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Osteoporosis (brittle bones) is a condition that weakens bones, making them fragile and more prone to fracture. It develops slowly over several years and is often only diagnosed when a fall or sudden impact causes a bone to break (fracture). Menopause can also increase the chances of developing osteoporosis because decreased oestrogen levels can lead to bone loss.

The most common injuries in people with osteoporosis are:

However, breaks can also happen in other bones, such as the arm or pelvis. Sometimes a cough or sneeze can cause a broken rib or the partial collapse of one of the spine’s bones.

Although a broken bone is often the first sign of osteoporosis, some older people develop the characteristic stooped (bent forward) posture. It happens when the bones in the spine have broken, making it difficult to support the body’s weight.

The stage before osteoporosis is called osteopenia. This is when a bone density scan shows you have lower bone density than the average for your age, but not low enough to be classed as osteoporosis. I was diagnosed with this two years ago but with the right treatment, you can still not develop osteoporosis.

I have been put on a calcium and vitamin D tablet which I take twice a day. A diet that’s low in calcium contributes to reduced bone density  (the amount of calcium and other minerals that are found in your bones), premature bone loss, and an increased risk of fracture.

Men do get osteoporosis but it is more common in women because women tend to have smaller, thinner bones than men, and may experience bone loss during menopause.

People who do not exercise regularly are also more at risk of developing osteoporosis than people who do regular exercise.

Several studies show that smoking is a risk factor for osteoporosis and bone fracture as does drinking lots of alcohol.

People who are very thin (with a BMI of 19 or under) are more at risk of developing osteoporosis, as they usually have less bone mass to draw from.

Other factors can also increase the risk of developing osteoporosis, including:

  • taking high-dose steroid tablets for more than 3 months
  • other medical conditions – such as inflammatory conditions, hormone-related conditions, or malabsorption problems
  • a family history of osteoporosis – particularly a hip fracture in a parent
  • long-term use of certain medicines that can affect bone strength or hormone levels, such as anti-oestrogen tablets that many women take after breast cancer
  • having or having had an eating disorder such as anorexia or bulimia

Some great ways to help improve your bone health include eating more vegetables, staying active, trying weight-bearing exercises, making sure you are getting plenty of Vitamin D by being out in the sunshine or taking supplements, eating calcium-rich foods, keeping your smoking or drinking to a minimum or not at all and maintain a healthy weight.

Source: NHS, Restless

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Osteopenia is when your bones are weaker than normal and your bone density is lower than the average adult, but not so far gone that they break easily, which is the hallmark of osteoporosis. Your bones are usually at their densest when you’re about 30. Osteopenia, if it happens at all, usually occurs after age 50. The exact age depends on how strong your bones are when you’re young. If they’re hardy, you may never get osteopenia. If your bones aren’t naturally dense, you may get it earlier.

Losing bone density is a normal part of ageing. This happens at different rates in different people. In fact, many people have osteopenia in later life as their bones get older. It could also be due to genetics, medication taken for a different condition or having naturally smaller denser bones.

Osteopenia is considered a chronic condition, but it affects everyone differently. While some people with osteopenia may struggle to complete daily tasks without experiencing intense back pain or injuring a bone, other people don’t even realize they have this condition. 

UCF Health writes that “back pain is common in people who have osteopenia because the spine loses its bone density, which makes it more difficult to support the body. Without strong spine support, the body struggles to hold itself up to walk or to sit in an upright position.

There typically are no symptoms in the early stages of bone loss. But once your bones have been weakened by osteoporosis, you might have signs and symptoms that include: Back pain, caused by a fractured or collapsed vertebra. Loss of height over time.

Having osteopenia does increase your chances of developing osteoporosis which then increases the risk of fractures. Chronic low back pain patients have an increased incidence of osteopenia and osteoporosis. 

If your mother or grandmother suffered from osteoporosis (we all know someone who does), you can also start to see the signs of osteopenia between the ages of 30 and 40, when bone loss gradually starts.

Bone density is measured with dual-energy X-ray absorptiometry (DEXA). DEXA is an imaging test that uses X-rays to determine whether you have healthy bones, osteopenia or osteoporosis. It provides a score called a T-score:

  • +1 to –1 indicates normal bone density.
  • –1 to –2.5 indicates osteopenia.
  • –2.5 or lower means osteoporosis.

DEXA gives healthcare providers a “baseline measurement.” That means they can compare the current test results to future results to determine whether bone density decreases over time.

There’s no cure for osteopenia, but it’s important to look after your bone density as much as possible. Treatment involves a simple approach to keep your bones as healthy and strong as possible and prevent it from turning into osteoporosis.

Source: UCF Health Cleveland Clinic Web MD

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As my readers know I have been having a ‘pain-free‘ time after having bilateral sacroiliac injections for my SIJ pain. On week six from having the injections, I started to feel some of the symptoms coming back but only on my right side.

Pain after walking mainly in my hip, pain putting my right shoe on, pain while standing, pain getting out of the car but only on the right side, pain doing housework and worst of all pain in the night when I turn onto my right side ( my favourite sleeping side).

Yesterday I had my follow up appointment and I was keen to tell him how successful it has all been until week six. He was delighted with the results and said if it all came back like it was before then his next procedure would be the Radio Frequency Ablation of my sacroiliac joints rather than a steroid injection.

He then asked me more about the pain I was experiencing and remembered he had ordered an MRI of my right hip the last time I saw him after an examination of me showed that area to be particularly painful.

When he looked at the results of the MRI it showed I had degeneration of the hip (Osteoarthritis) and Bursitis which he explained would definitely be the reason for my pain in that area. He said he could refer me for a steroid injection into my hip, or refer me directly to see a hip consultant.

I declined both offers as I feel I have had lots of steroid injections for my low back over the last 12 months and I am just not ready to deal with more investigations for another problem. I asked if he felt “Aqua Aerobics” would be a good thing for me to try and he could not praise this type of exercise enough for anyone with joint/nerve problems.

I have felt a bit weary this morning knowing I have yet another painful condition to deal with but I’m just going to get back onto my pain medication like before(which I had got right down to very little) and remind myself that my problems are not life-threatening I just need to make a few life-changing things to help with the pain.

My friend who is a nurse explained to me that anything ending in ‘itis’ means inflammation so she suggested taking some anti-inflammatories as well. I will have a chat with my GP first though.

Osteoporosis is the most common type of arthritis, is a degenerative joint disease. It results from wear and tears in the joints. In hip osteoarthritis, the cartilage in the hip joint thins over time, reducing the protective layer between bones, leading to bone-on-bone rubbing and the formation of new bone spurs. These changes contribute to the symptoms of hip osteoarthritis—which include pain and stiffness in the groin, buttocks, and knee.

Osteoarthritis is a progressive disease, with sequential stages. Your treatment will depend on the stage of your hip osteoarthritis.

The symptoms start with dull, aching pain in the groin, outer thigh, knee, or buttocks. Pain that is worse in the morning or after sitting or resting for a while, but lessens with activity. Increased pain and stiffness with vigorous activity. Pain in the joint is severe enough to cause a limp or make walking difficult. Any pain, swelling, or tenderness in the hip joint.

The causes of osteoarthritis of the hip are not known. Factors that may contribute include joint injury, increasing age, and being overweight.

Treatments could include taking supplements like glucosamine and chondroitin. You should also make sure you get enough calcium and vitamin D. ( I am already on a supplement for this after being diagnosed with Osteopenia a couple of years ago).

Walking, dancing, aqua aerobics are the types of exercise that work directly on the bones in your legs, hips and lower spine to slow mineral loss which is important if you have Osteoporosis. The main goal of treating osteoarthritis of the hip is to improve the person’s mobility (ability to get around) and lifestyle. I am really pleased I got down to the correct BMI during the last lockdown as it is obvious being overweight can play a big part in this condition.

Bursitis (bur-sigh-tus) is a condition that makes the area around a joint or bone painful, red and swollen. It can affect both adults and children.

It commonly affects the feetshoulderselbowsknees and hips. However, you can get it in or around any joint, and it can stop you from being able to move that part of your body properly.

Symptoms include:

  • red or swollen area
  • hot and sore
  • painful – usually with a dull, aching pain
  • sensitive and painful if you try to press on or move it.

Bursitis is caused by inflammation in a thin pocket of jelly-like fluid that sits between your bones and tendons. When it’s working properly, this fluid protects your joints and bones from knocks, falls, bumps and injuries.

This fluid cushion is called a bursa (bur-sa), or bursae (bur-sigh) if more than one is involved.

When your bursae are working normally, they act as lubricants for your bones and the soft tissue that supports them. This allows them to slide easily over one another.

Bursae also help to reduce friction. An example of this would be your shoe rubbing your foot. This creates friction, which is absorbed by the bursae instead of your bones or tendons.

Your body can also create a new bursa if it thinks a certain joint or limb needs added protection from friction. For example, if your shoe keeps rubbing the same area, or you regularly lean on the same elbow, your body will create added cushioning there. This will either be with an extra bursa or by increasing the fluid in the bursae that are already there.

Versus Arthritis suggest that if lying down is uncomfortable, then try to avoid sleeping on the side that hurts. A pillow placed behind your back can stop you from rolling onto the painful side and should help you sleep better.

The NHS say the best way to treat bursitis yourself is to help bring down swelling and pain and the best way to do that is to –

  • rest – try not to move the joint too much and avoid activities that put pressure on it
  • use ice – gently hold an ice pack (or a bag of frozen peas) wrapped in a tea towel on the area for around 10 minutes at a time and repeat every few hours during the day
  • take painkillers, such as paracetamol or ibuprofen, to ease any pain

It may also help to put extra cushions around the affected joint while you sleep, to help protect and support it.

Other treatments are –

  • steroid injection may be given into the affected joint to reduce the swelling – this will not be done if bursitis is caused by an infection
  • if bursitis is severe or keeps coming back, the inflamed bursa may need to be surgically drained or even removed (but this is rare)

Source: Very Well, WebMD, Versus Arthritis, NHS, BPB Health Disclaimer, Healthline