Upstatetpa.com

the MVP Newsletter for People with Low Back Pain TheSpineColumn
2007 Volume 1
Osteoporosis
By Ellen Levanites BSN, CMSRN CLNC The Bone Thief
Osteoporosis is a disease that weakens the bones to the point
where they easily break. The bones of the hip, spine, and wrist
are particularly vulnerable. It is called the silent disease as it
progresses over years but you may not be diagnosed with
osteoporosis until you break a bone.
Tips to reduce the risk of osteoporosis:
Lifestyle – Smoking increases the loss of bone mass,
so stop smoking. Limit your amount of alcohol; too much alcohol can put you at risk for falling. Calcium – People over age fifty need 1200 mg
of calcium daily. Foods rich in calcium include low fat dairy, canned fish such as salmon and green leafy vegetables. Eat foods fortified quickly for a few years, but the loss will slow down.
In men the loss of bone is slower but by seventy, men and women are losing bone at the same rate. Osteoporosis affects mostly women but more than 2 million men may also be affected. White and Asian Vitamin D – You need enough vitamin D in your
women are more likely to have osteoporosis.
diet to absorb the calcium. Our bodies make vitamin D by being exposed to sunlight for 20 minutes a day. You can also get Vitamin D from eggs, fatty fish, cereal and milk fortified with Vitamin D. • Women who have had surgery to remove their ovaries Exercise – For stronger bones and muscles you
need to be physically active. Weight bearing exer- cises three to four times a week are best. Walking, jogging, and dancing are good examples of weight • Use of certain medications over a long period of time enced a fracture this test can help your physician predict Your physician can do a comprehensive medical assess- ment to help determine your risk of osteoporosis. Bone Treatment includes healthy diet, exercise, and fall pre- mineral density testing can be done to measure your bone vention. Medications may be prescribed and are discussed mass. This will enable your physician to detect low bone in the article Treatment for Osteoporosis and Osteoarthritis in density before fractures occur. If you have already experi- Welcome to MVP’s Winter 2006-2007 edition of In This Issue
The Spine Column. This is a newsletter for members with chronic low back pain. If you have any questions Osteoarthritis
or comments about this publication please contact the Health Promotion Department at 1-888-357-4687
ext 2015.
Treatment
Newsletter Contributors
Health Promotion Coordinator
Health Promotion Coordinator
Clinical Pharmacist
Doctor of Chiropractics
Health Promotion Supervisor
Family Physician
of the Spine
Which muscles
Osteoarthritis, sometimes called degenerative joint disease is the most common type of
arthritis and is one of the most common causes of back pain.
Spinal osteoarthritis mostly affects the cartilage and the connective tissue that covers the ends of the bone joints. Healthy cartilage allows bones to glide over one another and is a protective important for a
shock absorber. This minimizes the impact of bouncing, jumping and other activities of daily life healthy back?
The joints between the vertebrae are called facet joints and when the cartilage between these By Rob Block, DC, DACRB, Ballston Chiropractic Office joints breakdown this causes more pain, which leads to decreased back motion and flexibility. It is often suggested that certain muscles Risk Factors
Treatment
are particularly important for a strong and It is likely that a combination of risk factors improvement of joint function, weight loss, trauma to the spine from accidents, surgery, helpful in improving a lot of back pain. Exercise is one of the best treatments for In truth, all of the muscles that surround Other risk factors-
osteoarthritis. It can improve your mood and the lower back are important. Isolating one • Age – advancing age of the spinal
outlook, decrease pain, increase flexibility, particular muscle, or group of muscles, is an attempt to find easy answers and typi- fitness. Walking, swimming and water aero- cally leads to poor results. It is similar to • Gender – osteoarthritis is more common
bics are a few exercises your doctor and/or part of a healthful diet; your diet must focus • Excess weight – causes more stress on
weight-bearing joints, reduce further injury will utilize tests, which reveal particular • Genetics – a family history of
Transcutaneous Electrical Nerve Stimulation instabilities and weaknesses to the stabi- lizing muscles of the spine. These muscles Symptoms
neck or lower back especially when getting out of bed or after sitting for a long period of your doctor can find the pain medication as part of a system that stabilizes the spine time. You may also notice a crunching feeling or the sound of bone rubbing on bone. Nerve the problem lies. This is very important as pressure may also develop due to changes in the bone in the affected area causing weak- Diagnosis
A combination of testing may be done start- ing with your doctor asking you to describe muscles that stabilize in all of the unstable and how they may have changed over time. sometimes see by a radio station. They are checking your reflexes and muscle strength.
tall and skinny, and would easy break or fall He/she will also observe you bend and walk. with a good wind, but are made stable by a series of guy wires attached from all sides joint or cartilage damage and the develop- and at various heights from top to bottom.
not be done depending on what other x-ray’s for it is when they pull collectively that they stiffen the structure, just as all of and ribs, therefore resisting injury from too much motion. This leads to an important part of a good rehabilitation program. A good rehabilitation pro- back from injury as the result of extending gram takes all of the exercises that you do on machines, on the floor, and on therapy balls, and makes them work for you during your normal day. We call this functional rehabilitation. With a muscles behind the spine, the thoracic and functional rehabilitation focus you will perform good lower back exercises and learn to take that new endurance and strength in your lower back and put it to use during bending forward too forcefully and control your normal day. What good is an exercise that promotes strength in your that motion, keeping your spine safe. The abdomen and your back if you’re bending incorrectly causing muscles side muscles, called the quadratus lumbo- to not engage and protect you? The exercises must be taught with rum, control side motion, but also attach to function in mind. This will help promote a stronger spine while you the pelvis, ribs and each of the 5 vertebrae fill up your dishwasher, while you lift up your baby, when your foot slips on the ice and your back quickly twists, when you are unpack- one of the vertebrae is loosely sitting on ing grocery bags and during all other normal activities. Unless the the other, they are susceptible to unstable exercise can be trained with function in mind it has little chance of In conclusion, a healthy back requires good endurance and stability because they attach those spinal strength of all of the muscles surrounding the spine and training bones to the very strong and stable pelvis to use those muscles to protect you during normal daily activities.
Osteoporosis and Osteoarthritis
Osteoporosis and Osteoarthritis are two medical conditions that may sound similar,
but represent different symptoms, treatments and outcomes. One treatment option may
be medication. Some medication therapies for each condition are listed below. You should inflammatory
consult with your physician for drug treatment and risks for either condition. You should provide your physician with a complete history of all medications, including over the counter joint pain – helpful
vitamins, herbal therapies, nutritional supplements etc., which you are taking.
lifestyle changes
US FDA Approved Drugs
US FDA Approved Drugs
for Osteoporosis
for Osteoarthritis
• Calcium Supplements
Many types of arthritis are characterized and there currently is no medication that will prevent the disease. Medication therapy therapy in the prevention of osteoporosis. mobility to improve quality of life.
and inflammation. Eventually this inflam- mation can lead to lack of movement. This a daily dose of 1000 to 1200 mg of Calcium increase in a more sedentary lifestyle leads Oral Analgesics
• Fosamax, Boniva, Actonel
obesity, heart disease, diabetes, cancer and used for Osteoporosis that helps to build Nutritional Supplements
bone strength. Some of the side effects with swelling of the throat, stomach ulcers and Nonsteroidal Anti-inflammatory Drugs
difficulty swallowing. It is important for you (NSAIDs)
to take these medications on an empty stom- ach, with at least 8 ounces of water (no other drinking. You should remain upright, either sitting or standing, for 30-60 minutes after to severe arthritis pain and inflammation.
These medications do have a risk of stomach problems so they should be taken with food.
• Micalcin, Calcimar, Fortical
They are contraindicated if you are taking for at least 5 years. These drugs are usually COX-2 Inhibitors
well tolerated with few side effects such as decrease joint pain. A diet rich in whole • Climara, Estrace, Estraderm, Estratab,
reduce joint inflammation. Avoiding stress, Ogen, Ortho-Est, Premarin, Vivelle,
NSAIDs are not effective or if you have a Activella, Femhrt, Premphase, Prempro
history of stomach disease, are taking blood as much as possible can be useful as well.
thinners. COX 2 inhibitors have a decreased Finally, an energetic exercise program is a incidence of stomach problems but have an • Forteo
Topical Analgesics
swimming and yoga are excellent workouts.
Forteo is a daily injection for the treatment If you are wondering “How do you relieve joint pain by introducing more pain?” Well, at high risk for fracture. Forteo is usually well tolerated although leg cramps and dizziness Injections of Cortisone, Glucocorticoids
have been reported. The safety and effective- and Hyaluronate
ness of Forteo beyond 2 years has not been Arthritis pain of the spine may be relieved from injections of steroids. Another therapy, • Evista
Synvisc, is injected into the knee to provide pain but ask your provider before starting that could make the problem worse. If you are similar to those with estrogen therapy.
have a lumbar disk problem, be careful with Evista can increase the risk of blood clots include a twist; like a commonly practiced be taken life long. It is important for you to consistently take your medications and to Ask your doctor which type of exercise is 1National Osteoporosis Foundation. Prevention: Calcium and Vitamin D. Website www.nof.org/prevention/calcium.htm.
Match the columns
After reading this issue of The Spine 1. Osteoporosis
A. Encourages healing by reducing
Column, take the following quiz and 2. Osteoporosis affects mostly
B. A large radio antennae
3. The spine is compared to…
C. Is sometimes called
4. Osteoporosis is most
D. An important therapy in the
5. Calcium supplements
6. Osteoarthritis
E. Good strength and endurance
7. Movement of a painful joint
F. Often called the “silent disease”
8. A healthy back requires
sometimes not diagnosed until a bone has been broken Please mail your complete quiz to: G. White and Asian women
H. Below the age of 45

Source: http://www.upstatetpa.com/member/pdf/Spine_Column_2007_Vol_1.pdf