April 24, 2012
Osteoporosis may seem like an odd condition for a podiatrist to encounter, however the reason why I chose to discuss this topic is that it affects the feet -- maybe not so much from a fracture standpoint but definitely for the foot pain it causes. Foot pain in the elderly is one of the most common complaints seen by the podiatrist every day.
Osteoporosis, which means porous or holey bone, is a condition in which bones become weak and thin due to lack of calcium. People with osteoporosis have an increased risk of bone fractures (breaks). Osteoporosis is often called a silent disease because many people do not realize they have it until they break a bone with or without trauma.
While the bones of the spine, hip, and wrist are the most common bones to become broken as a result of osteoporosis, metatarsals and other bones in the feet can also be affected. In fact, some people first find out they have osteoporosis because of a fracture in the foot.
It is estimated that over 10 million Americans (eight million women and two million men) have osteoporosis and another 34 million have low bone mass, known as osteopenia which, if left untreated, will deteriorate to osteoporosis in the future. At the present time, the majority of hip fractures occur in Europe and North America. In 50 years, it is estimated that 75 percent of all hip fractures will occur in developing countries like The Bahamas, with the numbers of hip fractures rising three-fold to 6.3 million a year. Osteoporosis is most commonly seen in women over age 50, but younger people and men can also have it too.
Risk factors for osteoporosis include:
o Gender. Women get osteoporosis more often than men.
o Age. The older you are, the greater your risk of osteoporosis.
o Body size. Small, thin women are at greater risk.
o Ethnicity. White and Asian women are at a higher risk than Black and Hispanic women.
o Family history. Osteoporosis tends to run in families.
Other factors that can be changed may include low estrogen levels in women after menopause, a diet low in calcium and Vitamin D, lack of exercise, cigarette smoking and drinking alcohol.
In most people, the highest bone mass is reached around age 30, but the bone continues to grow over time. Bone cells make and break down bone all the time. If the amount of bone made is equal to the amount of bone break down, then the bones stay strong. When this process is off balance, with more bone breakdown than bone building, the bone structure weakens and breaks easily.
Many older people present to the podiatrist's office complaining of generalized, nondescript pain in both feet. The patient often cannot pinpoint any particular area of the foot. Sometimes, these people may also suffer from arthritic joints, but can clearly point out these areas. When older persons complain of vague foot pain, many times it can be from osteoporosis. As the bones of the feet demineralize over time, they become weaker but are still expected to support the whole body as people continue their usual activities. This weakness in the bones reduces the strength of the individual bones and it is manifested as generalized foot pain. Sometimes, people may present with increased pain with walking, redness and swelling on the top of the foot, which may be signs of foot injury or even a fracture. These people should be seen by a podiatrist immediately.
Osteoporosis is diagnosed by a bone mineral density tests called a DXA (Dual-energy x-ray absorptiometry) scan or test. Not only is this test used to make the diagnosis, but can also be used to see if the treatment that the patient is receiving is actually strengthening their bones. X-rays can also be used as a diagnostic tool. On x-rays the bone looks faded, thin and washed out.
The following treatment is recommended to prevent osteoporosis.
o Supplements. Calcium and magnesium supplements help to build and strengthen the bone. A vitamin D supplement is needed for calcium absorption and bone building.
o Eat foods rich in Vitamin K and highly absorbable calcium such as broccoli, cabbage and spinach, romaine lettuce, sesame seeds and bok choy which will be more than adequate to build strong bones.
o Try not to eat too much meat, excess proteins, refined grains and sugar which causes the blood to become acidic. This causes the bones in the body to lose calcium instead of gaining calcium.
o Exercise. Even low to moderate weight-bearing exercise provides tension on the bone and strengthens it.
o Stop smoking and avoid
alcohol because they lead to calcium loss from the bone.
o Speak with your primary care physician to discuss if HRT (hormone replacement therapy) , it is good for you.
For the individual that already has osteoporosis, the condition may not be completely reversible. There are medications available that work by either stopping the cells that break down bone or that help by building up bone. However, it is vitally important to stop the conditions that lead to bone loss such as eating a high protein (meat) diet, smoking, drinking alcohol and a sedentary lifestyle.
As far as foot pain from osteoporosis, wearing laced shoes with a good arch can support the feet and go a long way to reducing the stress placed on the bones of the feet. The podiatrist may order pain medications for a short while for relief. Building strong bones is the most effective strategy for complete pain relief and prevention of fractures.
oIf you suspect you have osteoporosis see your primary care physician. If you continue to have foot pain you need to see a podiatrist. For more information on osteoporosis, email me at firstname.lastname@example.org or visit www.foothealth.org or www.footpainexplained. com. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street or call 325-2996 or Bahamas Surgical Associates on Albury Lane or call 394-5820.
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