In recognition of National Osteoporosis Month, we set out to explore some of the main preventative measures and treatment options for this condition. During our research, we were surprised to find that Osteoporosis causes 70-90% of 30,000 hip fractures annually and fewer than 20% of fracture patients in Canada currently undergo diagnosis or adequate treatment for osteoporosis! According to Osteoporosis Canada, without Bone Mineral Density (BMD) testing, 80% of patients with a history of fractures are not given osteoporosis therapies. That means that hundreds of thousands of Canadians needlessly fracture each year because their osteoporosis goes undiagnosed and untreated. Clearly BMD testing has huge advantages, so what is it exactly?
Bone Mineral Density Testing
A bone mineral density test uses X-rays to measure the amount of minerals — namely calcium — in your bones. The more minerals you have, the better. That means your bones are stronger, denser, and less likely to break. The lower your mineral content, the greater your chance of breaking a bone in a fall.
The test requires little preparation. For most bone scans, you don’t even need to change out of your clothes. However, you should avoid wearing clothing with buttons, snaps, or zippers because metal can interfere with X-ray images.
Who Should Get Tested?
Anyone can get osteoporosis. It’s more common among older women, but men can have it, too. Your chances increase as you age.
You should discuss with your doctor whether you need the test. They may recommend it if you meet any of the following risk factors:
- You’re a woman 65 or older
- You’re a postmenopausal woman 50 or older
- You’re a woman at the age of menopause and have a high chance for breaking bones
- You’re a woman who has already been through menopause, younger than 65, and have other things that give you a higher chance of osteoporosis
- You’re a man 50 or older with other risk factors
- You break a bone after 50
- You’ve lost more than 1.5 inches of your adult height
- Your posture has gotten more hunched
- You’re having back pain without any cause
- Your periods have stopped or are irregular although you’re neither pregnant nor menopausal
- You’ve gotten an organ transplant
- You’ve had a drop in hormone levels
What Happens After the Scan?
Your doctor will review your test results. The results, referred to as a T-score, are based on the bone mineral density of a healthy 30-year-old compared to your own value. A score of 0 is considered ideal.
The NIH offers the following guidelines for bone density scores:
- normal: between 1 and -1
- low bone mass: -1 to -2.5
- osteoporosis: -2.5 or lower
- severe osteoporosis: -2.5 or lower with bone fractures
Your doctor will discuss your results with you. Depending on your results and the reason for the test, your doctor may want to do follow-up testing. They will work with you to come up with a treatment plan to tackle any issues.
What Does a Treatment Plan Involve?
According to the 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada, exercise greatly improves quality of life for those with osteoporosis, particularly in the domains of physical function and pain, and improves muscle strength and balance. When our mobile physiotherapists work with osteoporosis clients, we focus on four main things:
- Exercises involving resistance training appropriate for the individual’s age and functional capacity.
- Exercises to enhance core stability and thus to compensate for weakness or postural abnormalities.
- Exercises that focus on balance, such as bosu ball work, or on balance and gait training.
- Falls prevention training to decrease the risk of falling.
As no single cause for osteoporosis has been identified, it is important to keep your osteoporosis risk factors in mind and communicate often with your Doctor if you think you may be a candidate for a Bone Mineral Density scan. Early diagnosis can be critical in the long term management and treatment of the condition. Also, keep in mind that any weight-bearing exercise such as walking, hiking, climbing stairs and weightlifting can increase bone density. As little as 15 to 30 minutes a day can be helpful. Weightlifting does not need to be with heavy weight either, it can be with as little as 2 – 5 pound hand or ankle weights. Or you can use your own body weight and let gravity do the job. It is important to note that weight-bearing exercise is extremely important for late childhood and teenage years, as this is when we build the most BMD. If you feel like you need some guidance when developing an exercise routine, or would like to set up a program for your child, please reach out to our office and we’d be glad to help you out!