Bone Density vs Bone Quality

Right, yes, NOW I understand it.  You need to put more stress on bones than they've previously had.  I've not walked much at all because of severe arthritis in knees and back problems (not osteoporosis) but have decided I'm pandering to those too much so AM going to walk more, so for me it will probably be beneficial and I'm thinking a little mild weight exercise, such as holding a can of food in each hand when exercising, should maybe help the spine keep strong too.  At the end of the day you can only do what you can do, and since I'm never going to be jogging or anything like that, then more walking is going to be an improvement for me.  I am cycling more but realise that isn't weight bearing at all, so that improves muscle strength in legs, which all helps balance, and also cardio, and general fitness makes us feel like more exercise, so more walking and so on.  That's my theory:-))))

I couldn't resist googling this a bit more and I thought this article was useful: Still, it's never too late to start a bone-healthy exercise program, even if you already have osteoporosis or are at high risk of developing osteoporosis.

Although people with osteoporosis may believe that exercise increases the risk of injury from broken bones, the truth is quite the opposite. A regular, properly designed exercise program may actually help prevent the falls and fall-related fractures that so often result in disability and premature death. That's because exercise strengthens bones and muscles, and improves balance, coordination, and flexibility, which is especially important for older adults and people who have been diagnosed with osteoporosis.

According to the National Osteoporosis Foundation, the best exercises for building and maintaining bone density are:

Weight-bearing exercise, such as walking, that makes you work against gravity while staying upright

Muscle-strengthening exercise, such as weight lifting, that makes you work against gravity in a standing, sitting, or prone position

Nonimpact activities such as balance, functional, and posture exercises also may benefit people with osteoporosis. Although these exercises don't build or maintain bone density, they may increase muscle strength and decrease the risk of falls and fractures.

Medical Evaluation Is Key

If you have osteoporosis or are at risk of osteoporosis, most experts believe that supervised weight-bearing exercise and strength trainingexercise is safe and effective. Studies of postmenopausal women report that aerobic, weight-bearing, and strength training exercise can increase bone mineral density in the spine, and that a simple walking program can increase bone mineral density in the spine and hip.

Before beginning any exercise program, it's important to undergo a thorough medical examination to determine which activities are safe for you.

There is no single exercise regimen that's best for everyone with osteoporosis. Each regimen should be specifically tailored to the individual patient based on a medical evaluation of:

Fracture risk

Muscle strength

Range of motion

Level of physical activity

Fitness

Gait

Balance

It IS difficult knowing what's best re meds and exercise and everything else because there is so much to research, but at least all this information does give us options on what we feel is the best way forward for us all.

You're right Mary.  Although I don't actually have osteoporosis (the GP told me I did and had me on Alendronic Acid before we were able to get hold of bone density test results), I don't want bones to deteriorate, but I did do so much less exercise than I might have done for years because of the knee arthritis, trying to hold off knee replacements,  until I realised that it was no good favouring that bit at the detriment of other parts of my body!  It's an exercise bike, but I've no doubt it's helping balance too, but then Tai Chi does that well also.  I think what you said about living life to the full by making choices helps us feel in control and be positive too.  There is a lot recently about exercise reducing the chance of brain deterioration too!

Hi lttlandro, 

I think you should talk over all your worries about medication side-effects with your doctor. For me, I had really low spine scores and a resulting  very high risk of fracture so medication was not so scary a thought. 

There are other very impressive contributors to this forum who have decided to go the non-med. route and are happy with this decision.

If you're looking for the source of this paper talking about bone density vs bone quality -  Google 

Bone Density vs Bone Quality, Cleveland Clinic. Angelo Licata 2009.

Kind regards,  J

 

Hi Juno-Iri-Dub

Thanks for your input. I'll certainly see my orthopaedist . I have too a very low T-score ( -4.5 equalized to -3.5 for age ( Z score) . I take it that you have already been on medication. for O.P. Interesting to know which medication ,  for how long and the effects. ( and side-effects, if any).

Has your bone density gone up?If so, how long did it take ? Are you off the medication now?  Does bone density stabilize with the medication, so that one can hope to evetually go off?

Thanks

Ittiandro

My spinal T score was -4.5 with no fractures but high risk of one. Hips were in the osteopenia range.  I was prescribed Forteo for 2 years which I used with no real problems. After 1 year of Forteo use my scan showed an improvement to -4 (or 11%). I haven't had a second scan yet. After finishing the Forteo, I was prescribed Actonel for apx.4 years which I'm still taking with  no  problems either.  . . . 

forteo is the only medication that actually builds new bone.

Apart from medication, Calcium,  Vit.D and execise (as advised by a physio.) is advised.

Please don't be so worried, you'll be fine. But do talk to your doctor about your worries, and if you're not happy with him, get a second opinion. It's very important that you have confidence in him and are comfortable with his treatment. 

Kind regards,  J

 

I was cleared to use Prolia (since the fosomex caused upper GI issues) I haven't tried it after reading up on it.  Would Forteo be something I should ask him about? Is this a six month injection and also a biologic?

Only the reference I mentioned above which you can Google. I don't know how to put up links. . . . 

Both Prolia and Forteo are used for those with severe OP, many fractures or who can't tolerate some of the other meds. No drug is perfect, or indeed without side-effects (though mine were minimal with Forteo).  It's Prolia that is the 6-monthly injection given by your GP. Forteo is a daily injection which is self-administered. It's in the form of a pen like the ones that diabetic patients use and pretty straightforward to use. Which drug your doctor may suggest may well be related to who is paying for it (ie. private health cover, state health cover). Both are expensive, with Forteo being the most costly. . . 

Maybe discuss both with your doctor and tell him your concerns about side-effects that you've read about. 

J

You're welcome Ruby, but not sure what the 'thank you' is for . .. 

J   x