Osteoporosis: difference from Osteopathy and prevention strategies

Okay, so before we get started- lets just clear up a pet hate of mine.

Osteoporosis & Osteopathy: a homonym of sorts. The short answer is the former is a disease of bone and the latter is a hands-on treatment for muscle, skeletal and spinal problems! I know most of you know this and I’m only really joking. But as my wonderful Gran used to say; “many a true word was spoken in jest!”

Further differentiation…

Osteoporosis is a disease of bone mineral density and has haunted women since the dawn of history. Egyptian mummies from 4,000 years ago have been found with the telltale dowager’s hump. Most young women today can expect to spend their old age standing as straight and tall as they ever were, thanks to recent dramatic improvements in the diagnosis, prevention, and treatment of osteoporosis.

John Hunter, an eighteenth century English surgeon, discovered that as new bone is laid down in the body, old bone is destroyed, or resorbed. This process is now known as remodeling and was later shown to play a critical role in osteoporosis, though it wasn’t even a recognized disease for more than 100 years after his death.

Osteopathy, on the other hand is a system of manual medicine and was founded in 1874, by Andrew Taylor Still MD DO (1828-1917), a medical doctor living on the Missouri frontier. He discovered the significance of living anatomy in health and disease and realised that optimal health is possible only when all of the tissues and cells of the body function together in harmonious motion.

He reasoned that disease could have its origins in slight anatomical deviation from normal. He then proved he could restore health by treating the body with his hands, naming his innovative approach to restoring health: Osteopathy. From Greek; “osteo” meaning bone, and “pathos” disease. While we’re on the subject of Greek etymology; “chiros” means hand- hence chiropractor.

Andrew Still understood that the human body is composed of many parts, all intimately related as a functional whole. More than a hundred years ago, Dr. Still realized that the human being is more than just a physical body. He envisioned a totally new medical system that acknowledges the relationships of the body, mind, emotions and spirit. What a revolutionary!

Anyway- back at the ranch….! Are you at risk of getting Osteoporosis?

There are many risk factors for osteoporosis – some of which you cannot change, including being female, being Caucasian or Asian and having a direct relative who has had an osteoporotic fracture. But this isn’t solely a disease of the fairer sex. Men are being diagnosed with this condition more frequently. Especially in Brisbane due to slip, slop and slapping and preventing any Vitamin D from being produced and increasing our risk of developing Osteoporosis as a result. Has the phrase “damned if you do, damned if you don’t” ever had a more suitable time of use?

However there are many risk factors you can address, which can allow you to take control of your bone health and help prevent osteoporosis:

  • A well-balanced diet, including adequate intake of calcium
  • Appropriate exercise
  • Adequate levels of vitamin D
  • Lifestyle changes – for example, stopping smoking and minimising alcohol and caffeine intake.

How can you tell if you have Osteoporosis?

Get a Bone density test done…
Currently the most reliable way to measure bone density is the dual-energy absorptiometry scan or DXA. A “DXA” scan is a short, painless scan that usually measures the density of your bones at the hip and spine.

There is a Medicare rebate for a DXA scan if you:

  • Have been previously diagnosed with osteoporosis
  • Have had one or more fractures due to osteoporosis
  • Are 70 years or over
  • Have a chronic condition including rheumatoid arthritis, coeliac disease and liver disease.

How to PREVENT getting it in the first place!

Diet and calcium
Enjoying a healthy balanced diet, with a variety of foods and an adequate intake of calcium, is a vital step to building and maintaining strong healthy bones. If there is not enough calcium in the blood, the body will leach (take) calcium from the bones.

You’ve heard all this before right? But parents of daughters should pay particular attention to this one. You really need to get the calcium rich foods into your offspring’s life as early as possible. A lack of intake of calcium in the early years increases the risk of developing this disease later on.

The average Australian adult is recommended to consume 1,000mg of calcium per day. That figure means nothing to me so I imagine it means nothing to you either. So here’s some practical perspective: 1 glass of milk has about 300mg of calcium and one slice of swiss cheese has about 270mg.

Postmenopausal women and men aged over 70 years are recommended to have 1,300mg of calcium per day. Children, depending on their age, will need up to 1,300mg of calcium per day.

Dairy foods have the highest levels of calcium, but there are many other sources of calcium including sardines, spinach and almonds. If you are unable to get enough calcium from your diet alone, you might need calcium supplements.

Vitamin D
Vitamin D and calcium promote bone density. Vitamin D is important because it helps your body absorb the calcium in your diet. We obtain most of our vitamin D from the sun, so it is important to expose the hands, face and arms to the sun for 6–8 minutes every day in the warmer months (avoiding the hottest period of the day between 10am and 3pm), and about 30 minutes in the cooler months.

Vitamin D can also be found in small quantities in foods such as:

  • fatty fish (salmon, herring, mackerel)
  • liver
  • eggs
  • fortified foods such as low fats milks and margarine.

If you want STRONG BONES, then exercise!

Don’t just go for a casual stroll though- you should be pumping Iron! Just kidding- but your choice of exercise does need to be reasonably intense.

Simply put; your body will design its bony density based on your needs. Very intelligent beings we are. So if you plan on going for a 30 minute leisurely stroll of an evening and expect your bones to become nice and strong; think again. Your body is an amazing adaptive organism- put it under pressure and it will repsond by giving you nice strong bones.General recommendations include:weight-bearing activities such as brisk walking, jogging, tennis, netball or dance. Non-weight-bearing exercises, such as swimming and cycling, do not promote bone growth.

Include some high-impact exercise into your routine, such as jumping and rope skipping. Consult your health professional – high-impact exercise may not be suitable if you have joint problems, another medical condition or are unfit.

Strength training (or resistance training) is also an important exercise for bone health. It involves resistance being applied to a muscle to develop and maintain muscular strength, muscular endurance and muscle mass. Importantly for osteoporosis prevention and management, strength training can maintain, or even improve, bone mineral density.

Activities that promote muscle strength, balance and coordination – such as Tai Chi, Pilates and gentle yoga – are also important as they can help to prevent falls by improving our balance, muscle strength and posture.

A mixture of weight-bearing and strength training sessions throughout the week is ideal, aiming for 30 to 40 minutes, four to six times a week. Exercise for bone growth needs to be regular and have variety.

Lifestyle changes

General recommendations may include:

Stop smoking – smokers have lower bone density than nonsmokers.

Get some sun – exposure of some skin to the sun needs to occur on most days of the week to allow enough vitamin D production. This varies considerably depending on the time of year, time of day and your skin colour.

Drink alcohol in moderation – excessive alcohol consumption increases the risk of osteoporosis.

Limit caffeinated drinks – more than three caffeinated drinks (such as tea, coffee and cola) a day is linked to an increased risk of osteoporosis.

Why are all the good things in life bad for us?!

Things to remember

Diet, vitamin D and exercise can help to prevent osteoporosis.

If you have osteoporosis, medical treatment can prevent further bone loss and reduce your risk of bone fractures.

Treatment options for osteoporosis include dietary changes, supplements, exercise, lifestyle changes, falls prevention and medications.

And most important to remember: Osteoporosis and Osteopathy are very different!!!

Enjoy the journey!

Anthony Collins