What are the consequences for back pain?
In theory, all bones in the human skeleton can display osteoporosis. However, the physical composition of the bones does vary and, as a result, some bones are more likely to exhibit osteoporosis than others. Unfortunately, the risk of fracture to the bones in the spine (as well as the wrist and hip) is far greater than for others; for example, 1.5 million osteoporotic fractures occur annually in America (approximately) and, of these, the following break-down is given:
- 700,000 vertebral fractures (spine)
- 300,000 hip fractures
- 250,000 wrist fractures
- 300,000 fractures at other sites
Source: The Osteoporosis and Related Bone Disease National Resource Center.
Within the spine itself, the area most at risk from osteoporotic fracture is the lumbar spine; this is because the vertebrae in this section carry the most weight (resulting in the most stress). A fractured vertebra will often lose between 15% and 20% of its overall height, causing many people with osteoporosis to literally shrink (the fracture itself is essentially a compression fracture, where the forces cause the holes inside the vertebrae to collapse).
In itself, an osteoporotic fracture is very painful, but the resulting collapse will often lead to secondary problems, most of which are very severe; for example, spinal nerves may become trapped, and the pressure on the inter-vertebral discs will increase (possibly leading to a Slipped Disc).
What are the risk factors?
Osteoporosis is caused by a number of factors; some of these, like age, sex and race, are beyond our control. Other factors, however, such as diet and lifestyle, can be changed to lower the risk of onset.
The primary risk factors are:
- Poor diet
- Lack of physical exercise
- Hereditary disposition
The vast majority of all sufferers are women (80%). In general, this is because women are smaller and lighter than men. They have a lower bone mass. Estrogen (a female sex hormone) also lowers the rate of bone depletion; during and after menopause levels of estrogen fall dramatically and, as a result, the rate of bone depletion increases. Estimates predict that up to 40% of all women over the age of 50 will suffer an osteoporotic fracture (source: Bone and Joint Decade).
Our diets are also extremely important in determining whether we are likely to develop osteoporosis. For example, the primary constituent of bone is calcium (something we consume via milk, cheese and other food-stuffs); hence, if our intake of calcium is too low, the risk of osteoporosis goes up; our bodies are literally unable to produce enough bone to keep up with the rate of depletion. Vitamin D, which promotes the absorption of calcium in the body, is also extremely important.
Our diets are also important in determining the risk of osteoporotic fracture; if we consume too much fat and sugar, we put on weight. Too much weight increases the level of stress on the entire skeleton (particularly the vertebrae in the spine) and this increases the risk of fracture.
Weight bearing exercise is very important in the prevention of osteoporosis. Most people know that exercise leads to an increase in muscle tone, strength and mass, but the same is true of our bones. The body actually responds by producing more bone (or increasing the rate of formation), so that we adapt to new levels of activity. A lack of physical exercise leads to a reduction in bone mass, increasing the chances of osteoporosis.
Can it be treated?
Most treatments for osteoporosis concentrate on prevention.
For example, by increasing the amount of calcium and vitamin D we consume, we can help to increase the rate of bone formation (provided we do so within safe, acceptable levels, high levels of calcium can lead to kidney stones, for example). Post-menopausal women are often given ERT (estrogen replacement therapy), or HRT (hormone replacement therapy, a combination of estrogen and progesterone), although alternative therapies exist. Increasing our levels of exercise, and cutting down on fat and sugar intake is also generally advisable, although exercise should not be attempted in the presence of a fracture.
Vertebral compression fractures can also be prevented (or at least delayed) by keeping the spine in a healthy, decompressed state. This can be achieved by using the Backrack™ or by visiting a spinal specialist, trained in Orthopaedic Medicine. The important point to note here, is that the back should be decompressed in a safe, non-violent manner (for this reason, we recommend that Osteopathy or Chiropractic are avoided in cases of osteoporosis).
In the event that a fracture already exists, the Backrack™ should not be used.
A number of experimental, surgical treatments do exist for the treatment of osteoporosis, but these are not widely available yet (regulatory approval is currently being sought). The techniques that are used on the spine, namely vertebroplasty and kyphoplasty, involve the injection of a special cement into the porous bone, where it rapidly solidifies, strengthening the overall structure. Unfortunately, we do not have access to clinical data that might indicate whether the treatment is successful or not.