Osteoporosis is a condition in which the mass and strength of the bones in the human body is decreased, either due to disease, dietary deficiency, lack of activity, or some other cause. The bones of the human body are continuously remodelled, built up and decomposed over the course of our lifetimes. From our pre-natal infancy to the day we die, our bones are constantly changing. Bones grow longer during adolescence and puberty, are built up with excess minerals that are taken in during diet, are reinforced in response to the rigour of physical work and exercise, and are deconstructed in times of sickness, poor health, and ageing. Over the course of our lifetimes, the physical demands that are imposed on our bodies in order to live in the world are reflected in our bones, such that the skeletons of ancient men and women can be examined to tell the stories of their lives and their history.
Osteoporosis occurs when the rate at which bones are broken down exceeds the rate at which bones are built up. Bone buildup is driven by external forces which stimulate the activity of bone-fortifying cells, growth due to adolescence and puberty, as well as the effect of hormones such as testosterone and oestrogen. Bone breakdown is a normal process that is a part of bone health; bones that are only built up but never broken down can become hyperdense, which can cause issues. However, when the rate of bone breakdown exceeds the rate of bone buildup, and this is maintained over a period of time, the loss of bone mass can increase the risk of fracture, infection, and pain. Ongoing bone breakdown has the same effect as degrading the foundations of a building - the building is still occupied but less stable, and poses a risk to the people inside.
Bone breakdown can be accelerated by many different factors, which can be due to lifestyle-related, ageing-related, and disease-related factors. The most typical lifestyle-related driver of increased bone breakdown is decreased physical activity. Decreased physical activity results in decreased physical force on the bones and joints, which deprives bone-building cells of stimulation and diminishes their activity. Other lifestyle factors that increase the risk of osteoporosis are inadequate amounts of dietary minerals like calcium and phosphates, increased alcohol intake, and cigarette smoking. Age-related and disease-related factors include long-term use of corticosteroid medication, thyroid disease, Crohn's disease, and problems with vitamin D metabolism, all of which impact the health of bones and joints and increase the risk of fracture or other injury.
Osteoporosis increases the risk of fracture of bones in the body, and these fractures can be life-threatening depending on the bone that has been broken and the impact that the break has on a person's ability to care for themselves. A fracture of the dominant arm can diminish a person's ability to feed, dress, wash and care for themselves. A fracture of the long bone of the thigh usually requires surgical intervention and in-center rehab. A fracture of the spine in the ribcage, neck, or lower back can be catastrophic in the immediate period, and ongoing over extended periods of time due to structural changes that impact how the muscles and limbs move.
In the community and in private clinics, osteoporosis is managed through a combination of structured exercise, advice regarding activity modification, and education regarding lifestyle choices. Osteoporosis is rarely due to a single cause, so treatment of the disease is also management of the individual. Comprehensive management will examine all the likely contributing factors that have resulted in the diagnosis of osteoporosis, and work to address them all individually. This is why other professionals like a dietitian, doctor, personal trainer or exercise physiologist may be involved in ongoing management.
Management of your discomfort depends on its causative factors, how it feels and changes during the day, what makes it better and worse, and the length of time you have been experiencing that pain. All of these factors will be addressed in your initial assessment, which is the first step toward managing and minimising any pain or discomfort. The treatment you receive will be tailored to address the specific cause of your discomfort, and will focus on minimising pain, maximising your ability to move pain-free, and developing a plan to minimise the risk of a flare-up in the future.
At Atlas Physio, we will provide you with education, structured management, and ongoing monitoring of your pain both in-clinic and out. Contact us to arrange an assessment, and to take the first step on a course of corrective care today.