Fighting Osteoporosis Through Physical Therapy

Ryan LaCorte Michael Yorke, Publications, Specialized Treatments

Are you one of the 44 million Americans suffering from Osteoporosis or Osteopenia?

Through research, the medical community has discovered methods not only to combat Osteoporosis, but also prevent it. In order to treat this condition, let’s discuss the facts.

  • Osteoporosis is a condition that causes bones to become thin and porous, decreasing bone strength and leading to increased risk of breaking a bone.
  • During their lifetime 50% of all women and 25% of all men over the age of 50 will have an osteoporosis related fracture.
  • Fractures from osteoporosis are more common than heart attack, stroke and breast cancer combined.
  • Women and men alike begin to lose bone in their mid-30s. As they approach menopause, women lose bone at a greater rate, from 2-3% per year due to hormonal changes.
  • Risk Factors: Age, sex, tobacco/alcohol use, vertebral compression fracture, fragility fracture, family history of hip fracture, medical conditions or use of medications that inhibit absorption of nutrients or contribute to bone loss.

Help Is Out There:

Over the past 20 years, treatment and prevention of osteoporosis have come a long way. Solutions can be broken down into 3 categories.

1. Physical Therapy:

By far the most conservative treatment for Osteoporosis is exercise through Physical Therapy. With the correct exercise program, the human body has the ability not only to prevent the loss of bone density, but also increase bone strength via the S.A.I.D. Principle (Specific Adaptation to Imposed Demands). By effectively increasing the strain or load on specific bone groups, we are able to facilitate bone mass development. Such activities must be specifically designed to stress bones in a safe manner. These exercises, in conjunction with manual therapy techniques to elongate muscle tissue and reduce compression forces on the bone, can drastically reduce the incidence of fractures. A physical therapist can determine if a simple exercise program can alleviate your symptoms.

2. Nutrition:

Nutrition and lifestyle play a key role in bone loss. Individuals who are not receiving adequate nutrition (low calcium or Vitamin D) or an excessive intake of protein, sodium and caffeine are considered at increased risk. Interventions such as calcium or vitamin supplements have been recommended for many individuals, as research has indicated that 1200-1500mgs of calcium a day along with 7-80 IU of Vitamin D reduced the fracture rate in post-menopausal women by 50%. This is generally a conservative approach and may help in the prevention of Osteoporosis in the post-menopausal female.

Research has shown that the body is better able to utilize calcium consumed in foods such as dairy products, oatmeal, tofu, soy seaweed, dark green vegetables, fish and some types of nuts. For those who are lactose intolerant (meaning they are unable to breakdown calcium into a bone building product) lactase drops may be utilized.

3. Pharmacology:

One of the biggest developments over the past 20 years in the treatment and prevention of Osteoporosis has been in pharmacology. Initially, Hormone Replacement Therapy was the most common intervention. Currently, Selective Estrogen Receptor Modulators (such as Nolvadex, Evista, Fareston) are more commonly recommended for the prevention and treatment of osteoporosis in post-menopausal women.

Antiresorptive medications or Biophosphates (such as Fosamax, Boniva, Actonel, Reclast, Fortical and Miacalcin) are now commonly utilized in the treatment of osteoporosis. Biophosphates work by preventing bone destroying osteoclasts from digesting bone.

The final class of pharmacological treatment is a bone forming medication known as Forteo. This is generally prescribed for those osteoporotic patients at high risk for fracture. Currently the FDA only recommends the utilization of this class of drug for 2 years due to potential side effects.

4. Specialized Treatment

At All-Care Physical Therapy, we specialize in the treatment and prevention of Osteoporosis and Osteopenia. We are one of the only facilities in Ocean County that have been certified in the treatment of Osteoporosis. It is essential that a physical therapist is aware of the risks of treating Osteoporosis and understand the most optimal therapeutic interventions to not only prevent the progression, but combat the disease itself.

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