This is the second in a series of columns, exclusive to healthandbone.ca that will focus on issues that are important to you, as a person concerned about their own bone health, or of that of a family member or friend. Dr. Marla Shapiro will draw upon her expertise and that of other expert colleagues to keep you up-to-date on the latest thinking in osteoporosis.
Osteoporosis is a chronic illness with potentially life-altering consequences when not managed properly. It is currently a major health concern in Canada and the world over and will continue to be so as the population ages.
Osteoporosis is a disease characterized by low bone mass and the deterioration of bone tissue. The bones weaken, putting those affected at greater risk of suffering a broken bone or fragility fracture. Fragility fractures are those that occur following a minor trauma, such as a fall from standing height, a sitting position or having missed 1-3 steps in a staircase.
Broken bones or "fragility" fractures that occur as a result of osteoporosis tend to happen most commonly in three areas – the wrist, the spine, and the hip. Research has shown that osteoporotic fractures result in longer hospital stays and lead to chronic disability. They can also impair mobility and decrease your ability to perform normal daily tasks independently. These effects can have a negative impact on a patient's outlook on life and their quality of life.
Osteoporosis affects people in many different ways. Some of the potential effects it can have on quality of life include:
In my practice I not only see the physical effects of osteoporosis but also the toll it can take emotionally. I asked Dr. Keri-Leigh Cassidy, Associate Professor in the Department of Psychiatry at Dalhousie University, about the impact of osteoporosis on mental health.
Dr. Cassidy says, "When faced with any chronic condition, people commonly have some negative thoughts and feelings, and worry about the implications. They might wonder what they can do about the condition, whether they will be able to cope with the consequences of a chronic disease, if there will be limitations to their functioning, or if they will have pain as a result. Sometimes these negative thoughts can compound feelings of loss and powerlessness related to the aging process."
Women with osteoporosis have often reported feelings of fear, anxiety and depression. One phrase that I hear often is "I'm afraid." Time and time again patients tell me they are afraid to even get out of their car when faced with an icy parking lot. They are scared of falling and breaking a bone. They become extremely anxious when faced with situations where a potential fall could occur.
I have patients who routinely turn down invitations from friends and family to participate in activities such as skiing, curling, and golfing. Going for walks outdoors in the winter is not something they would consider because they are so afraid they may come across a patch of ice and slip, fall and break a bone. As a result they begin to cut themselves off from friends and withdraw from family members. This change in the friendship and family dynamics seem to be all too common in patients with osteoporosis.
These changes may lead to feelings of isolation. I've heard patients say they feel they are "on the sidelines," watching life go by. Feelings of depression often follow.
Some patients isolate themselves for other reasons. Fragility fractures can lead to physical deformity which can progress over time. One such deformity is a pronounced curve in the upper spine, known as kyphosis.
Patients affected physically by osteoporosis often become uncomfortable with their appearance and develop a poor self-image. As a result they may not want to go out in public.