OSTEO-WHAT!

Wellness Concept

OSTEO- WHAT!

OSTEOPOROSIS vs. OSTEOARTHRITIS

By Healing Bridge staff

From the Healing Bridge Physical Therapy

June 2007 Wellness Notes

 

Osteoporosis and osteoarthritis are two common conditions facing many adults. They sound similar but are actually very different. The purpose of this article is to define each condition, how they are diagnosed and commonly treated.

Osteoarthritis is the degeneration of articular cartilage and bone at the joint line. Articular cartilage is the “cushioning” system our joints have so when we jump, run, squat, etc. our bones are not contacting one another. When osteoarthritis occurs in a joint, the cushioning system essentially wears out and we have more contact of the bones at the joint line. Osteoarthritis is a common condition that occurs as we age. It affects men and women equally. It is more common in sites where there was a prior injury or repetitive trauma/overuse such as the knees, hips, shoulders and spine.

Osteoporosis is a disease process which causes reduced bone mass and structural deterioration of both the quality and the quantity of bone. The disease leads to skeletal fragility and fracture. Bones become weaker, less dense and are more likely to break. Osteoporosis is more common in women and generally occurs post-menopausal. The spine, wrist and hip are common sites for fractures related to osteoporosis.

DIAGNOSIS:

Osteoarthritis is diagnosed initially by subjective complaints of pain usually with activity. There is often edema/swelling present and a loss of normal joint motion. An X-ray is usually taken which will confirm the diagnosis by demonstrating changes at the joint. There will be evidence of increased contact between bones.

Early signs of osteoporosis are changes in posture and loss of height. There is often no pain or symptoms associated with the early stages of the disease. A bone density scan, “dexascan” is taken to measure the density of the bones and confirm the diagnosis. Physicians are often ordering bone density scans prior to menopause to obtain a baseline of a women’s bone density. The scan is then repeated as needed to monitor bone density and detect changes as soon as they occur.

TREATMENT:

Neither of these conditions are and automatic prescription for pain, and fortunately there are many treatment options when pain and limitation are factors. Physical therapy has many tools to help with the osteoarthritic joints including exercise instruction to provide increased joint support where there is a loss in cartilage. PT can also assist in restoring joint range of motion, decreasing pain, education on body mechanics to avoid further injury and assistance with recommended changes in activity level. Osteoarthritis can also be treated medically by use of antiinflammitories and steroid injections. Patients are often encouraged to make lifestyle changes that can include weight loss and changes in activity level. Exercising in the water is often recommended to decrease the compression forces on the joints that are losing their cushioning systems.

Treatment for osteoporosis is usually involves diet, exercise and medication. It has been well established that weight bearing exercise is important in maintaining bone density. Physical therapists can help develop a safe, effective strengthening program that targets muscles that help maintain posture and overall body strength. Posture, body mechanics, and balance training are essential areas that need to be addressed in order to prevent fractures. Physicians often prescribe medication that can help improve bone density called biphosphonates (Fosomax and Boniva are examples of biphosphonates). These medications slow down the body’s destruction of old bone. Nutritional counseling can help increase the amount of calcium and vitamin D in the diet which are essential in keeping the bones strong. Supplements of these are often recommended in addition to dietary changes.

If you have been diagnosed or are concerned about osteoporosis, osteoarthritis or both, seek help! Early diagnosis and detection is key for both of these conditions in order to prevent progression of the disease. Contact Healing Bridge for a free consultation or chat with your physician to get the help you need.