Osteoporosis Ebook


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The bones that make up our skeleton are constructed of a thick outer shell with an inner "honeycomb" mesh made of tiny struts of bone. With osteoporosis, some of these supporting struts become thin, causing the bone to become weaker and more fragile, and thus more likely to break after what would normally be a minor break or fall.

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Osteoporosis Ebook

  1. 1. OsteoporosisThe Markland Clinic Tel: 01285 654059Cotswold Leisure Centre www.marklandclinic.comTetbury Road, Cirencester www.sportsperform.co.ukGL7 1US
  2. 2. What is Osteoporosis? Your BonesThe bones that make up our skeleton are constructed of a thick Your bones are made up of calcium salts and other minerals andouter shell with an inner ‘honeycomb’ mesh made of tiny struts of collagen (protein), both creating the structure of a thick outer layerbone. With osteoporosis, some of these supporting struts become and the honeycomb mesh inside. Throughout your lifetime, old,thin, causing the bone to become weaker and more fragile, and worn bone is broken down and replaced by new bone; bone isthus more likely to break after what would normally be a minor alive and constantly replacing itself, although a process that takesbreak or fall. Such broken just two years to complete in children takes up to ten years inbones are sometimes called adulthood. And although bones have usually stopped growing in‘fragility fractures’. length by the age of 18, bone density continues to increase into the mid-20s.Although these fractures canoccur in any part of the body, The balance between bone demolition and bone construction thenthe most commonly affected remains stable until the age of about 35, when bone loss increasesareas are the wrist, hip and very gradually as part of the natural ageing process.  For women,spine. These thin and fragile this bone loss becomes more rapid for several years following thebones are not painful in menopause which can lead to osteoporosis and an increased riskthemselves, but the broken of broken bones, especially in later life.bones that can result cancause pain and otherproblems.Although its often thought of as a womens disease, osteoporosisaffects men too – half of women over 50 in the UK and a fifth ofmen are likely to experience bone fractures, and this is mainly as aresult of osteoporosis.
  3. 3. Consequences of osteoporosis Who is at risk of osteoporosisIf you have osteoporosis, it doesn’t automatically mean that your and broken bones?bones will break, but it does mean that you have a ‘greater risk offracture’. And osteoporosis does not generally slow down or stop There are several factors that can put us at a higher risk ofthe healing process once a fracture has occurred. The older we developing osteoporosis:get, the greater our risk of breaking a bone, however there areprecautions we can take to limit the damage that osteoporosis can GENERAL RISK FACTORScause. Its never too late — or too early — to do something aboutosteoporosis. You can take steps to keep your bones strong and Genetics - The genes we inherit from our parents have a stronghealthy throughout life. effect on our own bone structures. If one of your parents has broken a hip, you may be more susceptible to developing osteoporosis and fragile bones. Gender - Women have smaller bones than men and they also experience the menopause, when the ovaries almost stop producing oestrogen, reducing the protection it gives to their bones. Race - People of Black Afro Caribbean descent are at a lower risk of osteoporosis as they tend to have bigger, stronger bones. Youre at greatest risk of osteoporosis if youre white or of Asian descent. Age - As bone density decreases in later life, about half of people will have osteoporosis by the age of 75. Low body weight - If you have a low BMI (body mass index) you are at greater risk of developing osteoporosis.
  4. 4. MEDICAL CONDITIONS THAT INCREASE YOUR RISK MEDICINES THAT INCREASE YOUR RISK OFOF OSTEOPOROSIS OSTEOPOROSIS Rheumatoid arthritis Corticosteroid tablets (steroids) if they are taken for other medical conditions for over three months A hysterectomy with removal of ovaries (before the age of 45) and other conditions which affect the hormones in your body Anti epileptic drugs (such as gender reassignment), and reduce the protective effects of oestrogen and testosterone. Some breast cancer treatments such as aromatase inhibitors Anorexia nervosa Prostate cancer drugs that affect either the production of the male hormone testosterone or the way it works in the body. Hyperthyroidism (levels of the thyroid hormone are abnormally high)  OTHER RISK FACTORS INCREASING THE LIKELIHOOD OF OSTEOPOROSIS Conditions such as Crohns or coeliac disease which affect the absorption of food (therefore preventing your healthy diet Other risk factors increasing the likelihood of osteoporosis: protecting you) Smoking – current smokers are more likely to break bones. Various conditions that lead to long periods of immobility (so Stopping smoking can lower this risk. reducing the opportunity for weight-bearing exercise) Alcohol - intake of more than 3 units daily. Cutting down your Organ transplants alcohol intake can lower this risk. Respiratory diseases Falling – older people who are at risk of falling are more likely to have fractures especially of the hip after the age of 75 years. So Diabetes its important to maintain balance and co-ordination for as long as possible, by keeping active and reducing risks in the home. HIV (AIDS)
  5. 5. If you think you are at risk… become less active, therefore often less steady on their feet and more prone to trips and falls.You cant see or feel your bones getting thinner, so many people SPINAL BONESare unaware of a problem they might have until they break a boneor start to notice a loss of height. If you think you have risk factors Fractures due to osteoporosis of the bones in the spine occurfor osteoporosis then its a good idea to discuss this with your GP. when the bones become compressed because of their reducedYou can be referred for a dual energy x-ray absorptiometry (DEXA) strength.scan to measure your bone density, and then possibly drugtreatment to strengthen your bones. A ‘compression fracture’ can happen in different ways, including wedge fractures which can tip the spineParts of the body commonly forward, causing an outward curve (kyphosis) and possible loss ofaffected by Osteoporosis height and curvature, which can cause further problems with the internal organs.WRISTS It is rare for these fractures to affectA broken wrist is often the first indication that you have the spinal cord with consequent lossosteoporosis. They often occur in middle aged women who have of sensation or paralysis, but theput out their arm to break a fall; healthy bones should be able to problems they can cause can still becope with many falls, but a fragile bone will fracture at this point. significant.HIPSOsteoporosis can lead to broken hips; this happens most in ourlate 70s or 80s. They happen as a result of a fall and can affect allaspects of life; and the fear of falling can often lead older people to
  6. 6. Building healthy bones and in a better position to withstand the natural losses that come with age.preventing fractures A HEALTHY DIETOsteoporosis becomes more common as bone density and Everyones body contains about a kilogramme of calcium, 99% ofstrength decreases with age.  Poor balance and co-ordination in which is stored in our bones. Of course, its important to eat plentythe older patient can lead to a higher risk of falls, and thus a of calcium to help build and maintain healthy bones, but there arehigher risk of fracture. The way we live our life in the first place, other vitamins and minerals which are also important. A balancedlifestyle changes and keeping active can help to prevent falling diet including a wide variety of foods will ensure you take in theand fractures. And if the risk of fracture does become high, correct nutrients to protect and maintain good health throughoutthere are drug treatments available that strengthen bones and your life.lower the risk.One way to think about keeping our bones strong is to imagine a‘bone bank’, made up of the bone we accrue in the early part ofour life, and the withdrawals made from it as ageing takes its toll.Although genetics decide the potential height and strength ofour skeleton, the way we live our life can also play a part in theamount of bone we invest in our bone ‘bank’ during our youthand how much we save in later life.When the skeleton is growing, during childhood through to earlyadulthood, it is vitally important to maximise bone strength. Thiscan, and should, be done in a variety of ways, for exampleeating a healthy, balanced and calcium-rich diet and takingplenty of load-bearing exercise. ‘Banking’ plenty of bone inthese ways, in these early years and beyond, puts the skeleton
  7. 7. Food Standards Agency recommendations for a healthy balanced people who cover up to become deficient - they will need to take adiet Include: supplement. Lots of fruit and vegetables (at least 5 portions of a variety EXERCISE every day) Childhood, adolescence and early adulthood - Bank plenty of Plenty of starchy foods, such as bread, rice, potatoes and bone density in these years by doing a variety of weight bearing pasta exercise as well as eating that well-balanced, calcium-rich diet. Weight-bearing exercise includes any kind of physical activity Choose wholegrain (brown) varieties of starches wherever where you are supporting the weight of your own body, for possible example jogging, aerobics, tennis, dancing and brisk walking. Weight lifting is another good type of bone-building exercise, Some milk and dairy foods where the action of the tendons pulling on the bones seems to boost strength. Some meat, fish, eggs, beans, and other non-dairy sources of protein Just a small amount of food and drinks high in fat and/or sugar. VITAMIN DVitamin D is vital for helping our bodies to absorb calcium. Ourprimary source of Vitamin D is the sun shining on our skin. Thebody converts this into vitamin D and stores it in our fat. Most of uswill get enough sun to help our bones without even having to thinkabout it, if we get out and about in the summer. However, it ispossible for older people, people who do not go out much and
  8. 8. The middle years - Your skeleton grows stronger if you do regularweight-bearing exercise. Keep up with the walking, jogging,dancing, aerobics and weightlifting. Join a gym or get togetherwith friends, but make sure this is maintained throughout theseactive and important years. STOP SMOKING AND REDUCE YOUR ALCOHOL INTAKE The toxic effect from smoking comes from the fact that it stops the construction cells from doing their work in building new, strong bone to replace the old. Once you stop smoking, this risk is reduced.Older age - Osteoporosis becomes more common as bonedensity and strength decreases with age.  Poor balance and co- Enjoying a glass of wine now and then could actually help yourordination in the older patient can lead to a higher risk of falls, bones. But drinking too much alcohol (more than 3 units a day)and thus a higher risk of fracture. The way we live our life in the damages the skeleton and increases the risks of fracture.first place, lifestyle changes and keeping active can help toprevent falling and fractures. And if the risk of fracture doesbecome high, there are drug treatments available that strengthenbones and lower the risk.
  9. 9. If you already have Balance and co-ordination - Get help from your GP or social services if you are at risk of falling or starting to fallosteoporosis... more frequently. Ask your physiotherapist to help with exercises to maintain your balance and co-ordination.If you have osteoporosis, it doesn’t automatically mean that your Keeping in good general health - As well as exercisingbones will break, but it does mean that you have a ‘greater risk gently and eating a healthy diet, do have your hearing andof fracture’. eyesight checked. Poor eyesight can increase your risk of falling and some kinds of hearing issues can affect yourAnd osteoporosis does not generally slow down or stop the balance.healing process once a fracture has occurred. The older we get,the greater our risk of breaking a bone, however there are Medication - Ask your doctor for a medicationprecautions we can take to limit the damage that osteoporosis review. Taking lots of different medications can sometimescan cause. cause side effects such as dizziness or drowsiness which increase your risk of falling and hurting yourself.So, if you already have osteoporosis, you can still keep yourselfsafe and strong and reduce the risks of fractures in a number of Hazard reduction - Review your home environment (or askways: someone to help you) to avoid the risk of tripping and falling. Clear pathways through the house are vital. Exercise - although you need to be more careful of vigorous, high impact exercise, its important to stay active. Leading an active lifestyle will make sure you have good balance and co-ordination and will also help to develop muscle strength, reducing the risk of falls and fractures. Find something you enjoy, such as swimming, gardening, walking, golf or Tai Chi.
  10. 10. Looking after your spine performing the movements we can show you ways to modify the exercise without necessarily reducing its effectiveness.In the middle years the The muscles strengthened when performing this exercise are alsoweakening of bone structure the muscles responsible for holding you upright, and it is probablecan result in a slow but that maintaining good posture at all time will assist theprogressive reduction in height strengthening process.and curvature of the middle orthoracic part of the spine, Contact us now if you would like a specific exercise programme toaccompanied by an increased help you strengthen your bones or prevent falls 01285 654059.risk of fracture. For more information on Osteoporosis and especially with copingResearch conducted at the with a diagnosis and living with the condition, we recommend youMayo Clinic in the US has visit the National Osteoporosis Society website:demonstrated that extensionexercises performed regularly http://www.nos.org.uk/significantly reduce the number of compression fractures. A similargroup exercised differently and another did no exercise at all andboth of these groups had more fractures in a year than thoseregularly extending. We hope you have found this guide useful. For more information about how we can help you, contact The Markland Clinic onThis study suggests that women and those in high risk groups may 01285 654059 or click here for more information.benefit from performing regular extension exercises. These shouldbe practised from about the age of 40 onwards, four times a week(15-20 stretches per session)If you are uncertain about this advice please make an appointmentto discuss your personal situation with us. Or if you have difficulty