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Osteoporosis

Living With Osteoporosis

Monday, April 23, 2012 - 12:52

Contributing Author: Guy Slowik FRCS

The good news is that almost everyone with osteoporosis can be treated successfully. The newer medications on the market today (described in How You Can Prevent Osteoporosis) [hyperlink to that section] are considered breakthroughs in the treatment of osteoporosis. But treatment begins after the diagnosis, which is quick and easy with your bone density test -- before the first fracture.

Knowledge is the key. The more you know about the prevention and treatment of osteoporosis, the better your chances of staying active and independent. The key to managing osteoporosis is to prevent as much bone loss as possible with a good diet, healthy habits, and proper exercise.

If you have been diagnosed with osteoporosis, there are certain things you can do to help yourself stay as active as possible.

Helpful Exercises

Certain exercises can benefit individuals with osteoporosis (and those who may be at risk). Be sure to discuss these exercises with your health care provider or physical therapist.

  • Back stretching - This is a good exercise to help you limber up for the day even before you get out of bed. It stretches the hips, the lower back, and knees.

    These exercises can be done on the bed or the floor.

    1. Pull one knee (at a time) to your chest. Place your hands under your knee to help pull the leg in further. Now do the same with the other leg. Repeat, alternating legs. Begin with five repetitions, two or three times a day, and gradually build up to 20 repetitions.
    2. Now pull both knees to your chest, at the same time, and hold for six seconds. Gently rock side-to-side while holding your knees.
  • Cheek to cheek - This is a fun exercise because you can do it anywhere, anytime, and practically in any position. This exercise strengthens the muscles of the buttocks, which help support the back and legs.

    If you do it when you are sitting down, you'll find that you rise up out of your chair a little as you contract the muscles.

    1. Press your buttocks together, and hold for a six-second count. Relax and repeat. Gradually increase up to 5, then 10, then 20 repetitions. Repeat two times daily.
    2. You can do this exercise as often during the day as you'd like. Frequent repetitions will not hurt you.
  • Pelvic tilt - This is one of the best exercises you can do to strengthen your abdominal muscles. This, in turn, will help support your back. You can do this one in bed or on the floor; depending on which is more comfortable.
    1. Lie down and bend your knees. Next, relax and raise your arms above your head.
    2. Then tighten the muscles of your lower abdomen and your buttocks at the same time, so that you flatten your back against the bed or floor. Hold this flat-back position for a six-second count.
    3. Then relax and repeat.
  • Bridging - This exercise strengthens the muscles in the back.It is done lying in bed or on the floor.
    1. Lie on your back and bend your knees. Now lift your hips and buttocks off the bed or mat 4 to 6 inches, making sure that you keep the small of your back nice and flat.
    2. Tighten your buttock and hip muscles to maintain this position, and hold for a count of six. Then, relax and lower your hips and buttocks to the floor.
    3. Repeat this exercise twice daily. Gradually increase your repetitions, per set, to 5, then 10, then 20.
  • Straight leg raises - This exercise strengthens the muscles of the abdomen and improves the flexibility of the legs. Lie on your bed or on the floor, whichever is more comfortable for you.
    1. To protect your back during this exercise, hug one leg to your chest, or simply bend your knee, and rest the foot on the bed. Now raise your other leg straight up, slowly, as far as you can, until you feel your back begin to arch. Try to keep your abdomen in. Keep your back firmly against the floor or bed as you did in the pelvic tilt. Hold the position for six seconds.
    2. Bend and lower the leg, and repeat the exercise. Now do the same with the other leg.
    3. Repeat this exercise, gradually increasing to 5, then 10, then 20 repetitions.
  • Partial sit-up - This exercise strengthens the muscles of the abdomen. You can do this exercise on your bed or the floor.
    1. Lie on your back with your knees bent. Raise your head and shoulder blades off the floor, and hold the position for a six-second count.
    2. Slowly return to lying on your back with your knees bent. Repeat.
    3. Start this exercise with only one or two repetitions, until your body adjusts to it. Gradually increase to 5, then 10 repetitions.
  • Back extension - This exercise for strengthening the back muscles is done lying on your bed or the floor, stomach down.
    1. Raise your head, arms, and legs off the floor. Do not bend your knees. Keep your torso straight.
    2. Hold for several seconds while you count out loud. Relax and repeat.
    3. Gradually increase this exercise up to 5, then 10 repetitions. If you experience discomfort, stop. Get the okay of your doctor or physical therapist before you try it again.
  • Cat camel - This exercise strengthens your back muscles. Skip it if you have painful knees, ankles, or hands, because it places pressure on these areas.
    1. Pretend you are going to crawl, and place your hands directly beneath your shoulders. Take a deep breath and arch your back the way a frightened cat does, and lower your head.
    2. Hold the position while you count six seconds out loud. Then, exhale, lower your back slowly, and raise your head.
  • Wall push - This exercise helps to stretch your body.
    1. Stand spread-eagle against a solid wall. Now arch your back inwards slowly.
    2. Repeat this exercise and gradually increase repetitions from 1 to 5 or more. This exercise is fun because you can do it anytime you feel you need a good body stretch.
    3. Repeat two times daily.
  • Deep breathing - This exercise improves your posture and gives you better movement through your chest.
    1. Lie down on your back and place your hands behind your head. Then, breathe deeply and raise your chest, while you fill your lungs completely. Hold for two seconds.
    2. Then exhale by drawing your upper abdomen in (keep your chest extended). Take the next breath against the uplifted chest.
    3. Begin this exercise slowly. Gradually increase the repetitions from 5 to 10, then up to 20.

Increasing Calcium In Your Diet

One of the best ways to help slow the progression of bone loss is to get enough calcium in your diet. Here are some practical ways to increase the calcium your consume:

  • Include 3 to 4 servings of calcium-rich products daily in your diet. Milk, cheese, and yogurt all contain lactose, which enhances calcium absorption.
  • If you are counting calories, instead of excluding dairy products, choose low-fat or skim milk products.
  • Drink vitamin D-fortified milk and get some exposure to the sun (use a good sunscreen to avoid skin damage).
  • Avoid a diet high in fat and protein, as excessive fat and protein can interfere with calcium absorption in the intestine.
  • Caffeine in coffee has also been implicated in calcium loss, so avoid drinking too much.

Preventing Injuries And Falls

Hip Protectors

If you have osteoporosis and feel unsteady or have problems with falls, you can wear a simple protection to prevent hip fractures. Hip protectors are simple and comfortable - mcuh like a pair of underwear which can be worn under a dress or pants. Tests show that in those who fall, hip fractures may be reduced by as much as 50 percent if hip protectors are worn. They can be purchased at a medical supply store or ask your doctor for help in finding a pair.

It's important to take extra care to avoid injury if you have osteoporosis. You can do this by making sure your home is safe.

Here are the most common causes of falls:

  • Slippery carpets, poor footwear
  • Fainting brought on by irregularity in heart rhythm or another condition that results in low blood supply to the brain
  • Sleeping pills or other medication that makes you drowsy
  • Excess alcohol
  • Muscle weakness
  • Poor eyesight
  • Impaired nerves in your legs
  • Impaired balance as in Parkinson's disease

Nice To Know:

Use this checklist to address problems in your home that could cause you to fall and injure yourself.

Home Entrance:

  • Walkways should be level, with cracks repaired.
  • Lawn equipment and toys should be put away.
  • Water hoses should be coiled or placed next to house.
  • Doormats should be flat on the ground with no turned-up edges.
  • Any steps leading into the home should be easy to see, and at the proper height.
  • Adequate porch and outside lighting are essential.

Living Room:

  • All electrical cords should be placed next to the wall or behind furniture.
  • You should be able to walk through the room without being obstructed by furniture.
  • Rugs should be flat on floor, anchored down, or have nonskid mats under them.
  • Avoid all waxes or floor shines that may cause slippery floors.

Bedroom:

  • Keep bedspread or dust ruffle at least one inch off the floor to avoid tripping.
  • Bed should be kept away from the wall for easy access when changing linens.
  • Electrical and telephone cords should be placed behind furniture.
  • Shoes should be organized in a shoebag hanging in the closet.
  • All accessories should be at easy-to-reach level and organized on shelves.
  • The room should be well-lit.

Bathroom:

  • Use flat, nonskid rug on the floor to avoid slipping.
  • Use nonskid bathmat in tub or shower.
  • Install an easy-to-reach shelf in tub or shower bath products and soaps.
  • Use liquid soaps to avoid slipping on bars.
  • Keep the bathroom well-lit.
  • Buy a nightlight for the bathroom and keep it on.
  • Store the medicines you use most frequently on the lower shelf in your cabinet.
  • Install grab bars in shower and by toilet.

Kitchen:

  • Place a nonskid mat by sink.
  • Smooth any rough edges that could cause you to trip.
  • Avoid floor wax and shine products.
  • Keep rarely-used items on the top shelves.
  • Pots and pans should be stored where you can easily reach them.
  • Stack plastic and glass items on lower shelves.
  • Store items you use daily, such as plates, bowls, glasses, and pans, at waist-to-eye level. This will help you avoid straining when you reach for them.
  • Kitchen table and chairs should be well-balanced.

Other Tips for Fall Prevention:

  • Go slow - falls may occur when you hurry.
  • Think before moving - carelessness adds to the risk of injury.
  • Don't hesitate to adjust or fix anything in your environment that you think could lead to a fall.

Pain Control

When osteoporosis causes fractures, bone pain can range from mild to severe. Pain relievers such as acetaminophen (such as Tylenol), aspirin, ibuprofen (such as Advil or Nuprin) or naproxen (Alleve) can help. Stronger pain relievers require a prescription and may be needed immediately after the fracture for a few days or weeks..

For fractures of the spine, along with pain medication, moist heat applied to the back twice daily for 10 to 15 minutes can greatly relieve pain as the fracture improves. Then, gradually resume activity and exercises as recommended by your doctor. For other fractures, you doctor can guide your activity and exercise.

Another method of pain control involves electrical stimulation of the skin overlying the area of discomfort. A pad attached to a portable battery can relieve pain by stimulating nerves in the region. This is called Transcutaneous Electrical Nerve Stimulation (TENS), and it is available in many physical therapy departments.

If pain becomes chronic, other methods are available for relieving it to allow you to increase your activity. Medications for pain, physical therapy to guide exercises, TENS, and other methods can change pain from terrible to inconvenient and manageable. Your doctor can guide you.

Osteoporosis