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Osteoporosis and osteopeana - same body why variation?

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Does anyone have any idea how we can have osteoporosis in one part of our body and osteopena (sorry about spelling) in another i.e. why isn't the skeletal system affected in an uniform way?

The scores for my lower body is much worse than for my upper body. It seems to be the same for many people, ie. osteoporosis in the spine and not in the hip and visa versa.

13 replies

Hello, I'm going to jump in here as I also take yoga, but will not bend forward into a sun salutation. If you have a qualifed yoga instructor, you will be given alternative poses that if you are in a class, will enable you to flow through the poses without risking strain to your spine. Please give this careful thought. Consider the pose benefit with the knowledge of known contraindications such as forwards flex. Isn't part of a yoga practice letting go of attachments to what we think we must do or what we think is hard? Chat with your yoga instructor and share the information you are learning on the community. There are several yoga instructors registered on the community. Place Yoga in Search (top banner). Post or send a message to the yoga instructor community members about a safer yoga practice without twists or forward flexion. Please don't take chances with the sun saluation or any yoga pose that may put you at risk. Sandi

Mother Goose:

I don't have a curved upper back. My lower back used to have a very pronounced curve but over the years I think from sitting too much at work and my osteopenia that is gone. I know the mantra is "preserve the curve" but I didn't and now I will as you suggest try to correct my posture at all times and see a PT for some specific exercises. Thanks for responding. I just joined this group and it is amazing.
You and many others have mentioned no forward bends. I do yoga and I am trying to avoid them as much as I can but it is hard because it is a part of the sun salutation.
Gloucester

Dear Gloucester:
The "undercurved back" reflects the "overcurved"upper back -- or the common posture of an older person and/or the osteoporotic posture that becomes the "dowager's hump". The common "forward head" -- with jutted out chin and ears forward of the cap of the shoulder as well as slumped shoulders are part of this faulty posture. Often hip flexor tightness from much sedentary activity that contributes to the flat lower back. This contributes to weaker butt muscles (the ones that stand us up and let us walk). Those with flatter low backs often have not much "tush". Walking -- and trying to stand tall as you can -- lift your shoulders and lift your head as if by a wire at your crown -- will improve your posture and give you good exercise for your "stand-tall muscles" as well as givng you valuable weight-bearing/stimulation of the bone that you need. Let yur arms swing naturally as you stride along. There are other exercises to stretch out hip tightness, but best to see a PT with osteoporosis experience to help you. Remember -- no bending from the waist or twisting. No crunches! ( these activities won't help your flat back anyhow).
Lucy Buckley PT aka Mother Goose

What exercises are best for an undercurved lower back?

Dear Raindancer:
Haven't visited this discussion in recent days. I did not realize you had sent in something because it was still under the earlier discussion about why different scores in different bones of our bodies.
Have you received Sarah's book yet? I would check what she has for stretches.
I gather you have a thoracic (chest) kyphosis -- more curved than flat with tightness in the front of your chest and arms and low back that goes with such a curve. Back-lying for such a stretch - with knees bent and feet flat on rug/floor/hard bed -- uses gravity to help the stretch. Maybe there is some reason (unknown to me) that you cannot do such a stretch on your back. Also, wall slides are useful for improving your posture and relating your present back curves to the upright posture. Such postural problems as forward head, overcurved upper back and undercurved lower back and tight hip flexors need attention. Remember to "stand tall" - as much as you can -- it's so hard to give up old habits, such as slumping, but good posture is very important to your bones and CAN be learned.
Good luck!
Lucy Buckley PT aka Mother Goose

I am lucky in that I can walk a mile or even 2 on land and after the first 5 or 10 minutes, my back and hips feel better than when I started. My back is somewhat better today, I think I pulled something when I got up Tuesday night.
My PT said my back is very tight and has me place a pillow under my chest with my face off the pilow and a rolled towel holding my face up enough to breathe. then I just relax for 3 minutes..that is supposed to stretch my spine a little and loosen it up. I can do 2 pillows this week and then go up to 3 later. It is so simple it hardly seems like an exercise but what would I know????

Have to do it 4 times daily, also a chin to shoulder stretch 4 times daily. She thinks I have a pinched nerve that is radiating to my shoulder blade. I have a bad upper back and a bad lower back but it is from 3 or 4 different things so she is trying to sort it out to find the best exercises for both areas.

When I had PMR I used to go to the Y for water exercise and it did help some. I really hate getting into public pools of any kind and after I saw baby feces floating while I was swimming [right after a water class for Mom's and babies] I lost my taste for it at all!. I did do some water walking in our son's pool but that is only open June, July and August.
Thanks for help.

Paula/Raindancer

Oh, dear, Raindancer:
Sorry you did something to your upper back when you got up from the floor. I can imagine that you might have not got up right. Check with your PT about this.
Best to logroll onto your face -- if not already there -- and then get onto all 4's and use a sturdy chair with arms to pull up onto knees and then all the way up. Doing otherwise risks damage to your back. Remember --- no forward bends from the waist -- or twists. Good way to sustain a vertebral fracture. Hope your injury is just soft tissue and quick to heal.
Water walking would be so good for your exercise. It's my main activity. Land walking not possible for more than 200' but I can do 2400' at a time in the water and get aerobic exercise besides -- along with resistance exercise with water bells. Having a Y so far away is a bummer!
Good healing!
Lucy Buckley PT aka Mother Goose

Hi Lucy,

I take 1000 Units of D daily plus whatever I can absorb from my Citrical. I take 4 to 6 daily of those which means another 800 to 1200. On the days when I can take my multi [ with 400 Units] I only take 500 units of D from tablet. I try for about 1800 to 2000 total which is a little more than they require but I think I probably have a deficit as the winters here are long and DREARY!!!

I will suggest a D test to my Dr.

I must mention that my husband is a "Sunshine" fiend and goes shirtless as much as possible from early May until sometime in October. He also drinks D fortified milk, never misses his 1 a day with 400 Units of Vit D, and never completely loses his tan from one year to the next. He has had 1 early skin cancer on his left ear rim, just had a dermotologist check 3 weeks a go and no signs of skin cancer.
He is 80 and no one ever believes it..he still looks about 65. He hasn't even lost any height, well, less than an inch. He is so healthy it's unbelievable.

I have studied up on Reclast since my Dr mentioned it but because of my immune system problems I am hesitating..if not for that, I would gladly try it.

While getting up from one of my floor exercises last night, I pulled or tore something in my upper back, it is very painful and making me sick to my stomach so I skipped part of my exercises today, back to PT in the AM. My back hurts worse than it did before I started going.

We are supposed to go to Cape Ann later this month so I hope this will be short lived, I don't even want to do the 25 minute trip to Sidney tomorrow.

Thank you for your help, and yes I agree, we must take care of our bodies. My worst nightmare is to be dependent on ANYONE!!!!.

When I had GB I was totally paralysed for about a month and it was horrible...it took me several months to learn to swallow again and I still have some trouble with that. I can walk now, although I had to relearn that as well, but because of foot drop, I had to stop running and I had to give up training other people's dogs because my reflexes are not as good.At least, I am still here though and with my loved ones.

However, I miss being the old me, my brain is still as good but my body has aged. I played 3 on 3 basketball at 67 until I got Polymyalgia at that age..now my only sport is walking and hiking on trails. I did swim for awhile but don't like it and the nearest Y is a 70 mile round trip and has so few hours open adult swim it really isn't worth going anymore.

Thanks again for your welcome thoughts,
Raindancer/Paula

How much D are you getting? I would not count on the sun too much for my D, if I were you, unless you live in New Mexico or some such place. D3 is all round better form than D2, by the way. BUT -- have uyou had your D tested? THis would be especially important considering your various aliments. Reclast is a biphosphonate that is given 1X year by IV. So it bypasses your stomach altogether. Some get flu-like symptoms for a few days, but preparation, before the injection apparently helps reduce such side effects. (Preparation such as taking acetaminophen and plenty of water beforehand). Many of my contacts are happy with this 1X year therapy. Maybe in your particular situation, this would not be appropriate. Was it discussed? Glad you didn't fracture when you fell, but neither have I fractured -- under similar circumstances. However, that just means we were lucky -- then. We are the custodians of our bodies. No one else can protect us -- we must protect ourselves.
Lucy Buckley PT aka Mother Goose

Thank you Lucy for the helpful info. I will have to spend more time doing my bent leg pushups I guess!
My Dr. has suggested Reclast, however I do not think I want to try it at this time, I have had 2 autoimmune diseases already and have an overactive immune system so I think I will wait for awhile at this point. If I can keep from losing any more bone in my wrists and spine, I will not have it.
I cannot take Fosamax or Boniva or any oral drug for this, I have such bad GERD that I am 80 milligrams of Nexium daily which is why my Calcium has not been asborbing these past several years.

I am trying Calcium Citrate now as well as extra Vit D. On the sunny days, I am doing a 15 minute sunbath as the Vit D from that will absorb without trying to get through my stomach.

I have used exercise bands in the past and never felt that they were doing much good. I have sent for Sara Meeks book and will be learning some new exercises from that.

I especially appreciate the info on the difference in our bones, my Dr never explained that so I couldn't figure out why my wrist and spine bone would measure differently than my hip...now I know.

I am not too worried about breaking a bone yet..I had 2 bad falls this summer [a log in high grass and an exposed tree root that I didn't notice] both times I fell hard on my right wrist, as well as my shoulder, hip knee and ankle [and one of the times I also hit my face]. I was kinda lame for a couple of days after the first fall which was harder and worse, the second one was only a shake up for the rest of the day. Nothing broke but it did teach me to look down when I am walking in rough terrain.
This is the worst part of getting older, always having to be careful and cautious..that is not my nature so I am having to slow down a bit and look out for my self more.

Thanks again for the help.

Paula aka Raindancer

We have 2 types of bone -- each designed with a different purpose. Indeed, our skeleton is a marvelously engineeered system. Cortical bone -- think of your shins -- is hard and dense and is subjected to our body weight and heavy forces. In healthy young bone, it takes a lot of force (not just a fall) to break cortical bones. These are the long bones such as in our legs and upper arms. They can lose bone as we age , but this happens much slower and from the inside of the bone. Now cancellous bone -- the 2nd type of bone -- is almost like a honeycomb (but much tinier criss-crossing). They idea of this much less dense bone is making its calcium more available to the everyday vital-to-life calcium we need in our blood to keep our nervous system working as well as heart and other purposes. 99% of our calcium is stored in our bones; 1% is that vital amount circulating in our blood. Also -- being located at the ends of the bones and in the spinal vertebrae -- presumably more protected -- cancellous bone is much lighter than the dense cortical bone and allows us to have a more functional skeleton. If we were made up of mostly cortical bone, we would not have enough calcium available on a regular basis AND -- our bones would weigh too much to be able to move around and get away from predators (in the old days, saber-tooted tigers and such). It is truly marvelous how well our body functions when we treat it right! SO ---- now to how bone keeps/grows strength -- weight-bearing is a big stimulus for bone strength. That is what we do on our two feet -- when they hit the ground. (Weight-bearing is not lifting weights). Obviously, unless we were doing lots of walking on our hands, our arm and shoulder bones do not benefit from weight-bearing exercise. BUT -- the pull of muscles and tendons against the bones as we do resistive exercise and activities stimulates the growth of bone. This is how we can build bone where weight-bearing does not apply. Bones respond to these forces. For example a tennis player will have a stronger bone in his/her serving arm. A runner, in his leg bones.
This is why we have different T-score in different bones. Because they ARE different bones. Those made up of more cancellous bone fracture much more easliy than the cortical ones. Hence, our spinal vertebrae suffer compression fractures -- often with little force,-- lifting a window, rolling over in bed for frail folks -- long before a hip might be fractured. The hip has a combination of both types of bone and can handle forces better -- at least for a time.
Lucy Buckley PT aka Mother Goose

My score in my wrist which Dr says usually equates with spine score is -3.5. My femur score is -1.1 which is much better. I have been on Prilosec for about 6 years [only took it part time]. About a year ago I had to go on 2 Nexium a day and that has been very damaging since it shuts down my stomach acid so much that the Calcium Carbonate that I have taken faithfully for many years cannot be absorbed.
I am now taking Calcium Citrate which has some acid in itself and also Vit 1000 plus Vit D in the Calcium. Hoping that at least some of the calcium will be absorbed now. My Dr never mentiioned this to me in spite of the fact that the study showing that PPI's prevent absorbtion of calcium altho' the study came out a couple of years ago.
It has been on TV recently which came as news to many Prilosec and Nexium takers.

I attribute my not too bad hip reading to the fact that I am a faithful walker and also I have always done pretty heavy work up until about 25 years ago which probably built good bone density in my hips. I am planning on returning to weight lifting to try to increase upper body bone and also studying other means of nutritional bone building such as making sure I get enough minerals.

We are all unique. Signs of aging and breakdown in disease processes is often individualized in any condition. Just like we all have our own fingerprint.

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