About Osteoporosis & Bone Density

OSTEOPOROSIS & BONE DENSITY

Osteoporosis is a common disease that causes bones to become fragile and brittle. Osteoporosis causes bones to lose minerals such as calcium more quickly than the body can replace them, and consequently there is a reduction in bone strength and density. As the bone becomes thinner, even a small bump or minor fall may cause a serious fracture (called a fragility fracture). Therefore, osteoporosis leads to a  higher risk of fractures compared to normal healthy bone. Osteoporosis is often called the “silent disease” because there are usually no symptoms until a fracture occurs.

Approximately 4.74 million Australians over the age of 50 have osteoporosis or poor bone health, and around 150,000 fractures occur each year due to osteoporosis or osteopenia (low bone density).  In fact, an osteoporotic fracture occurs every 2.9 minutes, which means that a fracture has probably occurred during the time you have spent on our website.

Osteoporosis particularly affects women after menopause and in their later years, although men are also affected. One in three Australian women, and one in five Australian men will develop osteoporosis and be in danger of a fragility fracture. Worse, still, after a fracture, 1 in 2 people never regain full mobility and 1 in 4 have to move into a nursing home. Physical activity and a healthy, balanced  diet rich in calcium and vitamin D can help prevent osteoporosis.

Scanning of the axial skeleton by dual energy X-ray absorptiometry (DEXA) is the gold standard in Australia for the measurement of bone mineral density (BMD). DEXA is a diagnostic tool for osteoporosis or osteopenia, enabling doctors to determine the extent of bone loss, for clinical decision making.

Riverside Medical Imaging (the x-ray clinic located in our clinic) provides an accurate and convenient bone densitometry service for patients and doctors. Early detection of bone mineral loss can help prevent the occurrence of an initial fracture. For patients who may have already had a fracture, investigation with a DEXA scan and initiation of osteoporosis medication combined with a healthy diet and exercise regime is crucial to reduce the very high risk of subsequent fractures.

Our Chiropractors recommend that any patient with risk factors for osteoporosis have a DEXA scan. You can chat to your Chiropractor about this, on your next visit. We are committed to the prevention, diagnosis, treatment and management of and increasing awareness of osteoporosis.

WHO SHOULD GET A SCAN?

There are many risk factors for osteoporosis. Therefore, you may like to have your bone mineral density (BMD) assessed if:

  • You are over 70 years of age
  • You consume inadequate amounts of dietary calcium
  • You have low vitamin D levels
  • You are a smoker cigarette smoking
  • Your alcohol intake exceeds more than two standard drinks per day
  • Your caffeine intake is more than three cups of tea, coffee or equivalent per day
  • You have poor physical activity levels
  • You experience early menopause (before the age of 45)
  • You have lost your menstrual period due to a reduction in oestrogen levels, which is vital for healthy bones
  • You have recently been placed on anti-depressants (especially SSRIs)
  • You have a long-term use of medications such as corticosteroids for rheumatoid arthritis, asthma or other conditions.

Some conditions place people at a higher risk of osteoporosis. Therefore it is advised patients with the following conditions have their bone mineral density assessed:

  • Thyroid disease or an overactive thyroid gland
  • Rheumatoid arthritis
  • Chronic liver and kidney disease
  • Conditions that affect the body’s ability to absorb nutrients, such as Crohn’s disease, coeliac disease and other inflammatory bowel conditions

If you have any of the conditions immediately above, you may be eligible for medicare bulk billing, for your bone density scan. In addition, every Australian man or woman over 70 years of age is eligible for medicare bulk billing. If a medicare rebate is not available to you, the cost of a scan is $87.50. Some private health funds do offer cover for bone density scans, so please check with your provider.

By |2017-01-01T08:23:53+00:00May 6th, 2016|Conditions, Education, Info|2 Comments

About the Author:

mm
Dr. Angus Steventon was inspired to become a Chiropractor when, as a fifteen year old, he spent a week observing his uncle, legendary Chiropractor Dr. Rodney Steventon. After leaving school, Dr. Steventon studied to gain his Bachelor of Medical Science from Sydney University. He then continued on to earn his Master of Chiropractic from Macquarie University. During his final years at Macquarie University he worked under the tutelage of his uncle Rodney in Sydney, and after graduating, began work as a Chiropractor in that same clinic. For ten years Dr. Steventon built up a successful practice alongside his uncle and several other Chiropractors, while simultaneously pursuing his passion for music. In late 2009 he and his wife of four years, Sarah, decided to return with their two young children to Sarah’s native Central Coast, joining forces with Dr. Bryce Conrad as a co-director of the Central Coast Spinal Care Centre. Since coming to the coast, Angus and Sarah have welcomed their third child, Tobias, brother to Zachary and Hannah. Angus has been a member of the Chiropractors Association of Australia since his graduation, and is the immediate past Vice President of the NSW branch.

2 Comments

  1. Dr. Urmila Sriskanda May 12, 2016 at 7:37 AM - Reply

    Antidepressants including SSRIs do not cause a reduction in BMD but SSRIs can increase falls risk in the elderly and falls can result in more fractures.

    • mm
      Central Coast Spinal Care Centre May 12, 2016 at 8:06 AM - Reply

      Hi Dr Sriskanda,

      There is emerging evidence that reductions in BMD are linked to SSRI use. Most GPs are not aware of this link. The link appears to go beyond the effects of depression, alone. Although the nature of the effect is still being investigated, numerous researchers and osteoporosis related organisations (including Osteoporosis Australia) are encouraging GPs to have their patients tested when they are put onto SSRIs. The magnitude of the effect appears to be strongest in the first 6 months of SSRI use. At present, the Medicare system does not rebate SSRI use as an indication for bone mineral densitometry. See the following references:

      J Bone Metab. 2013 Nov;20(2):95-8. doi: 10.11005/jbm.2013.20.2.95. Epub 2013 Nov 18. “CONCLUSIONS: It is necessary for patients taking SSRI to check bone density on a regular basis.”

      Endocrine. 2015 Feb;48(1):65-8. doi: 10.1007/s12020-014-0357-0. Epub 2014 Aug 5. “The evidence now seems sufficient to consider adding SSRIs to the list of medications that contribute to osteoporosis.”

      Osteoporos Int. 2015 Jan;26(1):273-9. doi: 10.1007/s00198-014-2859-2. Epub 2014 Sep 4. “SSRI therapy in GAD was found to be related with decreased BMD values. Further randomized controlled studies are warranted to determine whether SSRI use is a risk factor for osteoporosis; such studies should investigate these factors by performing BMD assessments before treatment.”

      J Musculoskelet Neuronal Interact. 2015 Jun;15(2):177-85. “Both depression and use of antidepressants should be taken into account as possible risk factors for osteoporosis in men.”

      Inj Prev. 2015 Dec;21(6):397-403. doi: 10.1136/injuryprev-2014-041483. Epub 2015 Jun 25. “SSRIs appear to increase fracture risk among middle-aged women without psychiatric disorders, an effect sustained over time, suggesting that shorter duration of treatment may decrease fracture risk. Future efforts should examine whether this association pertains at lower doses.”

      J Clin Psychiatry. 2015 May;76(5):607-13. doi: 10.4088/JCP.14m09195. “Chronic SSRI treatment in children and adolescents is associated with reduced, albeit stable, bone mass for age, while chronic risperidone treatment is associated with failure to accrue bone mass.”

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