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Osteoporosis
and osteoarthritis are two common conditions facing many adults.
They sound similar but are actually very different. The purpose
of this article is to define each condition, how they are diagnosed
and commonly treated.
Osteoarthritis
is the degeneration of articular cartilage and bone at the joint
line. Articular cartilage is the "cushioning" system
our joints have so when we jump, run, squat, etc. our bones are
not contacting one another. When osteoarthritis occurs in a joint,
the cushioning system essentially wears out and we have more contact
of the bones at the joint line. Osteoarthritis is a common condition
that occurs as we age. It affects men and women equally. It is
more common in sites where there was a prior injury or repetitive
trauma/overuse such as the knees, hips, shoulders and spine.
Osteoporosis
is a disease process which causes reduced bone mass and structural
deterioration of both the quality and the quantity of bone. The
disease leads to skeletal fragility and fracture. Bones become
weaker, less dense and are more likely to break. Osteoporosis
is more common in women and generally occurs post-menopausal.
The spine, wrist and hip are common sites for fractures related
to osteoporosis.
DIAGNOSIS:
Osteoarthritis
is diagnosed initially by subjective complaints of pain usually
with activity. There is often edema/swelling present and a loss
of normal joint motion. An X-ray is usually taken which will confirm
the diagnosis by demonstrating changes at the joint. There will
be evidence of increased contact between bones.
Early
signs of osteoporosis are changes in posture and loss of height.
There is often no pain or symptoms associated with the early stages
of the disease. A bone density scan, "dexascan" is taken
to measure the density of the bones and confirm the diagnosis.
Physicians are often ordering bone density scans prior to menopause
to obtain a baseline of a women's bone density. The scan is then
repeated as needed to monitor bone density and detect changes
as soon as they occur.
TREATMENT:
Neither
of these conditions are and automatic prescription for pain, and
fortunately there are many treatment options when pain and limitation
are factors. Physical therapy has many tools to help with the
osteoarthritic joints including exercise instruction to provide
increased joint support where there is a loss in cartilage. PT
can also assist in restoring joint range of motion, decreasing
pain, education on body mechanics to avoid further injury and
assistance with recommended changes in activity level. Osteoarthritis
can also be treated medically by use of antiinflammitories and
steroid injections. Patients are often encouraged to make lifestyle
changes that can include weight loss and changes in activity level.
Exercising in the water is often recommended to decrease the compression
forces on the joints that are losing their cushioning systems.
Treatment
for osteoporosis is usually involves diet, exercise and medication.
It has been well established that weight bearing exercise is important
in maintaining bone density. Physical therapists can help develop
a safe, effective strengthening program that targets muscles that
help maintain posture and overall body strength. Posture, body
mechanics, and balance training are essential areas that need
to be addressed in order to prevent fractures. Physicians often
prescribe medication that can help improve bone density called
biphosphonates (Fosomax and Boniva are examples of biphosphonates).
These medications slow down the body's destruction of old bone.
Nutritional counseling can help increase the amount of calcium
and vitamin D in the diet which are essential in keeping the bones
strong. Supplements of these are often recommended in addition
to dietary changes.
If
you have been diagnosed or are concerned about osteoporosis, osteoarthritis
or both, seek help! Early diagnosis and detection is key for both
of these conditions in order to prevent progression of the disease.
Contact Healing Bridge for a free consultation or chat with your
physician to get the help you need.
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