KOCHI: “I have lost six inches in height and none of my clothes fit me anymore. It is hard to get clothes that look nice when my back is so hunched over," says a septuagenarian lady with a hunched back due to osteoporosis.
While Indian Orthopaedic Association is celebrating Bone and Joint Day on
August 4 and the theme is “healthy ageing with strong bones", let us discuss some important factors related to it.
What is osteoporosis?
Osteoporosis is a metabolic bone disease characterized by low bone mineral density. 1 in 2 women and 1 in 8 men over 50 will have an osteoporosis-related fracture.
What will happen if not treated?
A trivial trauma can result in hip, vertebral or wrist fracture.Hip and vertebral fractures can be fatal if untreated. All hip fracture patients may need walkers or canes to move around.
The population at risk:
Postmenopausal ladies, old age, patients on steroids, smokers, alcoholics, lean persons, persons living a sedentary lifestyle.
Fracture prevention is the key efficacy endpoint in the medical management of osteoporosis for any patient. Enhancement of bone mass and improvement of bone quality are achieved by a combination of lifestyle modification, dietary supplementation with calcium and vitamin D, and pharmacologic treatment. This strategy has proved effective for the prevention and treatment of osteoporosis.
Lifestyle evaluation is an important component of the comprehensive treatment for osteoporosis. In addition to encouraging smoking cessation and moderation of alcohol consumption, patients should also be counselled about fall prevention and appropriate exercise training to further reduce the risk of fracture.
Weight-bearing contact exercises like walking, cycling, jogging and aerobics are recommended to increase the bone density. Though swimming is a good cardio exercise, it is not recommended for osteoporotic patients as it is a non-contact exercise. It is well documented that calcium additives have no role in the management of osteoporosis unless combined with aerobic contact exercise. Patients may be encouraged to wear hip protectors, which effectively attenuate force from a fall and are associated with >50% reductions in the risk of hip fracture as well as improvement in the patient’s self-confidence that they can avoid a fracture if they fall.
In short, healthy lifestyle, a diet rich in vitamin D and calcium, adequate sunlight exposure, regular aerobic contact exercises and cessation of smoking and alcoholism will go a long way in the management of osteoporosis.
The author is an additional professor in Orthopaedics, Government Medical College Thiruvananthapuram. Views expressed are his own.