Monday, April 23, 2018

PT Pathologies: Osteoporosis

Osteoporosis is a disease characterized by decreased bone density due to insufficient calcium and decreased osteoblast activity.  This condition results in porous bones that are more vulnerable to breaking; often it is asymptomatic until fractures begin to occur in the affected individual.  The bones of the hip, spine, shoulder and arms are most vulnerable to fractures.  Compression fractures of the vertebrae result in the characteristic kyphosis frequently associated with people suffering from osteoporosis.  According to the American Physical Therapy Association, there are 1.5 million fractures per year due to thinning bones; 55% of Americans over the age of fifty will fracture a bone.  Women are more likely to suffer these fractures, since the decrease of estrogen after menopause contributes to less osteoblast activity; since osteoclast activity does not decrease, there is a greater proportion of bone being broken down than being formed.

        There are various affecting factors that contribute to the formation of osteoporosis, and some of these are controllable.  The predisposing factors that are not controllable include: advanced age, gender, a slight skeletal frame, and genetics.  However, there are controllable factors as well, including: cigarette smoking, excess intake of alcohol and/or caffiene, a calcium poor diet, low vitamin D levels prolonged steroid use, lack of weight bearing exercise and an overall inactive lifestyle.  Although a greater proportion of sufferers are women, there are men who develop osteoporosis as well; men who have Celiac disease, inflammatory bowel disease, spin bifida, cystic fibrosis, rheumatoid arthritis, and/or kidney disease have a greater likelihood of developing porous bones and the resulting fractures.

        Individuals suffering from osteoporosis can benefit from physical therapy.  Although complications of this disease cannot be reversed, its progression can be decelerated.  In addition to the increased intake of dietary calcium, weight bearing and resistance exercises can help to increase osteoblast activity and result in stronger bones.  Examples of weight bearing activity that are of benefit including dancing, jogging, and racquet sports.  Activities such as weight lifting, exercise with resistance bands, water aerobics, push ups and yoga are examples of light resistance exercises that can benefit individuals with osteoporosis.  Additionally, a physical therapist can help patients develop better posture and balance; along with educating patients bout ways in which to increase the safety of their environment, these skills can help to lessen the chances of a fracture occurring.

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