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PPMRC OSTEOPOR0SIS MANAGEMENT:
Osteoporosis is a metabolic bone disease that affects 15–25 million people in the US alone.
Osteoporosis is marked by a decrease in the amount of bone tissue, producing brittle, fragile bones that can result in fracture.
Bones constantly change. They are living tissues. Part of their change process is controlled by your metabolism which adds new bone cells (osteoblasts) and removes and remodels bone by special cells (osteoclasts). Growing children have a greater preponderance of osteoblasts but also have osteoclasts. At the older end of the spectrum there are a greater preponderance of osteoclasts at work. Metabolic bone diseases occur when there is a change in that breakdown and build up process.
In osteoporosis, either too much bone is broken down without being replaced or your body is just not able to carry on the process the way it should. In either case, it means you have too little bone mass. And, too little bone mass puts you at greater risk for broken bones — even from something as simple as lifting a box.
All bones can be affected in the disease. But, the most common sites for fractures are the spine, wrist, and hip.
In very rare cases, children may suffer from osteoporosis. If this happens, most often another disease is to blame or sometimes a medication the child takes is at fault.
Risk Factors For Osteoporosis:
Advanced age>55
Female sex
Asian,Caucasian, or Hispanic ethnicity
Small body size/weight(<127lb/<57.7kg)
Positive family history in first degree relative
Premature natural or surgical menopause
low calcium intake
low vitamen D exposure
Immobilization or sedentary life style
Alcoholism
Hyperthyroidism/Hypogonadism
Medications Associated With Osteoporosis
(Are you on any of these medications?)
Glucocorticoids(steroids)
Excess Thyroid hormone
Dilantin/Tegretol/Phenobarbitol
Heparin
Leuprolide(Gonadotrophin-releasing hormone analog
HIV medications
Methotrexate
furosemide(lasix)
Neuroleptics/Reglan(drugs that raise prolactin levels)
Symptoms of Osteoporosis:
Some people who have osteoporosis may have no symptoms until their bones start to break.
Sometimes, in the early stages of the disease people may have a backache and start slowly to become round shouldered.
Once the disease has begun to worsen, a loss of height can occur. And, of course, bones start to break with only minor injuries.
Physical examination findings in Osteoporetic Patients
Patients with osteoporosis have an average loss of height 2-3in (40-80yr)
Degenertive disk disease with collapse of vertebraes
Kyphosis(arched back)
Poor balance and posture
Localized low back pain
Tight hip group and chest muscles
Treatment Options:
If your doctor thinks you might have osteoporosis, she or he will most likely take a complete medical history and do a complete physical exam first. Then, you might need some bone x-rays and even a bone densitometry test. This test measures the density of you bones to see if some mass has been lost.
Treatment of osteoporosis does not cure it. Instead, it helps to minimize bone loss.
Osteoporosis Rehabilitation:
Osteoporosis and Osteopenia both low bone mass states that leads to an increase risk of fracture. Patients that have low bone mass can develop a fracture from minimal trauma such as falling from a standing height or fracturing a bone in their spine from opening a window. Patients need to be evaluated by their endocrinologist but equally important is the referral to a Physiatrist(Physical medicine and Rehabilitation doctor that specializes in Osteoporosis posture management and exercise strengthening and rehabilitation.
How Can a Physiatrist Help?
Physiatrist (Physical Medicine and Rehabilitation Specialist) can provide back support and posture training support orthosis to limit the arched back and posture problems seen in most osteoporosis patients
Physiatrist can custom develop back extension exercise, pectoral stretching program which stretches and strenghtens the back and hip,chest wall group muscles which greatly improves standing and walking balance & bone density which limits balance loss and falls leading to more active confident and happier individuals.
Physiatrist as rehabilitation specialist are uniquely qualified to create a patient specific weight bearing, muscle strengthening and aerobic conditioning program which can limit the risk of hip or spinal fracure while providing pain relief, improved appearance and improved quality of life. Our clinic which is a pain clinic can also treat effectively any muscle soeness or pain that patients may have.
Call today (407-291-3077) for an appointment to begin living your best life.
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