About Osteoporosis and Fractures
Osteoporosis is a disease of the bone that makes a person’s bones weak and more likely to break. Approximately 10 million Americans have osteoporosis and another 44 million have low bone density, placing them at increased risk of a fracture. There are 54 million Americans at risk of breaking a bone and should be concerned about bone health. That’s half of all adults age 50 and older!
Unfortunately, many individuals will break a bone in their lifetime due to osteoporosis. Osteoporosis is found in one in two women and up to one in four men. While this condition is common, it should not be underestimated. Every year, of nearly 300,000 hip fracture patients, one-quarter end up in nursing homes and half never regain previous function. For women, the risk of fracture is equal to her combined risk of a heart attack, stroke, uterine, ovarian and breast cancer. Men are more likely to break a bone due to osteoporosis than being diagnosed with prostate cancer. Six months after a hip fracture, only 15 percent of patients can walk across a room unaided.
Facts About Bones, Bone Density Tests and Screening Tests
Before patients can become familiar with osteoporosis, they should understand how important bones are for their bodies. Bone is living, growing tissue that is both flexible and strong. Throughout life, patients are constantly losing old bone and forming new bone. However, bone loss usually speeds up at midlife in both men and women. In order for patients to build strong bones, they should exercise at least 2 and a half hours every week. Bones are what helps patients’ bodies become mobile and serve as protection. If patients fail to protect their bones, the damage to their bodies can be severe and sometimes permanent.
Bone density tests are the only tests that can diagnose osteoporosis before a broken bone occurs. This test is able to estimate the density of your bones and your chance of breaking a bone. Not to mention, a bone density test tells you if you have normal bone density, low bone density (osteopenia) or osteoporosis. The National Osteoporosis Foundation (NOF) recommends female patients who are the age of 65 years or older and men who are 70 years or older. Not to mention, the NOF recommends patients who break a bone after age 50 to have a bone density test. A bone density test may be necessary if patients have an x-ray of their spine showing a break or bone loss, back pain with a possible break in their spine and height loss of half an inch or more within one year.
One of the types of bone density tests recommended by the NOF is the central DXA, which is a test of the hip and spine using a central DXA machine to diagnose osteoporosis. DXA stands for dual energy x-ray absorptiometry. If for some reason the testing can’t be done on the hip or spine, NOF suggests a central DXA test of the radius bone in the forearm. When patients repeat a bone density test, it is best to use the same testing equipment and have the test done at the same place each time. This method provides a more accurate comparison with the patient’s’ last test result.
As for screening tests, which are also known as peripheral tests, they measure bone density in the lower arm, wrist, finger or heel. The types of peripheral tests include pDXA (peripheral dual energy x-ray absorptiometry), QUS (quantitative ultrasound) and pQCT (peripheral quantitative computed tomography). The benefits of having a screening tests are being able to identify which patients are most likely to benefit from further bone density testing. When central DXA tests are not available, screening tests serve as a good substitution. However, screening tests cannot accurately diagnose osteoporosis and they should not be used to see how well an osteoporosis medicine is working. Results of a peripheral test should not be compared with the results of a central DXA.
It is important to note that most central DXA machines cannot measure bone density in the hip and spine of patients who weigh more than 300 pounds. There are newer machines that can measure bone density in people who weigh up to 400 pounds, but these machines are not widely available.
Most people need a prescription or referral from their healthcare provider to have a bone density test. If patients are not sure where to go for a bone density test, they can contact their healthcare provider or their insurance plan to find out where the test is available. In addition, most hospital radiology departments, private radiology groups and some medical practices offer bone density testing. When patients arrive to their appointments, they should take the prescription or referral with them. The testing center will send their bone density test results to their healthcare provider. The patients may want to make an appointment to discuss their results with their healthcare provider. Patients that are taking an osteoporosis medicine should repeat their bone density test by central DXA every one or two years. After starting a new osteoporosis medicine, many healthcare providers will repeat a bone density test after one year.
Ways to Improve Bone Health
If patients can improve their balance and prevent from falling, they can avoid suffering from breaking their bones. Patients can include balance and training exercises as well as having their homes fall proof. Another helpful and underestimated tip for patients to avoid breaking bones is to consider learning about posture exercises.
Patients can incorporate weight-bearing and muscle-strengthening exercises in order to build bone density. Simple exercises can be helpful. Walking is good for bones, as is including a pair of light dumbbells or resistance bands in a workout. Patients can join a gym or group exercise classes in order to keep their bodies active and bones healthy.
Patients need to remember their bone density does not only increase with the activities they perform, but what they eat is just as important. They should eat five or more fruits and vegetable every day and less smoking and drinking can prevent bone density loss. In order for patients to have and build healthy bones for their bodies, they must consume enough calcium and vitamin D every day. To start, patients can try low-fat yogurt or Greek yogurt to add more calcium to their diet. They can include green vegetables that have calcium in their recipes. Good choices are broccoli, bok choy, kale and turnip greens. Even foods that have calcium and vitamin D added are helpful. Fortified juices, cereals, and milk alternatives like soy milk are some good choices. Patients can take a calcium supplement if they aren’t getting enough calcium from foods, but should not take more calcium than needed. Consuming a vitamin D supplement if they need one and find out how much vitamin D they need for their age.
While patients can take steps to help themselves, osteoporosis is a serious health concern and, as such, medical professionals should be involved in any major decisions about bone health. If you live in or around San Antonio, reach out to the South Texas Spinal Clinic at (210) 614-6432 for help.