by ???? – Physiotherapist
What is the difference between Osteoporosis and Osteoarthritis?
The short answer:
● Osteoporosis is a bone disease in which the amount and quality of the bone is reduced, leading to fractures (broken bones). It is characterized by decreased bone mineral density and can produce no pain or other symptoms until a fracture has occurred.
● Arthritis (arth = joint; itis = inflammation) is a disease of the joints and surrounding tissue (cartilage). Osteoarthritis and rheumatoid arthritis are the most common forms of arthritis.
The answer in a bit more detail:
OSTEOPOROSIS
The word “osteoporosis” literally means porous bones. Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the loss of old bone. For people who have osteoporosis, a fracture can cause a downward spiral of avoiding activity and then becoming deconditioned, leading to further fractures.
Symptoms:
It’s called “the silent thief” because it can progress without symptoms until a broken bone occurs. When bones become severely weakened by osteoporosis, simple movements such as bending over to pick up a heavy bag of groceries or sneezing forcefully can lead to broken bones. Hip, spine, and wrist fractures are the most common fractures.
Some signs you have osteoporosis can include:
● back pain, caused by a fractured or collapsed vertebra
● the gradual loss of height
● stooped posture
● bone fractures that occur much more easily than expected
Risk Factors:
● being female (affects 1 in 4 women and 1 in 6-7 men)
● being Caucasian or Asian
● Postmenopausal, in particular women with early menopause.
● Men with low testosterone
● having a family history of osteoporosis
● Individuals with coeliac disease (or other malabsorption conditions), overactive
thyroid or parathyroid conditions, rheumatoid arthritis, liver or kidney disease
● Taking corticosteroids (common for asthma)
● poor nutrition
● physical inactivity
● smoking
● low body weight
● small-boned frame
It’s recommended that every woman at age 65 should have a bone density test. But if you have clinical risk factors for bone loss as above, it really should be at menopause. Many women enter menopause with low bone mass already, and there’s a subset of women that can lose up to 5 percent of their bone mass every year for six years. For men, the guideline is age 70, unless there are additional risk factors.
Diagnosis
Osteoporosis is diagnosed through a bone mineral density test, a simple, painless test that measures the amount of bone in the spine and hip and takes 10-15mins. Your doctor will advise if you are eligible for a Medicare rebate, often if you meet some of the above risk factors. Some private health funds provide a reimbursement (please check with your fund). The sooner you find out if you have low bone density or osteoporosis, the sooner you can start managing your bone health.
What is the Best Exercise to Help my Bones?
Fortunately, a well-designed exercise program can help to offset the losses in bone density that occur with age and may even allow people to slightly increase their bone density.
The best exercises to help with bone density are:
- weight training exercises
- impact exercise.
When a bone is loaded with more force than it’s used to, assuming it’s not so high as to cause a fracture, this starts a signalling process in the bone that causes bone-building cells (osteoblasts) to lay down bone. The new bone will adapt and remodel over time to get stronger. It’s important to strengthen the bones as well as the muscles to support the joints and improve posture and balance. It is also important to include balance and posture exercises into your routine to help reduce the chance of falls.
The general guidelines for weight training for people with osteoporosis are as follows:
● Frequency: At least 2 times/week
● Intensity/Time: 1-3 sets of 8-12 repetitions of each exercise
● Type: 1 exercise per body part
What about Walking?
Walking, and other forms of cardiovascular exercise such as cycling and swimming, fail to produce significant increases in bone density in most people as those exercises don’t provide enough of a loading stimulus to stimulate bone growth. While these exercises have other physical and psychosocial benefits just walking, cycling or swimming won’t do enough to improve bone density.
However, brisk walking may provide an impact stimulus for people who have suffered osteoporotic fractures and may not tolerate other high impact activities. It is also a better form of cardio compared to cycling and swimming as these are not weight-bearing.
How to Protect your Spine when you have Osteoporosis
A physiotherapist will be able to give you specific advice according to your current level of fitness and flexibility. In general, it’s best to be aware of the following:
- Twisting: Try to avoid twisting quickly, repetitive twisting eg vacuuming, twisting too far eg reaching behind you in the car, and twisting while holding a heavy object. When you twist your spine, muscles pull strongly on the bones on one side of your spine. This force can break a bone in the spine.
- Bending: When you bend forward, you compress (squeeze together) the front part of each bone in your spine. Try to avoid bending quickly, eg picking something up off the floor, repetitive bending, eg. sit-ups, or bending while holding something heavy, eg a bag of groceries.
- Holding or lifting a heavy object as your spine then needs to support the extra weight.
OSTEOARTHRITIS
Osteoarthritis is the most common form of arthritis. It is a degenerative joint disease that involves the thinning or destruction of the smooth cartilage which covers the ends of bones, as well as changes to the bone under the joint cartilage.
Symptoms:
- Pain
- Stiffness
- Reduced movement in the affected joint
These symptoms affect your ability to do physical activities, which impedes your quality of life.
Most Affected Joints:
- Hips
- Knees
- Fingers
- Feet
- Spine
The pain may result from overuse of the joint, prolonged immobility, or painful bony growth in finger joints.
Diagnosis
Osteoarthritis is diagnosed based on medical history, physical examination, and x-rays of the affected joints.
Treatments include:
- Joint protection (reducing the joint’s workload)
- Strengthening exercises for the muscles supporting the joint
- Medication for pain relief
- Heat and cold treatments
- Weight control
- Joint replacement surgery for severe osteoarthritis
Why is Exercise important?
Exercise can prolong the life of affected joints and delay the need for joint replacement surgery. It will also assist in recovery post-surgery by improving muscle strength.
How can Physiotherapy help?
Individuals who suffer from osteoarthritis, osteoporosis, or a combination of both, should seek help planning how to manage both conditions and pay special attention to advice about exercise. One of the specially trained physiotherapists at Wisdom Physiotherapy can help ensure exercises are safe and beneficial for both conditions.
If you are experiencing Osteoporosis or Osteoarthritis, don’t put up with it, call us to make an appointment with one of our experienced physiotherapists. Call (08) 6389 2947 or click here to book online.
