Osteoporosis and Back pain

Osteoporosis is one of those things everyone should give some thought to. It hits men but women are sufferers a lot more often.

I worry that my wife might not be getting enough calcium or enough Vitamin D or perhaps not enough sunshine. All things which can slide one towards brittle bones which one day might fracture.

This week I've been reading the Johns Hopkins 2008 White Paper on Back Pain and Osteoporosis.I definitely recommend it to anyone who has any issues with their back or bones in general as $19.95 well spent. Johns Hopkins also provide a free report on osteoporosis.

The White Paper looks at the tough question of "What's the best exercise for chronic back pain ?" Johns Hopkins quotes the results from a study published in PAIN (you have to love a journal with an up front name like Pain!). The study recruited 240 people who had all had back pain for more than 3 months. 

They divided the back pain sufferers into 3 groups"

• those who received general exercise involving stretching strengthening and aerobic exercise
• those getting specific motor control exercise for specific trunk muscles with ultra sound feed back
• those who received spinal manipulative therapy.

In the first few months the people getting the specialized therapies progressed fastest but after 6 months it all started to equalize. The message seems to be to exercise - however you go at it and , most importantly, to keep exercising.

Anyone with osteoporosis probably wants to avoid exercises with the risk of causing broken or fractured bones. However Johns Hopkins is pretty adamant that "most people with osteoporosis should actually do more exercise not less." 

The National Osteoporosis Foundation sells an exercise video "Be BoneWise - Exercise" which provides exercises specifically for those with osteoporosis. 

Of course there is always the catch which says you really should have started looking after your bones a long time ago. There is one ongoing study - now 35 years long - which has been following 2,000 men (aged 49 to 51 years at the start). After this many decades they can see that only 8% of very active men have had hip fractures while 20% of non-active sedentary men have had hip fractures. 

The 2008 White Paper has some good tips for pain-free driving:

• Seat back almost straight up
  
• Knees slightly higher than the butt
  
• Both feet flat on the floor if you can (use cruise for long journeys)
  
• Hands at 9 o'clock and 3 o'clock position (rather than the higher position recommended by driving instructors)
  
• Elbows supported
• If back pain is very bad get out of the car and stretch every 30 minutes (if possible)
  

Johns Hopkins also has some some advice for getting some sleep. Back and neck pains go together with poor sleeping - not surprisingly. Firstly the right firmness of mattress is critical - not too hard and not too soft. The American Chiropractic Association is in favor of mattresses with inner spring coils. When buying a new mattress the Consumer Association says to lie for 5 minutes on each side while testing mattresses. Let you back start to conform to the shape it will be in overnight to get an idea for comfort. This makes for a slow decision but worth it.

Safe, pain-free exercise seems to be the key. Nearly every day and keep going - for ever. 

Some exercise ideas.