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Osteoporosis is a disease marked by a decrease in the density within our bones.  This loss of density is caused by the loss of minerals, namely calcium, from within our bones.  While the term has now come to be common place, patients often ask similar questions regarding the condition.  So let’s make sure everyone has a solid understanding of the basics regarding osteoporosis and how to best deal with it.

Why does this happen?  Our bodies use calcium for all sorts of processes, not just keeping our bones strong.  Calcium is an important component for muscle contractions as well conduction of nerve impulses.  These processes are critical for our ability to survive each day.  So when we do not have proper amounts of dietary calcium available in the bloodstream, our body will look for it wherever it can find it.  The most accessible supply of calcium is in your bones.  Big moral of this part of the story, having lower dietary levels of calcium forces your body to go to its reserves, which over the long run causes your bones to lose their calcium deposits and ultimately their tensile strength.  For many people, a long-term low dietary intake of calcium is the direct cause of osteoporosis in later years.

Who can get it?  We most commonly hear of women developing osteoporosis after menopause.  Estrogen helps protect against bone density loss.  So when women  start menopause and their estrogen levels drop, they become more susceptible to osteoporosis.  After the age of 75, both men and women can develop senile osteoporosis with a prevalence of 2:1 women to men.  People who have had bariatric surgery resulting in the reduction of their stomach size are often less able to absorb nutrients and are at greater risk for osteoporosis.  Finally, patients who have a long history of taking corticocorticoids, regardless of their sex, are also susceptible to the condition.

How do you know you have it?  Your healthcare provider can assess if you are at risk by taking a thorough history.  He or she would ask questions regarding history of fractures (especially ones where the injury occurs with minimal force), whether or not you have reached menopause (for women),  history of medications, and a variety of other questions.  Your physician may monitor your height from year to year after age 50 to watch for decreases in height over time.  You may be sent for specific blood work that would measure blood calcium levels, levels of vitamin D in your blood stream, even other markers such as thyroid and parathyroid levels in your body.  X-rays can reveal changes in bone density, with your bones showing “less white” than they should.  A bone density test is considered the most accurate way to measure for osteoporosis.

What can I do to make sure I don’t get osteoporosis?   The best cure is prevention.  We hit our peak bone density in our 20’s.   So proper preventative measures all throughout our lives are the best way to avoid osteoporosis.  Making sure you get enough calcium each day is a good place to start.  Generally speaking, between the ages of 18-50, we need about 1,000 mg of calcium per day.  After 50 we need approximately 1,200 mg per day.  In addition to dairy products which can be difficult to digest for many people, good sources of calcium include dark green and leafy vegetables, canned salmon or sardines, and some cereal products are fortified with calcium as well.   We also need vitamin D on a daily basis.  This is most easily obtained with exposure to sunshine.  But for people who cannot access the sunlight directly, it can be found in salmon, canned tuna, sardines, and milk too.  Finally weight-bearing exercise strengthens our bones and should be a consistent part our lives from an early age.

Treatment options.  There are a variety of long-term medications that can be used in conjunction with the lifestyle modifications listed above.  Because many of the medications have side-effects, it is best to discuss these in depth with your medical doctor.

Are chiropractic adjustments safe if I have osteoporosis?  There are a variety of low-force treatment options for patients with bone density loss.  They may involve techniques that use special instruments (activator) or gently adjustive manual techniques like SOT.  It is absolutely esssential however, that you maintain the health and range of motion of your spine, whatever stage in life you find yourself.  Also, be sure to tell your chiropractor if you have been diagnosed with osteoporosis or osteopenia or if you have a family history of it.

There are a variety of resources that provide even further detail into the condition.  One such organization is the National Osteoporosis Foundation.  They can be found at www.nof.org.  Most importantly, if you have any concerns that you may have this condition, talk to your chiropractor or medical doctor.  You are always your best advocate.