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Bone & Muscle Health
Bone & Muscle Health Articles
Like their names suggest, osteopenia and osteoporosis are related diseases. Both are varying degrees of bone loss, as measured by bone mineral density, a marker for how strong a bone is and the risk that it might break. If you think of bone mineral density as a slope, normal would be at the top and osteoporosis at the bottom. Osteopenia, which affects about half of Americans over age 50, would fall somewhere in between.
The main way to determine your bone density is to have a painless, noninvasive test called dual-energy x-ray absorptiometry (DXA) that measures the mineral content of bone. The measurements, known as T-scores, determine which category — osteopenia, osteoporosis, or normal — a person falls into (see graphic).
While calcium is essential for bone strength, some experts believe that Americans are getting too much calcium, which can actually lead to an increased risk of a hip fracture.
Recently, news stories reported that studies found that daily calcium and vitamin D supplements may not help older women protect their bones or prevent colon cancer — at least not as much as we thought they would.
Researchers for the Women's Health Initiative (WHI) looked at more than 36,000 healthy women ages 50–79. Half of the women took 1,000 mg of elemental calcium and 400 IU of vitamin D each day. The other half took a sugar pill (placebo). After seven years, the women taking the supplements showed slightly better bone density in their hips. They also had fewer hip fractures, but the results could have occurred by chance: Protection against hip fractures, a key goal of improving bone density, was not proven.
So, should women ditch their TUMS, calcium chews, and vitamin-D–fortified dairy foods?
How long have you had painful joints?
Which joints are involved and which are most painful?
Is the pain worse or better after walking or other exercise?
Does the pain wake you at night?
Does it occur at rest?
Do you have swelling or deformities in any joints?
What activities can you no longer do because of the arthritis?
How long ago did you stop doing them?
How far can you walk?
Do you have difficulty opening jars or grasping objects?
Do you have any other conditions, such as heart or lung disease, that also limit your ability to function?
What have you done to treat your osteoarthritis?
What therapies help the most?
Do you use a cane (for osteoarthritis of the knee or hip)?
What medications do you take (over-the-counter and prescription) to treat the pain?
How effective are they?
Do you know the side effects of each medication?
Blood tests if your symptoms are atypical for osteoarthritis
X-rays of the involved joints
CT scans of the involved joints
MRI scans of the involved joints
Where is the pain in your back?
Does it radiate to your legs?
Is it worse when you walk?
Does the pain from walking occur suddenly or gradually?
Is it relieved by standing?
Is it relieved by sitting or lying down?
What bothers you more, the pain in your back or the pain in your legs?
Does the pain worsen when you cough or sneeze?
Do you have numbness or decreased sensation in your legs?
Have you had problems with your balance?
Have you had any changes or difficulty in your ability to urinate?
How long have you had the pain?
Is it getting worse?
How much does it limit your usual activities?
How is your quality of life affected by the pain?
Have you ever had spinal surgery?
Have you ever injured your back?
Have you ever had hip surgery?
Do you have diabetes?
Do you have poor circulation, such as peripheral artery disease?
Do you have foot ulcers?
Have you ever had vascular surgery?
Do you have any sort of neuropathy (nerve damage)?
What are you doing to treat the pain?
Have you seen a physical therapist?
Are you interested in an injection of a cortisone-like medication into your back? Do you know anything about this procedure?
Pulses in the feet, behind the knee and in the groin
X-rays of the spine
CT scans of the spine
MRI scans of the spine