approach menopause, the decrease in estrogen will accelerate bone loss. As men get older, they also experience hormonal changes including a drop in testosterone; for this reason, men over 65 years of age are also at higher risk
- Family history of osteoporosis
- More than three month use of glucocorticoid medications
- Medical history: Certain conditions can impact absorption of nutrients, cause inflammation, and lead to reduced physical activity – all contributing to secondary osteoporosis (i.e. celiac disease or rheumatoid arthritis). As well, a history of a vertebral compression fracture or hip fracture can also indicate you are at higher risk of developing osteoporosis in your future
- History of cigarette smoking or alcohol consumption
- Low body mass index (BMI)
How is osteoporosis diagnosed?
Osteoporosis is typically diagnosed using a Bone Mineral Density test. This test uses x-rays to measure how dense your bones are and can be used to determine your future fracture risk. Testing is indicated for anyone over 65 years of age, or sometimes younger if you have additional risk factors as listed above.
What are some treatment options?
A comprehensive management plan for osteoporosis often includes multiple healthcare providers. Addressing nutrition, pharmacology, and exercise are some ways that you can delay or stop the progression of the disease.
Speaking with a pharmacist or dietitian to address your specific nutritional needs is important to ensure you are getting enough calcium, vitamin D, vitamin K, magnesium, and protein to maintain healthy body tissues, including bones.
There are also multiple pharmacological options for help managing osteoporosis in both the male and female population – depending on the severity of the disease and your fracture risk, your primary care provider will work with you to decide if medication would be indicated.
Common medications used for the treatment of osteoporosis include:
- Antiresorptive medications: these help stop the breakdown of bone tissue
- Anabolic medications: these encourage the formation of new bone. These tend to be used in those with a higher fracture risk or history of severe fracture.
How does physiotherapy help?
Exercise has been shown to be an effective addition to an osteoporosis treatment plan. Research shows:
- Functional and balance training can reduce falls and fall related fractures, improve quality of life, and improve physical function
- Resistance training can improve quality of life, physical function, bone mineral density, and reduce mortality
- Enjoyable activities, such as walking, yoga and pilates, can improve physical function and quality of life, but are not currently shown to impact bone mineral density or falls risk
Working with a physiotherapist to address your specific limitations and safely incorporate effective exercise in your routine is an important aspect of maintaining healthy bones.
The current guidelines for exercise include:
- Balance and functional exercise 2+ times/week
- Progressive resistance training 2+ times/week, incorporating abdominal and back extensor strengthening
- Participation in enjoyable activities such as yoga, pilates, and walking as long as safety is considered
- Participate in variety of exercise at moderate-vigorous intensity for 150 minutes/week
- Be mindful of exercises that require rapid, repetitive or sustained movements; working at end range of motion; or twisting/flexing of the spine
For more information, please visit osteoporosis.ca where you can learn about the disease, diagnosis, and treatment, and complete the fracture risk assessment. If you are interested in incorporating exercise into the management of your bone health, please contact us! We are happy to get you started on your journey.
References:
Osteoporosis Canada. https://osteoporosis.ca/
Morin, SN, Feldman, S, Funnell, L, Giangregorio, L, Kim, S, et al. (2023). Clinical practice guideline for management of osteoporosis and fracture prevention in Canada: 2023 update. Cmaj, 195(39), E1333-E1348.