MS and the Risks of Osteoporosis

Vicki Health Guide
  • World Osteoporosis Day is Wednesday, October 17, 2010. Also, the last day of National Action Week for Bone and Joint Decade is October 17. The theme for World Osteoporosis Day this year is mothers and daughters.

    Osteoporosis is a condition of low bone density. It is characterized by sponge-type holes in bones and is the most common bone disease. Four times as many men and three times as many women have the disease than report it. Ten million people in the United States have osteoporosis, and a total of 75 million in U.S., Europe and Japan.  Millions more have osteopena, a low bone mass that indicates high risk for osteoporosis. This is a widely-experienced condition and is a significant health care cost as the population ages. Fractures are estimated to increase by 50% over the next 20 years.

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    Bone health is important, and a chronic condition like MS makes it even more important, especially when balance and walking are affected. Strong bones are crucial to our health, our daily lives, and even our overall quality of life.

    For me, this story of osteoporosis is personal.

    Most people, especially young people, consider osteoporosis to be a disease only for older people. This is not necessarily true. Osteoporosis does not discriminate. It does happen to little old ladies who walk bent over and break their hips when they fall. Historically, the perception has been that it is a normal part of aging in women. However, the truth is that osteoporosis sneaks up on aging people as well as those who are energetic and active, both men and women, including Sally Field and Joan Rivers, me, and maybe you.

    Bone mass is at its peak before 30 and starts decreasing after that. Stronger bones have less chance of contracting osteoporosis. The bone strength is dependent on everything that happened before it reaches its peak.

    The most common problem from osteoporosis are fractures. Hip fractures are the most devastating type, accounting for 300,000 hospitalizations a year. Wrist and spine fractures are also of high occurrence.

    Spinal fractures may happen due to falls, but even opening a stuck window or just sneezing can be the cause. Many spinal fractures involve small bones that stabilize and straighten the spine, maintaining good posture. Instead, there may be a dowager's hump or a tendency to lean toward one side or another. There is usually back pain and reduced spinal strength even before posture difficulties are noticed.

    Osteoporosis is largely a hidden condition until the damage is done. My doctor tells me I have a severe case. I began taking Fosamax like many others living with this condition. Each year my new bone density test ingdicated no improvement, but it was not worse either. Fosamax is taken once weekly.

    My doctor was trying to improve my bone health, so I began with a new medication. Forteo one is taken by daily injections in the stomach or thigh. Unlike most of the disease-modifying MS drugs, the needle is very small. This one was approved for a two year program. After three years, and again because of no improvement, I moved on to a third medication therapy.

  • I now take Miacalcin, using a daily nose spray. Since I began this treatment, Reclast, taken only a once-yearly in fifteen minute infusions, has been introduced and another is expected next year. There seems to be a great improvement over the last ten years in medications for osteoporosis.

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    Besides the medications, osteoporosis is treated and hopefully prevented by weight-bearing exercise like walking or dancing. Anyone with MS might find that difficult, especially if they are in wheelchairs or have an awkward gait.

    Remember when Wonder Bread commercials told young children it was good for strong bones? We need to impress our children and teens that bone health is important, and that they can make a difference for strong bones now and in their future. If they take measures now, they can expect a high quality of life without osteoporosis later.

    It is vital to be aware of the possibility of osteoporosis with MS, regardless of age or gender. Don't just wonder if you need a bone density test, ask your doctor. It is important!

    Investing in health will produce enormous benefits.
    Gro Harlem Brundtland

    Notes and Links:

    International Osteoporosis Foundation

    Rare fractures caused by Bisphosphonates (Fosamax-type drugs)

    Healh Central Osteoporosis Connection

Published On: October 20, 2010