Myths about Bone Health

Bone health is often overlooked until a fracture occurs. Understanding the basics can help prevent one of the most common and debilitating consequences of aging..

Bones are like trees, they need the right nutrients and environment to grow, repair, and remodel. Building and maintaining optimal bone health requires an active effort at all stages of life.

One of the common myths about osteoporosis is that it's an inevitable part of growing old.

Bone mass is built up until our thirties and then we start slowly losing some every year.

Although bone loss is inevitable, our lifestyle can significantly slow down or speed up the rate.

Physical activity, adequate nutrition, and good health are necessary for bone health. Weight-bearing resistance exercises and aerobics have a beneficial effect on bone mass.

Smoking, alcohol, sedentary lifestyle, being overweight, and certain medications accelerate bone loss.

Another common myth is that only women are affected by osteoporosis.

Although women are 4x more likely to be affected especially post-menopause, osteoporosis affects men as well and can lead to hip fractures, wrist fractures, and spine fractures most commonly.

Medical treatments for osteoporosis exist and may slow or reverse the process. However, the focus should be on prevention throughout one’s healthy years.

Does osteoporosis indicate abnormal or diseased bone?

Osteoporosis is a term that describes a low bone mass or density, although the structure of the bone itself is normal. Less severe osteoporosis is called osteopenia.

Your bone density is considered to be normal, osteopenia, or osteoporosis based on a measurement on a special X-ray called a DEXA scan. The T-score on the bone density report compares how much your bone mass differs from that of an average healthy 30 year old.

Osteoporosis is defined by the World Health Organization as a T-score that is lower than the average 30 year old by 2 and a half standard deviations, also indicated by a T-score of -2.5.

Osteopenia is defined a T-score that is between -1.0 and –2.5 standard deviations below an average healthy 30 year old adult.

Not everyone with osteopenia will develop osteoporosis.

Is it painful?

Osteoporosis in itself does not cause pain.

However, osteoporotic bone is more likely to fracture which may lead to pain and morbidity.

One of the most devastating consequences of fractures is loss of mobility, independence, and quality of life.

Reduced bone density can also jeopardize the results of spine surgery especially if it involves instrumentation and fusion.

Who should get tested?

Healthy men and women starting at 65 years of age, earlier if any risk factors or history of fracture.

Patients scheduled for elective spine surgery may benefit from preoperative optimization of bone density if possible.

What can be done about it?

1) Diet Respect the recommended dietary allowance for calcium and Vitamin D by age, adequate protein intake, stay away from processed foods, alcohol and cigarettes.

2) Excercise Both weight-bearing and resistance training exercises are necessary. Weight-bearing exercises trigger the body to build bone and are crucial for bone strength. Muscle training or resistance training aims to improve strength, balance, and flexibility, and is crucial for fall prevention and injury avoidance. Combine with stretching and core-strengthening (yoga, pilates, planks) and restorative sleep for maximum gains and optimal health. The best way to achieve and maintain such a level of activity is through integrating small sustainable changes in your routine and build on them.

3) Risk management & Injury prevention The risk of falls increases with aging. A large number of injuries and fractures happen indoors. It is natural to pay attention in a new environment, but we tend to let our guard down around the house, browsing our phones while we multitask. Maintain situational awareness at all times, ensure adequate lighting, avoid clutter, avoid heights and ladders, and install safety guards in the bathroom or on the stairs if necessary. Take your time and focus on the task at hand. Don’t run to get the phone or the door, it’s not worth it. One second can change your life.

4) Medical treatment If deemed necessary, pharmacologic agents are available that may slow the process of bone loss and sometimes restore bone density. The DEXA scan is usually repeated after 2 years to monitor progress.

Only you have your back!