Managing Osteoporosis Through Physiotherapy: Building Strong Bones

Osteoporosis is a medical condition characterized by weakness of bones, increased bone fragility, decreased bone mineral density (diminishing mineral content in the bone), and microarchitectural damage. It is also known as a "Silent disease" because typically no symptoms appear until there is a broken bone. This condition affects millions of people worldwide and is primarily associated with aging but can also affect young adults. it is more common in postmenopausal females. 

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Why does Osteoporosis occur?

Typically, at a young age, your bones are strong enough to bear your body's weight and help you continue your life. Your bone tissues are resorbed and then replaced with new and healthy tissues - the process of remodeling but as you age your body's ability to form a new bone - remodeling decreases. Hence, your body reabsorbs bone tissue but is unable to replace it with new tissues so the bone becomes weak as its mass is decreased. it becomes more porous and hence fragile. This fragility increases the risk of fractures, commonly, in weight-bearing bones and most used bones, due to repetitive stress, like wrists, spine, hips, etc. 

Types of Osteoporosis:

1. Primary Osteoporosis: also known as idiopathic osteoporosis and It is associated with the natural aging process and hormones. It refers to a type of osteoporosis that occurs without any underlying medical condition or specific cause.

         - Senile Osteoporosis: It is associated with a decline in bone mineral density during a normal aging process. It affects both men and women and is linked to decreased bone mass.

          - Postmenopausal Osteoporosis: Menopause is the most common cause of osteoporosis due to decreased estrogen levels, which are essential in maintaining bone mass. As it declines, so does the bone mineral density.

    2. Secondary Osteoporosis: It is associated with any underlying medical condition or medications that can affect bone health and strength.

    3. Juvenile Idiopathic Osteoporosis: This is a rare form of osteoporosis that affects young individuals for unknown reasons. 

Recognizing the telltale Signs and Symptoms:

Unlike other medical conditions, Osteoporosis does not have specific signs and symptoms. You will be unable to differentiate or even suspect anything until a fracture happens even after a minor fall or in some cases coughing hard. 

A few signs and symptoms that may present over time after the diagnosis are;

- A slight decrease in height as a result of vertebral fracture

- Stooped or kyphotic posture.

- Bone pain

- Limited mobility due to pain

- Numbness or tingling in case vertebral fracture causes nerve compression.

Osteoporosis can be diagnosed with a Dexa scan (a special x-ray scan for osteoporosis) or T and Z-scores. The T-score is a comparison between a suspected individual and a young adult of the same gender during his peak bone mass period while the Z-score is the comparison between a suspected individual and another person of the same age and gender. 

Risk Factors:

Some primary risk factors are;

• Age (50+)
• History of prior fracture
• Gender - more common in females
• estrogen deficiency 
• low BMI 
• Family history of Osteoporosis
• Smoking

Secondary risk factors include;

• Long-term use of glucocorticoids
• Nutritional deficiencies like Calcium deficiency
• Underlying medical conditions like; GI illness (Celiac disease), thyroid disorders, autoimmune disorders (rheumatoid arthritis), etc
• Bariatric surgery - Weight loss surgery
• Anti-seizure medications
• Proton pump inhibitor medications - Used for acid reflux.
• Alcohol consumption
• Long-term thyroid replacement therapy
• Chemotherapeutic agents
• Vitamin D deficiency

Role of Physiotherapy in Managing Osteoporosis:

Physiotherapy is an effective way to manage osteoporosis without invasive treatments. This approach focuses on improving bone health, lowering the risk of fractures, and promoting overall physical well-being. Here are some of the significant benefits that people with osteoporosis can expect from physiotherapy:

• Exercise Prescription: A physiotherapist can design a tailored exercise program with weight-bearing and resistance exercises. Weight-bearing exercises, such as walking and dancing, stimulate bone formation, while resistance exercises, such as lifting weights or gravity exercises, strengthen muscles, and protect bones.

• Balance and Posture Training: Osteoporosis increases the risk of falls and fractures. Physiotherapy can help improve balance and posture, reducing the likelihood of accidents. This is especially important for older adults.

Balance Training

• Pain Management: Physiotherapy can alleviate pain and discomfort associated with osteoporosis through various techniques, including manual therapy, heat or cold therapy, and electrical stimulation.

• Patient education: Physiotherapists can educate individuals on proper body mechanics and movements to avoid activities that may increase the risk of fractures.

• Lifestyle Modifications: Physiotherapists can provide guidance on lifestyle changes, including nutrition and smoking cessation, to support bone health.

• Fall Prevention: Physiotherapy can include fall prevention strategies and exercises to reduce the risk of fractures resulting from falls.

Osteoporosis is a prevalent condition that affects bone health and increases the risk of fractures, particularly in older adults. Physiotherapy offers a holistic approach to managing osteoporosis and improving bone density, muscle strength, balance, and overall well-being. With the guidance of a skilled physiotherapist, individuals with osteoporosis can build and maintain strong bones, ultimately improving their quality of life and reducing the risk of fractures. If you or a loved one is living with osteoporosis, consider consulting a physiotherapist to develop a personalized plan to manage this condition and promote bone health. Remember, it's never too late to invest in your bone health and overall well-being.