Osteoporosis
Osteoporosis is a disease characterised by low bone mineral density, micro bone surface deterioration with a consequent increase in bone fragility and susceptibility to fracture. Diagnosis is confirmed by measures of bone density (B.D) via a DEXA (dual-energy x-ray absorptiometry) scan. Osteoporosis is confirmed when B.D is 2.5 standard deviations bellow “young normal adult”.
Causes
Primary osteoporosis is caused by a disruption in the cycle of bone turnover. This includes:
Post-menopausal osteoporosis (type 1)
Age related osteoporosis (type 2)
Secondary osteoporosis is commonly caused from endocrine (hormonal) deficiencies that lead to the bones being affected. These include:
Hyperthyroidism
Chronic liver disease
Hypophosphatasia
Signs & Symptoms
There is often a long latent period before clinical symptoms or complications develop
The earliest symptom of osteoporosis is often an episode of acute dull ache type pain – similar to that of osteoarthritis
Differential Diagnosis
Osteomalacia
Osteoarthritis
PROmotion Assessment and outcome measures
Subjective examination including a family history check of osteoporosis and a thorough check of when the pain occurs, how it occurs and importantly – where it occurs.
Assessment of hip flexors, extensors, abductors, knee extensors and plantar flexor muscles.
Flexibility testing of muscles surrounding affected joint/s
Balance testing – BESS test, stalk stand
Cardiovascular ability testing
How to Manage
Education & advice surrounding correct loading of the joints and how to avoid overloading.
Correct postural re-training
Advice and training in breathing mechanics
Specific strengthening and loading of joints and surrounding musculature
Specific cardiovascular training
References
Myers, J., Nieman, D. C., & American College of Sports Medicine. (2010). ACSM's resources for clinical exercise physiology: Musculoskeletal, neuromuscular, neoplastic, immunologic, and hematologic conditions. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins Health.
Bello MO, Garla VV. Osteoporosis In Males. [Updated 2020 Jan 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538531/
APA Glaser, David L., MD*; Kaplan, Frederick S., MD*† Osteoporosis: Definition and Clinical Presentation, Spine: December 15, 1997 - Volume 22 - Issue 24 - p 12S-16S