In early November 2016, I was one of only two Osteopaths, out of over 500 delegates, who attended The National Osteoporosis Conference at the ICC Birmingham. Over 3 days there was a huge amount of information and the latest research on Osteoporosis, its causes, symptoms, diagnosis and treatment.
Here are some of the points that I found surprising, shocking or really important to know.
Mild vertebral collapse will be missed or not reported on in many X Rays or scans, unless they are specifically asked for by the requesting GP. Only 40% of all vertebral fractures come to the GP’s attention at the time, but are picked up many years later, following a hip fracture or further vertebral fractures.
In older people, the relative risk for a second hip fracture increases by almost twelve times during the first month after a hip fracture. The fracture risk drops to six times the normal level at three months. The second hip fracture risk is still twice the normal level after one year following a hip fracture.
Almost half the number of deaths in older people following treatment for a hip fractures are due to malnutrition, either in hospital, or at home afterwards.
In older people, one of the commonest complication following a hip fracture is delirium.
Vertebral fractures can be clinically silent, but usually present as back pain. In older women, if there is lateral waist pain with the back pain, there is a four and a half times increased risk of it being caused by a vertebral fracture. A loss of height of more than 4cm is also an indication of vertebral fracture.
One of the most significant indications of a vertebral fracture is a loss of space between the bottom rib and the top of the pelvis. You should be able to get three to four fingers in the space between your ribs and the top pelvis (hip bone at your waist). If you can get fewer than two fingers, or if there is no space at all between the bottom rib and the top of the pelvis that is a strong indication of a fractured vertebra.
24% of men and 21% women in the UK have low vitamin D. EVERYONE should take vitamin D during the winter months, not just the high risk groups.
Insulin dependent (Type 1) diabetics have a higher risk of osteoporosis and a 5 times higher hip fracture.
Women with inflammatory bowel disease are at risk of osteoporosis due to malabsorption and systemic inflammation.
It was always thought that it was just the steroid treatment that caused osteoporosis, but it is now known that the systemic inflammation creates pro inflammatory cytokinines that are a primary mediator for bone loss
Vitamin D deficiency during pregnancy is linked to low bone mass density in the child at age 9 years of age, and even up to 20 years of age. Recommendation for pregnant mums is 1,000IUs a day.
Weight lifting and impact exercises improve bone density and bone quality. Weight lifting in a gym needs to be done under appropriate supervision, with the aim of lifting 10 repetitions to failure (or near failure). Weight lifting can be done at any age, and is not just for the young.
Walking is not as good at loading bone as previously thought, as there isn't enough impact through the femur and hip to simulate bone formation. This includes exercises such as hopping on one leg, 50 times on each leg once a day every day.
Women avoid lifting weights as they are concerned that they don’t want to look ‘muscle-y’ , but as women over 40 can lose 1% of their muscle mass EVERY YEAR, they need to weight train to preserve the muscle strength that they have.
This loss of muscle strength is why women get so much neck pain and headaches, due to the loss of upper body and cervical muscle.
If you want to keep your health, strength and bone density - get to the gym! But find yourself a really good personal trainer.
The next Osteoporosis Conference isn’t until 2018, so watch this space for more Osteoporosis updates.