Osteopenia, Osteoporosis and Osteoarthritis
with Hannah Williams, Physical Therapist, Boone Health Therapy Services
Bones, bones, our magical bones. Human bones grow stronger and more dense (less prone to fracture) until we reach the age of about 25. As we go through young and middle adulthood, from about 30 to 50, our bone density remains stable. This is due to our bones breaking down while new bone builds simultaneously.
After about 50, bone breakdown takes over more than new bone being formed, and bone density starts to decline. Most women will experience a decrease in their bone density after menopause.
Bone density is measured by a DEXA scan (dual x-ray absorptiometry). It measures the amount of calcium and other minerals you have in your bones. Your results will include a number called a T-score. The lower your number (the more negative your number is), the weaker your bones are and the greater likelihood that you may fracture or break a bone in the future.
Osteopenia
Similar to prediabetes being the precursor for type 2 diabetes, osteopenia is a precursor for osteoporosis.
After a bone density scan, if your number is between -1.0 to -2.5, you have osteopenia.
Osteopenia is a diagnosis given to people with bone density that is lower than the normal range but is not at the stage to be classified as osteoporosis. A T-score in this range should not be ignored, as it does still indicate an increased risk for fracture.
If you get diagnosed with osteopenia, you’re likely going to get osteoporosis.
Osteoporosis
If your T-score from a DEXA scan is lower than -2.5, you have osteoporosis. Osteoporosis is a disease of the bones. It is a decrease in bone density to a point where there’s a greater risk for fractures.
Fragility fractures are a fracture when a person who is standing upright falls to the ground or from other minimal trauma. Vertebral compression fractures, or spinal compression fractures are fractures at the level of the spine. These can come from inappropriate lifting, a fall, or other activities such as – twisting wrong, opening a window that is stuck, or picking a grandkid up with unsafe body mechanics over the course of a weekend. Humerus (upper arm bone), wrist and hip fractures are also common with osteoporosis.
How Can Therapy Help With Osteoporosis?
“It’s important to mention that bone density will not likely increase with exercise alone. That’s something that would require medication,” Boone Physical Therapist Hannah Williams said. “But therapy can help prevent falls.” Therapy will work on looking at fall risk, working on balance, and strengthening legs to support low fall risk and normal function. And while it won’t increase bone density, therapy can help maintain bone density. “Over time, we expect your bone density to continue to decline without intervention,” Hannah said. To maintain bone density, therapy works on weight bearing exercises and resistance training.
“Bone density is site specific, so if we help you strengthen the bone in your leg, it’s not going to result in an increase in bone density in your shoulder,” Hannah said. “For that reason, we work on full body strengthening. We also work on flexibility and balance to help with overall health and to decrease fall risk. While physical therapy helps maintain bone density, working with a physician to address nutrition and possible medication is the best place to start.”
Osteoarthritis
Osteoarthritis is something that most of us will have. It’s the gray hair of the bones. Our bones are separated by cartilage, which serves as a cushion and helps them not rub against each other. As we age, cartilage in certain joints may wear down, leaving bone to rub together. Hips, spine, knees and hands are the most common joints to get osteoarthritis.
On its own, it’s not a cause for concern. Even if a back x-ray shows degenerative changes, degenerative disease, or osteoarthritis, this is a common condition most people beyond the age of 30 are going to have without pain. Most of us walking around have it and don’t even know it.
There can be pain associated with osteoarthritis. Certain joints may hurt after they’ve been moved, or even the opposite. Joints can become stiff if they haven’t moved in some time.
How Can Therapy Help With Osteoarthritis?
“Physical therapy is a great option if you have pain associated with osteoarthritis.” Hannah said. “During your sessions, we can work on improving flexibility, decreasing inflammation, improving range of motion, and strengthening the muscles around the joint to support the joint for better function and alignment.
“We won’t be able to change or remove your osteoarthritis, but we can help you live pain free.”
By Erin Wegner
For more information on Boone Therapy Services or to make an appointment, call 573-815-3868 or visit boone.health/therapy-services