What is osteoporosis?
Osteoporosis is a loss of bony tissue; as we age, our bones become more porous unless we take measures to prevent it. When we lose bone mass, our bones become fragile — making a fracture much more likely, especially during a fall.
Because the loss of bony tissue occurs without symptoms, osteoporosis is sometimes called “the silent thief.” Unfortunately, it is often first discovered when a bone breaks. Over 80% of all fractures in those who are fifty years of age or older are caused by osteoporosis.
Having osteoporosis can affect your life in many ways: It can cause disfigurement and a loss of mobility. Lowered self-esteem, depression, and lack of independence may follow.
What are the risk factors for the disease?
You can lose bone mass steadily for many years without experiencing any symptoms of the disease — until you fall and break a bone. Unfortunately, if osteoporosis is first diagnosed at the time a fracture occurs, it is already fairly advanced.
Early detection of bone loss is critical. Osteoporosis Canada suggests that if you are over 50 and have even one of these risk factors, you should consider talking to your doctor about getting a bone density scan:
- You are 65 years of age or older;
- You have broken a bone from a simple fall after the age of 40;
- Your mother or father had a hip fracture;
- You smoke;
- You drink three or more alcoholic drinks per day;
- You are taking a medication for rheumatoid arthritis such as prednisone;
- You have rheumatoid arthritis, celiac disease, COPD, or chronic liver disease;
- You have had gastric bypass surgery;
- You experienced early menopause (before age 45);
- You lost more than 10% of your body weight after age 25;
- You weigh less than 132 lbs (60 kg).
As well, if you are over 50 and have either lost 2 cm (3/4″) in height in a short time period, or 6 cm (2 1/2″) overall from when you were younger, or you have kyphosis (a forward curvature of the back), Osteoporosis Canada recommends that you talk to your doctor about getting a regular back x-ray to check for the possibility of a spine fracture.
What is the difference between osteopena and osteoporosis?
Osteopena is simply the early stages of osteoporosis. If you get a bone density scan, your T-scores will indicate whether you have osteopena or osteoporosis (or both).
What is a bone density test?
This is a painless procedure. The spine, hip, or forearm are x-rayed to measure how many grams of calcium and other bone minerals are present within the bone. The higher the mineral content of your bones, the denser and stronger your bones are. As the bones deteriorate, they look a bit like swiss cheese.
Two reasons bone density testing is done are:
- To identify decreases in bone density if you have already had one test — these are usually done at least three years apart; or,
- To determine your risk of breaking a bone in the future.
What does the T-Score mean?
Your T-Score is your bone density compared with what is normally expected in a healthy adult (the scores are different for men than for women). Your T-score is the number of units — referred to as standard deviations — that your bone density is above or below the average.
-1 and above: bone density is considered normal.
Between -1 and -2.5: A sign of osteopenia, which means your bone density is below normal and may lead to osteoporosis.
Below -2.5: Your bone density indicates osteoporosis; treatment is required, and a fracture is possible if you fall.
Here are the results of this author's bone density tests over the space of six years:
Do I have to take medications if I have osteoporosis?
Since bone is living tissue, it constantly renews itself. When we are young, our body usually takes care of this for us. We help it by making sure we get some sun exposure and eat foods rich in calcium and vitamin D.
By the time we reach 40, however, the process is not quite so efficient. Alas, we begin to lose bone density. If you have been diagnosed with osteoporosis, you have already lost a significant amount of bone and may continue to do so unless you take medication.
There are many medications available and you need to talk to your doctor about what works best for you. No matter what drug therapy you choose, however, remember that a diet rich in calcium and vitamin D is essential to maintain healthy bones.
What exercises will help?
According to many studies, these activities will help maintain or increase bone mineral density:
- Low-Impact aerobics;
- Weight bearing and resistance exercises; and,
- Flexibility and breathing activities.
Strength training has elicited improvements specifically in the end of the radius bone (in the forearm near the wrist) and the hip bone.
Bone mineral density increase will usually include improvements in balance, gait, and a reduction in risk of falls. However, to prevent fractures, consider the following:
- Have you fallen two or more times in the past year?
- Do you have an unsteady walk?
- Do you feel that you have poor balance?
- Do you need to push with your arms to get up from a chair?
- Do you need an assistive device such as a cane, walker or wheelchair?
If you have answered yes to one or more of the above, you are at risk of falling. You need to consider ways to prevent falls. If possible, find a fitness class for older adults that includes balance training.
What should be avoided?
If you have osteoporosis, it is recommended that you avoid or use cautiously:
- Some bending movements such as forward spinal flexion, and especially spinal flexion while using resistance;
- Uncontrolled spinal rotation;
- Improper or unguarded lifting; and
- Some activities such as racquet sports, downhill skiing, roller blading, rowing, golf, and high-impact aerobic and step fitness classes.
This article is part of a series about various health conditions and the benefits of exercise. The other articles are:
- Exercise and Allergies
- Exercise and Allergies
- Exercise and Arthritis
- Exercise and Asthma
- Exercise and Balance
- Exercise and Cancer
- Exercise and Chronic Pain
- Exercise and Circulation
- Exercise and COPD
- Exercise and Dementia
- Exercise and Diabetes
- Exercise and Heart Disease
- Exercise and Hypertension
- Exercise and Lifestyle and Older Adults: Recent Research
- Exercise and Mood
- Exercise and Our Brain
- Exercise and Pain vs. Burn: Will it ever stop hurting?
- Exercise and Parkinson's
- Exercise and Sleep
- Exercise and Stroke
- Exercise and Viruses: Exercise Immunology
I am a BCRPA-certified fitness instructor in Vancouver, BC. I teach four classes at the West End Community Centre in Vancouver, BC, mostly designed for the older adult. The Inevitable Disclaimer: Everything published here expresses only my opinion, based on my training and research. What you do with the information is entirely your own responsibility. I am not liable for any injury you suffer that seems to be related to anything you read here. Always consult your doctor before beginning an exercise program. For other articles, return to the table of contents.