Most of you have heard about osteoporosis thanks to all the pharmaceutical commercials that line your television. But how much do you really know about the disorder, its effects, what makes you more likely to contract it, and how can you effectively manage it? 

To better understand this often-overlooked health issue, here is a short guide with vital information about osteoporosis and its management. Keep reading for more information.

What is Osteoporosis?

Osteoporosis is a chronic, progressive condition characterised by a loss of bone mineral density caused by altered bone microstructure, which ultimately increases your risk of low impact fragility fractures. According to the World Health Organisation (WHO), osteoporosis is defined as a bone mineral density (BMD) that lies 2.5 standard deviations or more below the average value for young healthy women (a T-score of <-2.5 SD), in postmenopausal women and men aged 50 years or above.

What Are The Causes of Osteoporosis?

Primary causes of osteoporosis include:

  • Postmenopausal condition: Decreased levels of oestrogen causes bone loss.

  • Senile osteoporosis: Bone loss due to advanced ageing.

  • Idiopathic juvenile osteoporosis: Bone loss due to unknown cause in children aged between 2 to 14 years.

 Secondary causes of osteoporosis include:

  • Endocrine: hyperthyroidism, hyperparathyroidism, Diabetes Mellitus, etc.

  • Gastrointestinal: Malabsorption syndrome, IBD, malnutrition, lactose intolerance, etc.

  • Rheumatological and connective tissue disorders.

  • Certain medications such as steroids, anticonvulsants, etc.

  • Immobilization.

  • Genetic disorders such as Marfan syndrome and glycogen storage diseases, etc.

What Are The Symptoms Of Osteoporosis?

Signs and symptoms of bone loss are as mentioned below:

  • Back pain: Acute, episodic pain in the lumbar/low thoracic region.

  • Fractures: Fragility fractures due to low-impact or minimal trauma such as an ankle fracture after stepping off a curb. Compression fractures of the spine, particularly involving the upper back/low thoracic or lumbar spine are the most common type of fractures seen in osteoporosis.

  • Kyphosis: A hunchback, an exaggerated, forward turning of the back due to increased front-to-back curvature of the spine.

  • Dowager’s hump: A hump at the base of the neck due to outward curvature of the thoracic spine. 

  • Decrease in height: As a result of collapsed vertebrae due to chronic weakening of the bone.

Can Physiotherapy Help Manage Osteoporosis?

Yes, exercises can help strengthen the bones when done properly and under the guidance of a well-trained professional/physiotherapist. 

A well-planned, structured customised routine of regular exercises involving strength training and low-impact weight-bearing best suitable for your age and general health condition can help prevent bone loss, improve posture and balance, and reduce the risk of falls and fracture. 

These exercises include: 

  • Strength Training:

    • Weight-bearing exercises such as walking, jogging, running, stair-stepping, circuit training, skipping rope, etc.

    • Muscle-strengthening exercises, using weights (such as dumbbells) or resistance bands (such as therabands) include squats, single-leg heel raises, prone trunk extension with cushion, push-ups, lunges, etc.

  • Flexibility Exercise:

    • Exercises such as hip leg lifts, bridge, chair stand, foot stomps, etc. These stretching exercises will keep your muscles limber and joints flexible, thus preventing falls and fractures.

    • Sustained stretching is best for patients with osteoporosis.

    • Stretches that flex your spine or cause you to bend at the waist are contraindicated. Ask your doctor/physiotherapist for the most suitable stretching exercises for you.

  • Balance Exercise:

    • Simple exercises such as standing on one leg, physioball, tilt board balance or movement-based exercises such as tai chi, yoga and pilates can improve stability and balance. 

  • Postural Exercises:

    • Extension exercises that target or prevent structural changes of the spine such as thoracic kyphosis include chin tucks, scapular retractions, and thoracic and hip extensions.

    • These exercises only involve stretching and strengthening the extensor group of muscles to improve posture and balance.

    • Flexion and twisting exercises are contraindicated especially in patients who are at risk for spinal fractures.

  • High-Intensity Training:

    • Especially for women in menopausal years or the early postmenopausal period, high-intensity training is highly effective in preventing bone loss.

    • High-intensity training includes body-weight and resistive exercises performed at a high intensity, similar to circuit training. 

    • This form of training is not recommended for individuals with low bone mass.

Can Osteoporosis be Prevented?

Yes, it is possible to prevent osteoporosis by building adequate bone density throughout childhood, adolescence, and early adulthood. Here are a few steps you can take to improve bone health at any age:

  • Follow a healthy diet. Include foods rich in proteins, calcium, and vitamin D such as green leafy vegetables, tofu, yoghurt, salmon, red meat, egg yolk, and dietary supplements.

  • Quit smoking. 

  • Control your alcohol intake.

  • Limit caffeinated drinks.

  • Get some sun.

  • Stay physically active.

Take care of your health and opt for preemptive measures to prevent osteoporosis. Good nutrition and regular exercise are essential for healthy bones throughout your life.

Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.