When Sherry Morse fell from a horse in 2015, she fractured many bones and suffered a “hanging shoulder injury,” typically the result of a high-speed automobile accident. An orthopedic surgeon said he could expect this severity if someone falls off a plane.
“I got off my horse while walking,” said Morse. “It shouldn’t have been such a serious injury.”
Two years earlier, after undergoing a hysterectomy to treat painful fibroids, Morse was diagnosed with osteopenia, a loss in bone density that is not as severe as osteoporosis. She was 43 years old.
Nearly 54 million Americans suffer from low bone mass or full-blown osteoporosis, a disease that leads to more severe bone loss.
After Morse’s shoulder injury, another bone density scan showed she had developed osteoporosis – despite taking medication for her osteopenia.
“It was a bit devastating,” said Morse.
Who is at risk of osteoporosis?
Osteoporosis literally means “porous bones” and occurs when bone loss exceeds bone formation, which typically begins after the age of 50. Osteoporosis can lead to fractures, especially wrists, hips, and spines.
“While it is common to view osteopenia and osteoporosis as diseases that only affect the elderly, these can actually be diagnosed in people of all ages,” wrote Dr. Kimberly Templeton, professor of orthopedic surgery at the University of Kansas, and a member of HealthyWomen’s Women’s Health Advisory Board in an email.
She added that this misconception can discourage people from having their bone mass assessed.
Although men suffer from osteoporosis, women are disproportionately affected. 8.2 million women suffer from osteoporosis and 27.3 million from bone loss. Approximately 25% of women aged 65 and over develop osteoporosis. One in two breaks a bone as a result.
Studies of racial and ethnic differences suggest that Latina women have lower bone density and a higher risk of fractures than others. Black women have higher bone density and a lower risk of fractures than whites and other ethnic groups, but are less likely to be screened or medicated after a fracture.
Bone loss can be caused by certain health conditions, medications, or other treatments and lifestyle factors. Risks increase with early menopause, previous fractures, or a family history of osteoporosis-related fractures and other health conditions, including:
Certain medicines – including some steroids, chemotherapy, antidepressants, and hormone treatments – can increase your risk of osteoporosis even if they treat or prevent other conditions. The risks increase the higher the dose and the longer you take the medicine.
Weight loss, which can improve your cardiovascular health and lower your risk of cancer, can hinder the absorption of nutrients and increase your risk of osteoporosis. Other risks include a low-calcium diet, malnutrition, excessive alcohol consumption, and cigarette smoking.
When should you get a bone density test?
For many people, breaking a bone is the first sign of osteoporosis.
To detect osteoporosis before a fracture, women over 65 and women at higher risk ages 50 to 65 should get a bone density test called a DXA (or DEXA) scan. Women with a history of fractures or parents with a broken hip have a higher risk of fractures.
“If you have chronic back pain and / or have lost extra height, you should discuss with your doctor whether this is due to low bone mass and whether you should start treatment,” Templeton said.
The insurance can cover DEXA scans before age 65 for people at higher risk. Medicare Part B handles DEXA scans every 24 months, depending on your medical history or health status. If your insurance doesn’t cover your scan, the estimated out-of-pocket cost is $ 125. However, the costs vary depending on where you live.
How to keep healthy bones
“Osteoporosis can be prevented even in people with osteopenia,” Templeton said. “It’s never too early or too late to focus on your bone health.”
“The first thing you need to do is look at things that can be changed in your lifestyle to improve your bone health,” Templeton said, adding that this is especially important for people who have risk factors for bone loss, that you cannot change.
- Stop smoking
- Reduce your alcohol consumption
- Get enough calories and specific nutrients (protein, calcium, and vitamin D)
- Start or intensify strenuous exercise such as walking, jogging, hiking, or dancing (always consult a doctor before starting a new exercise program).
- Work on balance and strength training to avoid falls and breaks
While these changes may be difficult to make, Templeton says they are critical.
Drugs called bisphosphonates can prevent further bone loss in women at high risk or women with significant bone loss and can improve bone mineral density and reduce the risk of fractures. When taking bisphosphonates, it’s important to get adequate calcium and vitamin D.
“There are risks in taking these drugs, but the risk of breakage due to low bone mineral density usually outweighs the risk of the drugs,” Templeton said.
Don’t let osteoporosis control your life
A diagnosis of osteoporosis can feel like a kick in the gut – an inevitable sign of aging or a looming feeling of vulnerability. But that doesn’t mean that one should indulge in a life in a rocking chair.
When Morse learned that she had osteoporosis, she realized that she had a choice.
“I’m not going to let this ruin my life,” she told herself. “I can’t sit at home and be worried and scared because I will feel worse.”
Despite the risks, Morse’s diagnosis didn’t stop her from doing what she loves: horseback riding. She literally got back on her horse and kept riding.
National Osteoporosis Foundation
American bone health