Bones,Joints and Osteoporosis
What is Osteoporosis?
Contributed by Julie Brock, CVRT
Osteoporosis (porous bone) is a disease in which bone becomes fragile and susceptible to fracture. The National Osteoporosis Foundation estimates that there are 10 million Americans who have the disease of whom 8 million Americans are women and 2 million are men. The disease affects about 55% of those over age 50.
Bone is living tissue. It is constantly being absorbed and replaced. Osteoporosis occurs when the creation of new bone can’t keep up with the removal of old bone. As people age, bone mass is lost faster than it is created. Under a microscope, healthy bone looks like a honeycomb, while a bone with osteoporosis has much bigger holes and spaces. The bone has lost density or mass, bone tissue has deteriorated, and the bone has become weaker. The result is a bone at risk for fracture. Fractures of the hip, wrist, and spine are the most common fractures occurring with osteoporosis.
Who is Affected?
Men and women and people of all races are affected by osteoporosis. White and Asian women who are past menopause are at the highest risk. According to the Mayo Clinic, women who went through early menopause, took corticosteroids for months at a time or have a family history of hip fracture are at high risk and should see a doctor. The reduction of estrogen levels at menopause is one of the strongest risk factors for developing osteoporosis. Likewise, men experience lower levels of testosterone as they age which increases risk. Also, people with a small body frame tend to> have a higher risk because they have less bone mass to draw from as they age. And overactive thyroid or overmedication for underactive thyroid has been associated with osteoporosis.
Can I Feel It in My Bones?
People can’t necessarily feel their bones getting weaker and may not know that they have osteoporosis until they break a bone from a minor fall. Even a simple action such as bending over to pick up a newspaper can cause a break. Some breaks can even occur spontaneously in those with osteoporosis. Fractures of the spine can be especially hidden in those with osteoporosis and may exhibit as severe back pain, loss of height and/or kyphosis which is the exaggerated posterior curvature of the thoracic spine know commonly as humpback, stooped posture.
Be sure to read JoAnne Martin’s story about her experiences.
According to the Mayo Clinic, dietary factors including low calcium intake, eating disorders, and gastrointestinal surgery make osteoporosis more likely.
Treatment and Prevention and their Relationship to Visual Impairment
Even after the first fracture, effective treatments can decrease the risk of further fracture. In fact, osteoporosis can be diagnosed, treated, and prevented before any fractures occur. Prevention of falls is particularly important in those with osteoporosis. Precautions such as removing household hazards, installing grab bars, wearing well fitting shoes, using handrails on stairs, and using particular caution when taking medications which cause drowsiness can help to prevent falls. According to the Centers for Disease Control and Prevention (CDC), more than one-third of adults ages 65 and older fall each year in the United States. People with vision loss are almost twice as likely to experience multiple falls as those with normal vision. The dual issue of vision loss and osteoporosis makes it even more imperative to use measures to utilize fall prevention measures.
A bone density test (BMD) can determine if medication is needed to prevent further bone loss. The BMD is recommended for women age 65 and over and for men age 70 and over. Medications can be prescribed to slow bone loss and speed up new bone formation if osteoporosis is diagnosed.
Calcium and vitamin D are also important in preventing and in slowing the progression of osteoporosis. The National Osteoporosis Foundation recommends a diet of 1,200 mg of calcium daily which may be difficult to get without the use of supplements. Vitamin D makes it possible for the body to absorb calcium from food. While some Vitamin D can be obtained through the skin from direct sunlight, people are encouraged to limit sun exposure due to the risk of skin cancer. So, most people need to take a supplement. People from 51- 70 years of age should take 400 international units (IUs) of Vitamin D per day and persons over the age of 71 should take 600 IUs daily.
The National Osteoporosis Foundation recommends regular weight bearing and muscle strengthening exercise along with the avoidance of excessive alcohol use and smoking as a part of treatment for osteoporosis. Exercise is an important part of treatment for osteoporosis and should be discussed with your physician. Activities involving twisting or impact may need to be curtailed while regular weight bearing and strengthening exercise is often advised under a doctor’s recommendation.
What Types of Exercises Are Most Beneficial for People with Osteoporosis?
- Weight bearing exercise causes the bone and muscle to work against gravity. Some examples of potentially appropriate weight bearing exercise are walking and dancing.
- Strengthening exercises might include lifting weights, resistance machines, circuit machines, exercise bands, and Pilates. Swimming provides resistance and strengthening exercise.
- Balance exercises are a third form of exercise that help prevent falls and fractures. These include tai chi, yoga, balance boards, Pilates, karate, and dance.
Be sure to check with your doctor before undertaking any kind of exercise program.
How Can a Person Who is Blind or Visually Impaired Exercise?
Here are some VisionAware resources and information
- Developing Balance
- A Matter of Balance National Program
- Exercise for People Who Are Blind or Have Low Vision
- Study on Visual Impairment, Balance, and Falls
- Fear of Falling, Eye Disease, and Limitations in Daily Activities
- Bone and Joint Issues Affecting Older Persons
- Osteoporosis. Mayo Clinic Foundation for Medical Education and Research
- Exercise for Strong Bones. National Osteoporosis Foundation
- PubMed Health, A Service of the National Library of Medicine, National Institutes of Health