Osteoporosis – Things we all need to know

Osteoporosis is commonly linked to post-menopausal women. However, men, younger women, children and pregnant women can also be affected.
Osteoporosis literally means ‘porous bones’ and is a condition where you are at greater risk of breaking or fracturing a bone (to break or fracture a bone means the same thing).
Within your bones, there is a mesh-like structure, which looks like a honeycomb. When you have osteoporosis the struts that make up this mesh become thin making the bones fragile and easier to break, even with a minor bump or fall.

Osteoporosis bone

There are two types of cells in bone constantly building new bone and breaking down old bone as a natural process called bone turnover. Up to our mid 20’s the building cells are working harder to build stronger bones but from our 40’s the breaking down cells work harder and our bones become gradually weaker as part of the natural ageing process.
There are certain things, however, that can increase the rate of this bone weakening and so increase the risk of developing osteoporosis and fractures. These risk factors are discussed below.

Bone health is largely inherited from our parents so if one or more of your parents has broken a hip you are more likely to break a bone yourself.

By 75 years old about half the population will have osteoporosis at some level.

Women have smaller bones than men and also the menopause accelerates the process of bone turnover.

Previous Fractures
If you have previously broken a bone easily then you are more likely to have fractures in the future.

Afro Caribbean people are at less risk as their bones are naturally stronger than Caucasian or Asian people.

Drinking excessive alcohol appears to be a significant risk factor for osteoporosis.

Current smokers are more likely to break bones. It has a toxic effect on the bone-building cells.

Low Body Weight
This often means bones are finer and smaller and in older people, there is less padding if they do fall. Also, fatty tissue does produce small amounts of oestrogen which may help women’s bones in later life.

See National Osteoporosis Society web site for more details https://www.nos.org.uk

Older people (over75) who for whatever reason, e.g. poor balance or poor eyesight, are at risk of falling are more likely to have a fracture as a result.

Certain medical conditions
-Rheumatoid arthritis
-Low levels of oestrogen in women– due to early menopause or a hysterectomy with ovaries removed (before 45), Turner’s syndrome or Anorexia Nervosa (or a past history of). Excessive exercise can also reduce hormone levels (especially if there is loss of normal menstrual periods)
See National Osteoporosis Society web site for more details https://www.nos.org.uk
-Low levels of testosterone in men e.g. following surgery or treatment for cancers.
-Hyperthyroidism, abnormally high levels of thyroid hormones
-Parathyroid Disease
-Conditions that affect the absorption of food such as Crohn’s or coeliac disease
-Conditions that cause long periods of non-movement e.g. a stroke.

Certain Medicines
-Taking steroids for more than three months
-Anti-epileptic drugs
-Breast cancer drugs
-It is also thought that the long term use of proton pump inhibiting drugs such as omeprazole used for relief of acid reflux and stomach ulcers and the Depo-Provera progesterone contraceptive injection could increase the risks of developing osteoporosis but more research is needed.

See National Osteoporosis Society web site for more details https://www.nos.org.uk

What Can We Do
So although it seems our genes play a large part in this the way we live our life can also play a part in the amount of bone we invest in our ‘bone bank during our youth and how much we retain in later life.

Healthy Balanced Eating
Getting enough calcium is important but you also need a healthy balanced diet with a wide variety of foods from the four main groups, fruit and vegetables, carbohydrates like bread, potatoes, pasta, cereals, milk and dairy products, protein such as meat, fish, eggs, pulses, nuts and seed. This will make sure you have all the correct nutrients that your bones need as well as calcium. Some examples of calcium-rich foods are milk, yoghurt, cheese, baked beans, tofu and whitebait NB Low fat or fat-free dairy products have as much, if not more, calcium as their full-fat versions.
In childhood, adolescence and early adulthood we can ‘bank’ plenty of bone to be better able to withstand the bone loss in later life.
You should not need to take additional calcium supplements if following a healthy varied diet unless advised by a health professional.

Vitamin D
The body needs vitamin D to help absorb calcium and the best source is sunlight. 10 minutes only of sun on bare skin once or twice a day with no sunscreen (obviously taking care not to burn) between the months of May to September will get you through the winter months.

Stop smoking
Another good reason to try to give up.

Reduce alcohol consumption
Stick to government guidelines of a limit of no more than 2-3 units a day for women and 3-4 for men.
NB a unit is equal to a small glass of wine (125ml), 1/2pt of normal strength beer or cider or a single shot of a spirit such as whisky or gin.

Regular weight-bearing exercise will help your bones grow stronger, for example, jogging, aerobics, tennis, dancing and brisk walking. We can top up our ‘bone bank’ during our younger years (pre mid 20’s) with plenty of weight-bearing exercise during our youth.
Exercise such as Tai Chi, swimming, golf, gardening can help maintain muscle strength, balance and coordination so helping lessen the risk of falling as we get older.
Get advice on the type of exercise that is best suited to you, your age, mobility, balance etc.
Frailer people may need specific exercises from a physiotherapist or a referral to a falls prevention service at a local hospital.

Reduce the risk of falls in the home
Don’t rush on the stairs, use the handrail.
Look out for loose rugs, trailing wires or bedspreads, slippery floor surfaces, poor lighting.



On an osteopathic note, people with osteoporosis can still have an osteopathic treatment you just need to let your osteopath know that you have the condition and they will take this into consideration. They will also be assessing your risk factors for osteoporosis, if you are not diagnosed, during the case history taking and will adapt treatment techniques accordingly to ensure continued good bone health.