What is osteoporosis?

Osteoporosis is a disease in which the bones become fragile and brittle. They fracture more easily than normal bone. Even a minor bump or fall can cause a serious fracture. Half of all women and one-third of men over 60 in Australia will have a fracture due to osteoporosis.

Osteoporosis and fractures are major causes of injury, long-term disability and even death in older Australians. One fifth of people who suffer a hip fracture will die within six months. Of those who do not die, 50 per cent will be unable to walk without help or stay in their own homes. Some may even need full-time nursing care.

Osteoporosis is often called a silent disease, as there are usually no signs or symptoms until someone has a fracture. Any bone can be affected but the most common are bones in the hip, spine, wrist, ribs, pelvis and upper arm.

What causes osteoporosis?

The health of your bones depends on:
• your genes (60-80%)
• the level of hormones in your body. In women this hormone is oestrogen; in men it is the hormone testosterone.
• how physically active you are
• what you eat

These things affect how well bones form in early adulthood when your bones are at their strongest. After the 30s, it is important to maintain bone strength and prevent bone loss.

Menopause and osteoporosis

Menopause means the time around which a woman has her last period. Most Australian women reach menopause between the ages of 45-55, but it can happen earlier.

From about the age of 45 years, women may begin to lose bone at the rate of about 1-2% per year. This is because womens bodies usually make less oestrogen at this age. After menopause, oestrogen levels keep decreasing, and this speeds up bone loss to about 2-4% per year, especially in the first 5-10 years after menopause. This stage of bone loss caused by menopause may last up to 15-20 years. All women lose bone at menopause. The amount varies, but some can lose as much as 30% of their bone during those years. If you have an early menopause for some reason, you will begin to lose bone at an earlier age.

Men and osteoporosis

The male hormone, testosterone, does not decrease suddenly like oestrogen does in women during menopause. Instead, testosterone gradually decreases from about 50 years of age in men. However, mens bone density tends to stay the same until they are much older. But after 75 years of age, both men and women lose more bone, especially in the hip. This is part of the ageing process.

Risk factors for osteoporosis

Risk factors for osteoporosis and fractures caused by osteoporosis are similar in women and men. They include some things that you can change, and some that you can not.

Preventing osteoporosis – reduce your risk

Preventing osteoporosis is important. Although there are treatments for osteoporosis, there is no cure. You can reduce your risk of developing osteoporosis and having a fracture by:

• Having a balanced diet rich in calcium and vitamin D. For most people, three serves of dairy foods daily will provide enough calcium
• Vitamin D to help the body absorb calcium. Vitamin D is in small amounts in foods such as dairy products fortified with vitamin D, egg yolks, salt water fish and margarine. The best source of vitamin D is from safe sunlight exposure.
• Weight-bearing, high impact and strengthening exercises (such as walking, tennis, dancing and weight training)
• Having a bone density test, if appropriate
• Asking your doctor if you need medication
• Asking your doctor if any medicines you take may be causing bone loss
• Not smoking
• Drinking less alcohol

What is Arthritis ?

Arthritis is a major cause of disability and handicap in Australia affecting people of all ages and walks of life. Arthritis is not a single condition. There are over 150 kinds of arthritis, all of which affect one or more joints in the body. The most common types of arthritis are osteoarthritis (OA), rheumatoid arthritis (RA), fibromyalgia, lupus and gout, which account for 90% of all arthritis cases.
Arthritis is often misinterpreted as simply a disease which affects elderly people, when in fact 60% of those who are diagnosed with arthritis are between the ages of 15 – 60 years. One in one thousand children are also diagnosed with juvenile arthritis, while it is estimated that three in every thousand children live with the condition but remain undiagnosed.

The word arthritis comes from Greek: arth- = joint and –itis = inflammation. So, arthritis literally means inflammation of the joint.

How Common is Athritis?

Arthritis affects 3.4 million Australians, 16.7% of the population. Of the proportion of Australians affected, 60.4% are women. 60% of all people living with arthritis are of working age.

What Causes Arthritis?

There is no one single cause or list of causes for arthritis. This is due to the fact that there are over 150 different types of arthritis, and often several factors contribute to an individual developing this common problem.

Different Types of Arthritis

The disease also can affect other parts of the body. Arthritis causes pain, loss of movement and sometimes swelling. Some types of arthritis are:

Osteoarthritis, a degenerative joint disease in which the cartilage that covers the ends of bones in the joint deteriorates, causing pain and loss of movement as bone begins to rub against bone. It is the most prevalent form of arthritis.

Rheumatoid arthritis, an autoimmune disease in which the joint lining becomes inflamed as part of the bodys immune system activity. Rheumatoid arthritis is one of the most serious and disabling types, affecting mostly women.

Gout, which affects mostly men. It is usually the result of a defect in body chemistry. This painful condition most often attacks small joints, especially the big toe. Fortunately, gout almost always can be completely controlled with medication and changes in diet.

Ankylosing spondylitis, a type of arthritis that affects the spine. As a result of inflammation, the bones of the spine grow together.

Juvenile arthritis, a general term for all types of arthritis that occur in children. Children may develop juvenile rheumatoid arthritis or childhood forms of lupus, ankylosing spondylitis or other types of arthritis.

Systemic lupus erythematosus (lupus), a serious disorder that can inflame and damage joints and other connective tissues throughout the body.

Scleroderma, a disease of the bodys connective tissue that causes a thickening and hardening of the skin.

Fibromyalgia, in which widespread pain affects the muscles and attachments to the bone. It affects mostly women.

Preventing Arthritis

As the specific causes of the different types of arthritis remains unclear, it is difficult to say what may assist in the prevention of the development of arthritis. However, listed below are a few steps which may be beneficial in reducing the effects of arthritis.

• Maintain appropriate weight.
• Protect joints from injuries and overuse.
• Regularly exercise to maintain healthy bones, muscles and joints. Obviously, regular Physiotherapy care is of benefit too, ensuring optimal spinal/joint range of movement and flexibility.
• Eat a healthy diet as nutrients are vital for joint health.
• Hydrate your body. Water makes up 70 percent of the cartilage in joints and plays a major role in the lubrication and shock absorbing properties of healthy joints.

Correct Lifting

Lifting injuries are a common cause of back pain. You can protect yourself against damage with good lifting habits, both at home and in the workplace.

How Lifting Can Injure Your Spine

When you lift, your spine is put under stress. Twisting or jerking while lifting and carrying can injure the small joints of the spine. The discs which separate the vertebrae (spinal bones) and the ligaments which hold the vertebrae together are also at risk. The discs are composed of a jelly-like core, surrounded by a strong fibrous ring. With repeated unsafe lifting, the fibrous ring or its supporting ligaments may tear or rupture. This is commonly known as a disc bulge or herniation.

Lifting while bent forward will increase the stress on your spine. Contributing to this stress are factors like the weight of the load, how far it is held from your body, how often and how fast you lift and how long you hold the load.

To protect your spine from injury, always attempt to take the following steps:
• Get a firm footing with your feet apart for a stable base.
• Bend your hips and knees instead of bending at the waist. This allows the leg muscles to take the load and not the spine.
• Tighten your abdominal muscles. Abdominal muscles support the spine when lifting.
• Ensure that you have a strong grip and that the load is as close to you as possible.
• The closer it is to your spine the less force it exerts on your back.
• Brace yourself for the lift but continue to breathe normally through the lift.
• Lift steadily and do not jerk the load. Look straight ahead, not down.
• Keep your back straight and avoid twisting or bending to the side.
• To lower the object, place your feet as you did to lift, tighten stomach muscles and bend your hips and knees.