Osteoporosis

Some 10 million Americans have osteoporosis and another 34 million have low bone mass, putting them at risk of the disease. While osteoporosis mostly affects people over the age of 55, it can strike at any time.

Osteoporosis literally means "porous bones" and refers to the loss of bony matrix and calcium that causes bones to become weaker and more likely to fracture, or break, with minor trauma.

Osteoporosis is a "silent disease." You cannot feel bone loss or your bones becoming weaker. Often the first sign of osteoporosis is a fracture.

Osteoporosis is a chronic disease that can have tremendous impact on an individual's quality of life. Bone fractures can lead to chronic pain, height loss, and difficulty moving.

Risk factors

Although we all experience bone loss as we age, not everyone develops osteoporosis or experiences fractures. Bone mass typically begins declining in both men and women in their mid-30s.

However, certain people are more likely to develop osteoporosis than others. Risk factors include:

• Being female — Women make up four out of five people with osteoporosis
• Thin or small frame
• Family history — If you have a parent with osteoporosis, you are also  more likely to have it
• Estrogen deficiency as a result of menopause, especially if menopause is early or the result of surg  — Women can lose up to 20 percent of their bone mass in the first five to seven years following menopause, making them more susceptible to osteoporosis
• Low lifetime calcium intake
• Advanced age
• Inactive lifestyle
• Smoking and alcohol abuse
• Use of certain medications (like corticosteroids, chemotherapy, and anticonvulsants)
• Consuming large amounts of caffeine may decrease calcium absorption
• Certain diseases or conditions, such as anorexia nervosa

Prevention and treatment

Although there is no cure, osteoporosis is preventable and treatable.

• Talk to your doctor about bone mineral density (BMD) testing — Consider testing if you are a woman over the age of 65 or a man over the age of 70; a postmenopausal woman or man age 50-79 who is at an increased risk for the disease; or a woman or man who has had a bone fracture,
• Make sure you get enough calcium and vitamin D — If you are age 50 or older you should consume at least 1,200 milligrams of calcium a day and 800-1,000 International Units of vitamin D a day.
• Exercise — Bone is living tissue, just like muscle. The more you exercise and gain strength, the healthier and stronger your bones will be.

Osteoporosis treatment is usually a multi-pronged approach including an increase in calcium and vitamin D intake, lifestyle changes, exercise, and medication when appropriate.

Exercise

There are primarily two types of exercises that help stimulate bone growth: weight-bearing exercise and resistive exercises.

Weight-bearing exercise is an exercise in which you are on your feet, like jogging, walking, dancing, and jumping rope. Resistive exercises are strengthening exercises in which you are pushing or pulling against resistance, with weights or elastic bands.

Mila Rodgers, physical therapist for John Muir Health, says that bone-strengthening exercises are important for all ages.

"For children, the best exercise or sport is one that requires running, jumping, kicking, or contact with a ball. Even swimming has been shown to increase bone density in athletes," she says.

Experts recommend 60 minutes of exercise for children and teens daily. Sports, dancing, and skateboarding are all good ways to promote good bone health.

For adults, the recommendations are more specific. For persons with no medical considerations, experts recommend a combination of weight-bearing exercise and strength training.

The best type of weight-bearing exercise is one that is either high loading or impact exercise, such as step aerobics, jumping rope, or stair running. High loading or impact sports such as soccer, volleyball, or tennis are also a good way to stimulate bone strength.

Ideally, adults should perform at least 150 minutes a week of weight-bearing exercise and do strengthening exercises two or more times a week.

Healthy bones

Individuals with osteopenia (low bone mass), or osteoporosis, should consult a physician before starting any exercise program. Your doctor may still recommend weight-bearing exercise, but usually with lower impact, like walking, dancing, or using the treadmill.

Your doctor will probably also recommend strengthening exercises, but not exercises or sports that require twisting or bending of the spine, like sit-ups, bowling, or tennis. In older adults, balance exercises or Tai Chi classes once a week may also be helpful.

"With any exercise program, you must continue to challenge yourself," says Jeannie Peterson, physical therapist at John Muir Health.

"For instance, if you are already walking, you might add more days, or add hills, longer distances or increase your speed. If you are doing weight bearing exercise, you might try adding strengthening exercises two to three times each week,” she says.

“Our bodies respond to change, so exercise needs to be varied and challenging to continue being beneficial. Early detection and exercise can make a difference when it comes to osteoporosis. It is never too early to think about the health of your bones."