Osteoporosis is the thinning of bones or the loss of bone density over time. Osteoporosis is the most common form of bone disease, affecting an estimated one in five American women over the age of 50. Often osteoporosis is a factor in bone fractures, particularly after a fall. Calcium and phosphate are naturally occurring minerals needed to create new, strong bone. If an individual does not get enough of these minerals, their bones can become thin or brittle.
Causes
The loss of calcium and phosphate that causes osteoporosis typically occurs gradually as a person ages. It is especially evident in post menopausal women but can also occur in men. Other factors that play a role in osteoporosis include:
- Natural drop in estrogen following menopause
- Being confined to bed or non weight bearing for a long period of time
- Chronic rheumatoid arthritis
- Chronic kidney disease
- Eating disorders
- Taking corticosteroid medications for long periods of time
- Hyperparathyroidism
- Vitamin D deficiency
- Family History
- Smoking
Symptoms
There are often no symptoms in the early stages of the disease. It is often considered the “silent disease”. As the disease progresses common symptoms include:
- Bone pain and tenderness
- Fractures, even with little or no traumatic cause common in the spine and hip.
- Loss of height over time
- Pain in the low back
- Pain in the neck
- Stooped posture or kyphosis
Physical Therapy Interventions
Physical Therapists are professionals, educated and trained to administer interventions. As defined by The Guide to Physical Therapist Practice, interventions are the skilled and purposeful use of physical therapy methods and techniques to produce changes consistent with the diagnosis, prognosis and the patient or client’s goals.
A treatment for osteoporosis begins with a bone density test (densitometry or DEXA scan) to measure how much bone an individual actually has and confirms the diagnosis of osteoporosis. Goals for treatment include controlling pain, slowing down or stopping bone loss, preventing fractures, and minimizing the risk of falls.
Treatment
- Manual Therapeutic Technique (MTT): hands on care including soft tissue massage, stretching and joint mobilization by a physical therapist to improve postural alignment, mobility and range of motion. The use of mobilization techniques also helps to modulate pain.
- Therapeutic Exercises (TE) including site specific stretching and strengthening exercises to improve posture, regain range of motion and strengthen the affected muscles to support, stabilize and decrease the stresses place on the spine.
- Neuromuscular Reeducation (NMR) to restore stability, retrain the affected extremity and improve movement techniques and mechanics, and balance (for example, walking, kneeling, squatting and stair climbing). Gait and balance training may be indicated to reduce the risk of falls.
- Modalities including the use of ultrasound, electrical stimulation, ice, cold, laser and others to decrease pain and inflammation of the involved area if there is a fracture involved.