Category Archives: Bone Health

6 Osteoporosis Treatments

According to the National Institutes of Health (NIH), more than 53 million people in the US either already have osteoporosis or at high risk of developing it due to low bone mass. That’s Osteoporosis Awareness & Prevention Month each may is so important. At Paris Orthopedics and Sports Medicine, we are proud to provide care for people suffering from osteoporosis and bone loss at our Bone Health Clinic. A few of the osteoporosis treatments we recommend include the following options:

1. Bisphosphonate Medications

Bisphosphonates are the most common medications used for osteoporosis treatments. Doctors usually recommend them as the first line of treatment, especially in women who are postmenopausal. Common bisphosphonates include:

  • Alendronate (Fosamax) – Oral medication taken either daily or weekly
  • Ibandronate (Boniva) – Taken as a monthly oral tablet or IV injection that is given four times a year
  • Risedronate (Actonel) – Taken as a daily, weekly, or monthly oral tablet
  • Zoledronic acid (Reclast) – Available as an IV infusion that’s given every 1-2 years

2. Hormone Therapy Osteoporosis Treatments 

Hormone therapy is also called hormone replacement therapy (HRT) and is a common treatment for the symptoms of menopause. It is primarily used to treat hot flashes and night sweats. Estrogen HRT can also be used as an osteoporosis treatment, but it is not the first choice of most physicians due to potential side effects. When HRT is used to treat osteoporosis it may include estrogen on its own or a combination of estrogen and progesterone. These hormonal treatments can come as creams, skin patches, oral tablets, or injections.

3. Hormone-Related Medications

Some medications that are used to treat osteoporosis are not hormone replacement drugs, but they mimic hormones. These drugs include:

  • Selective estrogen receptor modulators (SERMs): These drugs recreate the effects of estrogen to preserve bone. These medications are taken daily as an oral medication. Common forms of SERM used to treat osteoporosis are raloxifene and bazedoxifene. 
  • Calcitonin: Calcitonin is a hormone made by the thyroid gland that regulates the body’s calcium levels. Synthetic forms of calcitonin are used as osteoporosis treatments in people who can’t take bisphosphonates. It can also be used to treat pain in people who have osteoporosis-related spinal compression fractures. Calcitonin can be given as an injection or taken as a nasal spray. 
  • Parathyroid Hormones (PTHs): Parathyroid hormones are responsible for controlling calcium and phosphate levels in the body. Osteoporosis treatments that use synthetic PTH can help promote bone growth in people with severe symptoms. These drugs tend to be expensive.

4. Antibody Medications

There are two antibody medications used at osteoporosis treatments.

  • Denosumab (Prolia): This medication slows the process of bone loss and helps maintain bone density. It is given as an injection every six months.
  • Romosozumab (Evenity): This newly approved medication helps increase bone formation. This medication is also given as an injection, but you get two injections once a month for up to a year.

5. Vitamin Supplements

Getting plenty of calcium and vitamin D is an important addition to all osteoporosis treatment. Calcium is the mineral that makes up most of your bones, so consuming it is good for maintaining bone mass and protecting bone health. Vitamin D is important as well because it helps your body absorb the calcium you consume through food and supplements. 

The National Institute of Arthritis and Musculoskeletal and Skin Disease’s basic recommendations for calcium intake are as follows:

  • Adults 19 – 50 years old: 1,000 mg per day
  • Men 51 – 70 years old: 1,000 mg per day
  • Women 51 – 70 years old: 1,200 mg per day
  • Adults 70 years old and over: 1,000 mg per day.

Consult the entire list for more information on recommendations for young people and women who are pregnant or lactating. 

6. Physical Activity

Along with other osteoporosis treatments, exercise is an important part of protecting your bone health.

  • Weight-bearing activity (30 minutes daily): These activities can help build and strengthen the bone.
    • Walking, dancing, aerobics, using the elliptical machine
  • Muscle-strengthening exercise: This type of exercise doesn’t strengthen bones, but it strengthens your muscles to protect bones and prevent falling.
    • Weight lifting, weight machines, lifting your own body weight
  • Flexibility exercise: Thes exercises improve muscle flexibility, balance, and strength. People with bone loss, especially in the spine, should check with their doctor about safe positions to practice during activities like:
    • Yoga, pilates, Tai chi

The team Paris Orthopedics and Sports Medicine are dedicated to helping our patients recover from a wide range of orthopedic conditions and injuries. Our services include general orthopedic medicine, joint replacement, sports injury treatment, and osteoporosis treatments at our bone health clinic. If you’re having trouble with bone loss, call (903) 737-0000 to make an appointment.

*To read our policies regarding COVID-19, please visit the home page of our website for an update.

9 Exercises for Joint Health

Your joint health is an important factor in overall health and fitness. Joints allow us to move in all kinds of ways: jumping, twisting, turning, and walking to name a few. To keep your joints healthy, you need to keep your muscles strong and limber. These exercises for joint health will build muscle and increase flexibility.

  1. Flexibility Exercises

Your joints benefit from your muscles being strong and flexible, so yoga, pilates, and tai chi are great exercises for joint health. These exercises and other stretching routines can improve your range-of-motion. They also get you moving with a low impact on your joints.

  1. Squats

You can do squats without any equipment. This exercise uses your own body weight to help strengthen the muscles around your knees, ankles, and hips. To do a bodyweight squat, stand in front of a chair or bench. Keep your knees in line with your feet as you lower yourself to the seat. Touch the seat lightly and stand again. Be careful to not let your knees extend past your toes, as this can cause injury.

  1. Lunges

Low lunges can help stretch and strengthen your hip flexors, which can get tight from sitting for extended periods of time. Step forward with one foot, bend your knee and extend your back leg behind you. Adjust so that your front knee is not bent past 90 degrees. Square your hips and press forward to feel the stretch. Hold for 30 seconds and then switch sides. You can increase the intensity of lunges by adding an overhead reach.

  1. Pullups

Pullups are great for strengthening the muscles around the shoulders and elbows. If you can’t do a pullup unassisted, doing an assisted version will also do the trick. For an assisted pullup, stand on the platform of the pullup machine. For an unassisted pullup, stand on the ground. Begin with the arms fully extended and pull all the way up.

  1. Pushups

Like pullups, pushups help protect your shoulders and elbows. Your form is important when doing pushups, so make sure you keep your body in a straight line and don’t let your back sag during the pushup. Start at the top of the position with your hands shoulder-width apart. Lower your chest toward the floor and then extend your arms to push back up. You can do modified pushups by starting on your knees or using a ball.

  1. Swimming

Aerobic exercises, or cardio, is crucial for maintaining overall fitness and can keep you energized. It can also help with stamina. Swimming gets your heart pumping and your muscles working without straining joints, making it one of the best low impact aerobic exercises for joint health. 

  1. Cycling

Cycling can be a good low-impact aerobic exercise for those with joint issues. Using a bicycle and getting outdoors can be a good way to take your workout out of the gym and get fresh air. Stationary bikes, including the recumbent type, are another good option. For higher intensity cycling workout, look into local spin classes.

  1. Weight Training

Weight training and strength training exercises help build and maintain the muscle necessary to support and protect joints. There are several strength exercises for joint health that use free weights, weight machines, and resistance that are good for joints. Just make sure you rotate which muscle groups you exercise to avoid overuse.

  1. Foam Rolling

Foam rolling is a great way to release knots and improve your flexibility. As mentioned before, flexibility exercises are important for protecting your joints. Many stores sell foam cylinders meant for rolling. Or you can DIY a roller by using a PVC pipe or small ball (tennis balls are good choices). To roll out your knots you can roll over a large area to stretch and lengthen muscles or use shorter back and forth motions to work out a knot or sore spot. \

Other Tips

  • Keep workouts low impact to avoid further joint injury
  • Apply heat before starting to relax joints and muscles
  • Use ice after workouts (for up to 20 minutes) to prevent pain and swelling.
  • Move gently, especially as you begin the workout
  • Go slowly and ease into each exercise
  • Don’t overdo it and listen to your body, especially if you are just getting back into an exercise routine
  • Talk to your doctor about what kind of pain and soreness is normal before you start your routine.

At Paris Orthopedics and Sports Medicine, our board-certified physicians are experts at treating injuries of all types and severities. If you have questions or concerns about your joint health, including which exercises are best for joints, call (903) 737-0000 to make an appointment.

 

7 Lifestyle Tips for Good Bone Health

Bone loss occurs gradually over the years as the holes and spaces in the bone grow larger, resulting in decreased density and mass. This deterioration usually starts between the ages of 30 and 35, however, here are seven lifestyle tips you can implement now to promote good bone health. 

  1. Eat Calcium-Rich Foods

Calcium deficiency is proven to diminish bone density, contribute to early bone loss and increase one’s risk of fractures. Make sure you are consuming the recommended amount of calcium through nutrient-dense sources like milk, cheese and yogurt. There are also many non-dairy sources including leafy greens, seafood, or fortified alternatives like Lactaid, soy, almond or rice milk.

2. Get Enough Vitamin D

Vitamin D helps you absorb calcium in foods. Fortunately, it can be food not only through the foods you eat but also through adequate sunlight and supplements. Even just 8-15 minutes of exposure to sunlight is enough to produce an adequate amount of vitamin D for most individuals. If you’ll be in sunlight any longer than that, don’t forget to apply a broad-spectrum sunscreen. 

3. Focus on Balance

Calcium and vitamin D are certainly important to bone health, but it’s important to eat a balanced diet to ensure you are getting enough of the other essential vitamins and nutrients. Protein, omega-3 fatty acids, vitamin K, magnesium and zinc are all also important for bone health. 

4. Stay Active

While you may be inclined to think physical activity puts your bones at risk for injury, the truth is that staying active is essential to good bone health. Aim to be active for at least 30 minutes a day, five days a week (or 150 minutes each week). Be sure to include a mix of weight-bearing exercise, resistance activities and stretching exercises. 

5. Limit Caffeine Consumption

Overconsumption of caffeine is widely known to contribute to difficulty sleeping, nervousness and stomach irritation, but did you know it can also decrease the amount of calcium you absorb? Adults should consume no more than 400mg of caffeine per day, which is roughly 2-3 cups of coffee, but keep in mind many foods and other beverages also contain caffeine. 

6. Kick Bad Habits

It’s no secret that excessive alcohol consumption and smoking have many adverse effects on your health. Both also contribute to bone loss and increase the risk of bone fractures. If you drink, do so in moderation, but you should quit smoking and tobacco use entirely.

7. Don’t Skip Your Annual Exam

When it comes to your health, prevention and early detection are key. Your annual exam is a great time to talk to your doctor about any concerns you may have about your bone health or risk factors for osteoporosis. He or she may recommend a bone density test to evaluate your bone density and determine your rate of bone loss. Your doctor can also offer guidance to make sure you are getting adequate amounts of essential vitamins and minerals. 

For More Information

If you are suffering from osteoporosis, call (903) 737-0000 to schedule an appointment with the Paris Orthopedic Bone Health Clinic today. Our experts are committed to providing diagnosis, treatment and education for the primary and secondary prevention of osteoporosis.

5 Ways to Prevent Osteoporosis

Osteoporosis is a concern among many people, especially as they age. Osteoporosis is a disease in which bone density and quality decrease. Bones become fragile and porous, increasing the risks of fractures. Bone mass is lost gradually with age, and often there are no symptoms until there is a fracture.

Bones are made of living tissue that changes and grows as we age. Peak bone mass is achieved during childhood and adolescence. After that, bone strength is maintained by a process called remodeling, in which old bone is removed by resorption, and new bone is formed. As adults age, resorption begins to happen at a higher rate than formation, which can lead to bone thinning, or osteoporosis.

While adults do not necessarily build bone mass, following certain lifestyle guidelines can help limit remodeling and resorption so that bone strength is maintained as much as possible. If you are concerned about bone loss, we’ve outlined five ways to prevent osteoporosis: 

1. Choose the Right Sources of Calcium

The International Osteoporosis Foundation (IOF) has a guide for you to find the right amount of calcium-based on age and sex. The best way to get calcium is through food. Dairy products are the most common foods associated with calcium, and they are a good readily-available source. Dairy is also a good source of protein and other nutrients, making it a good choice. Make sure you check to see if you should be using low-fat options, as those are often recommended in many diets.

If you can’t or don’t eat dairy, then there are other sources. People who eat fish may consider canned fish that include edible bones like sardines. The bones are where the calcium comes from. Vegetarians, vegans, and people who don’t like fish can also find calcium in plant-based foods and fortified alternatives:

  • Green vegetables like broccoli, bok choy, and curly kale
  • Nuts (almonds and Brazil nuts in particular)
  • Some fruits including apricots, dried figs, and oranges
  • Calcium-set tofu
  • Fortified grains, breads, and cereal
  • Fortified beverages including fruit juices, mineral water, and soy drinks

Note that some produce has high calcium content, but are not good sources for it because they also contain “oxalates” which prevents the calcium in those foods from being absorbed. Spinach is the most common example of this. Some dried beans and seeds have “phytates,” which have the same effect. 

Aim to meet your calcium requirements through dietary choices and only supplement if you can’t meet the recommended amount with what you eat. However, if you need extra calcium and it’s not possible to eat enough calcium-rich foods to get enough, supplements are an option. 

Talk to your doctor about the best supplements to use and make sure there are no possible negative interactions with any medications you are currently taking.

2. Get Enough Vitamin D

Getting the right amount of calcium isn’t enough when trying to prevent bone loss. You need to make sure to meet vitamin D requirements in order for the calcium to be absorbed. Exposure to sunlight prompts the skin to make vitamin D3. For most children and adults being exposed to sunlight for 10 to 15 minutes each day is sufficient. Certain foods are also sources of vitamin D3, while other plant sources provide vitamin D2, which is closely related. Check this guide from IOF to see how much vitamin D you might need, and where you can get it.

Food sources of vitamin D are pretty limited, especially if you follow a vegetarian or vegan diet. The best sources are oily fish (salmon, sardines, mackerel), liver, and eggs. In some places, you can also find dairy products and grains fortified with it as well. When it comes to vitamin D supplements, also read labels and consult your doctor about which varieties they recommend (if they don’t prescribe them to you).

3. Make Healthy Lifestyle Choices

Making good choices for your overall health will usually also benefit your bone health. Along with making sure you get enough calcium and vitamin D, you need to pay attention to general nutrition and have a balanced diet. Get enough protein and eat plenty of fruits and vegetables for vitamins, minerals, and antioxidants. Other vitamins and minerals you need to get enough of include zinc, vitamin A, vitamin K, magnesium, homocysteine, and B vitamins.

There are also certain things you should avoid to prevent osteoporosis. Caffeine can interfere with calcium absorption and have a “leaching” effect. Some people have linked carbonated beverages to calcium leaching as well, but there is no proof of this. However, limiting soda is a good idea anyway, as other beverages are healthier (like milk for bone health). Alcohol should also be limited or avoided.

Smoking has also been found to be detrimental to bone health, as well as the health of many other organs and systems. To reduce the risk of bone loss, stop smoking and avoid being exposed to secondhand smoke.

4. Get Regular Exercise

You already know that exercise is good for keeping muscles strong, but did you know it is also important to bone health? Getting certain types of exercise can stimulate the cells that build bones, which will prevent bone loss and maintain strength. But you need to make sure you get the right kind of exercise.

Weight-bearing and resistance exercises can help children build bone density and adults maintain it. Weight-bearing exercises focus on carrying your own body weight against gravity. Examples of weight-bearing exercises include walking, running, dancing, hiking, tennis, and aerobics.

Resistance, or muscle-building, exercises use objects to create an opposing force for your body to work against. Weights and resistance bands are probably the most commonly used tools in resistance training. Water is also a good resisting force, so doing exercises in the pool an option, with the added benefit of being low-impact.

5. Watch Out for Under-Nutrition

While maintaining a healthy weight is important, some people take dieting and food restriction too far in an effort to be thin and suffer from under-nutrition. Young girls and women are at a higher risk for this. Many weight-loss diets result in deficiencies of certain nutrients, including those important to bone health (vitamin D, calcium, and protein).

If you are struggling with disordered eating or undernutrition, seek help from medical professionals and counselors. The National Eating Disorder Association (NEDA) has resources to get you started.

Make an Appointment

Paris Orthopedic and Sports Medicine provides patients in Northeast Texas and Southeast Oklahoma with comprehensive orthopedic services, including managing bone health. If you have concerns about bone loss and ways to prevent osteoporosis, call us at (903) 737-0000 to make an appointment. You can also request an appointment online

 

Types of Osteoporosis

Osteoporosis is a condition that many of us will experience at some point in our lives. According to recent statistics from the International Osteoporosis Foundation, worldwide, 1 in 3 women over the age of 50 years and 1 in 5 men will experience osteoporotic fractures in their lifetime.

When we think about osteoporosis, we may commonly associate it with an elderly individual breaking a hip from what seems like a minimal intensity fall, but we understand that this is a possibility due to age and bone health. While the condition may seem fairly straight forward, many aren’t aware that there are four different types of osteoporosis.

1. Primary Osteoporosis

Primary osteoporosis makes up the vast majority of the cases. There are many factors that contribute to its severity such as age, nutrition and activity level. Gender is often also a factor, as primary osteoporosis is more prevalent in women than men.

As bones reach their peak density around age 30, there is a gradual decline over time that occurs if one’s activity level does not help offset the amount breakdown-taking place. This occurs secondary to hormone levels decreasing, mainly testosterone (which promotes bone growth) and estrogen.

While we often associate this type of osteoporosis with the elderly population, it can happen in younger adults as well if activity levels are not enough to stimulate bone growth activity. Additionally, if hormone levels drop secondarily to overtraining or malnutrition, bone breakdown may also start as early as high school such as is seen in conditions associated with the Triad in male and female student-athletes.

2. Secondary Osteoporosis

Secondary osteoporosis is very similar to primary except that it occurs in response to a particular disease, normally one that will affect hormone levels within the body such as conditions that interfere with thyroid health. While primary may be addressed through a gradual change in activity levels and diet, secondary osteoporosis is often treated by hormone replacement therapy and other more extreme measures.

It is important to note that secondary osteoporosis may occur subsequently with primary, but must have an etiological mechanism to be classified as secondary.

3. Osteogenesis Imperfecta

Osteogenesis imperfecta is a condition that is the result of a genetic mutation, affecting roughly 6-7 out of every 100,000 people. It has eight known types ranging from mild to severe and mainly affects bone health, causing conditions to manifest similar to traditional osteoporosis.

The condition will normally exist with other symptoms such as respiratory issues, height defects, and an abnormally small rib cage. Depending on the severity, bones can break often with very little stress applied. Also, in severe cases, the associated respiratory issues may decrease life expectancy in accordance with all of the other comorbidities present.

4. Idiopathic Juvenile Osteoporosis

This pediatric condition has no known cause and usually has an onset just before puberty. In essence, it is brittle and porous bones with no other associated symptoms and will usually resolve without medical treatment after a relatively short amount of time.

If this condition is found to be present, it is recommended to have children monitor their activity or follow their physician’s guidelines for maintaining general health.

When to Seek Help

If you are suffering from osteoporosis, call (903) 737-000 to schedule an appointment with the Paris Orthopedic Bone Health Clinic today. Our experts are committed to providing diagnosis, treatment and education for the primary and secondary prevention of osteoporosis. For more information, you can contact our office or visit The National Osteoporosis Foundation.

6 Signs That You May Have Osteoporosis

According to the National Osteoporosis Foundation, approximately 10 million Americans have osteoporosis and another 44 million have low bone density, placing them at increased risk.

Often referred to as a “silent disease,” osteoporosis is a bone disease that makes a person’s bones weak and more likely to break. But, if you can’t feel your bones getting weaker, how are you supposed to know if you have osteoporosis before you have a fracture? Here are six warning signs to look out for:

  1. Receding gums: Like many other health problems, your dentist may be the first to notice early signs of osteoporosis so it’s important not to skip your regular teeth cleanings. If he or she notices receding gums, they can screen for bone loss in the jaw.
  2. Weakened grip strength: Women are more likely to develop osteoporosis than men due to having smaller, thinner bones and the decrease of estrogen at the onset of menopause. Studies of postmenopausal women and their overall bone mineral density revealed that weaker handgrip strength can be an indicator of lower bone density. Those with stronger grip strength were also less likely to fall and get injured.
  3. Weak, brittle fingernails: Nail strength can be a good indicator of bone health. However, weak and brittle fingernails don’t always mean there is a problem. It could just be the result of swimming frequently, gardening or participate in other activities that may affect your nails.
  4. Loss of height: The most notable symptom of osteoporosis is the loss of height due to compression fractures in the spine. Unfortunately, by the time you notice this symptom your bones have already significantly deteriorated and is considered later-stage osteoporosis.
  5. Back or neck pain: There are many causes of back or neck pain, but regardless of the reason it can significantly impede your everyday activities. Compression fractures of the spine caused by osteoporosis may also cause pinched nerves that radiate out from the spinal cord. You may experience mild tenderness or debilitating pain.
  6. Stooped posture: Compression fractures may also cause slight curving of the upper back, or stooped posture. The medical term for this is kyphosis, but you might commonly hear it referred to as a widow’s hump.

Contact Paris Orthopedics

Osteoporosis can be prevented by building strong bones during childhood and adolescence. If you are experiencing any of the above symptoms or fear you may be at risk, the team of medical professionals at Paris Orthopedics and Sports Medicine can help.

Our experts are committed to the diagnosis, treatment, and education for the primary and secondary prevention of osteoporosis. Schedule an appointment with the Paris Orthopedic Bone Health Clinic today.