Bone is a living tissue that is constantly breaking down and being replaced. Osteoporosis happens when growth of new bone does not keep up with the breaking down of old bone. This makes the bones very brittle and fragile. Primary osteoporosis is a result of the normal aging process, while secondary osteoporosis is a result of another disease process.
Bone regeneration normally takes place much faster than the deterioration process and the bones grow in mass reaching a peak in a person’s 20s. As people age, the breaking down process becomes faster than the regeneration process. The amount of bone mass at the peak can partly determine the likelihood of developing osteoporosis. There are many risk factors. It is most common in older women, due to a decrease in estrogen, as well as people taking corticosteroids or with a decreased dietary intake of calcium.
The goal of treatment is to address the underlying causes and prevent fractures.
There are typically no symptoms in the early stages of bone loss
Patients often complain of back pain as the vertebra collapse or pain from a fracture. Pain control is essential for the patient to participate in rehab.
Falls and injuries are more difficult to heal with osteoporosis as the bone takes longer to regenerate. Provide assistance with ambulation, remove rugs or fall hazards and maintain a clear and well-lit path.
If patient is in cast or splint, make sure the device fits properly and assess for skin integrity and circulation.
Medications to slow bone loss may be given as an oral medication daily, weekly or monthly. Some medications require weekly, monthly or quarterly injections.
Fat embolism is a complication of fractures and can lead to respiratory insufficiency.
Pain and injury make positioning difficult for some patients. Assist in repositioning every 2 hours as needed to prevent skin breakdown and assist with mobility.
Immobility can cause atrophy of muscles. Assist as necessary with ROM activities to prevent injury.
Consult with PT/OT for evaluation and rehab to maintain functionality and mobility.
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