Have you ever thought of what your bones look like on the inside? Here’s a good way to picture them… especially if you like chocolate. We’ll use a mint Aero chocolate bar to make it easier to see, and help you understand what the disease osteoporosis is a little bit better.
The outside layer of your long bones, like those in your arms and legs, is made of a smooth layer known as cortical bone. This type of bone is very hard and strong, so that our bones can support our weight and help us move—this is what we’ll compare with the brown chocolate layer of the Aero bar pictured. It might be hard to believe, but the inside part of our bones—at the ends where our joints form—look more like the bubble part of the Aero bar, pictured in green here, called spongy bone or cortical bone. Inside the “bone shaft”, or long part of the bone, there is a smaller layer of spongy bone, and in the centre, a cavity where bone marrow is manufactured and stored, which creates new blood cells.
The spongy bone what we’re going to talk about when we discuss osteoporosis. You might be thinking, “If the spongy bone is the problem, why do we have it? Why aren’t bones solid to be stronger?” The little “bubbles” in spongy bone are what keeps bone light enough that we can move efficiently. If our bones were solid, they’d be extremely heavy and it would be difficult to move.
When you have osteoporosis, your bones become brittle, because the holes in the spongy bone increase in size. This makes it very easy to fracture bones. The risk of osteoporosis is greater with females than males, increases with age, having low body weight—risk factors for fracture are low bone mineral density (diagnosed by an X-ray called a DEXA scan), family risk for fracture, and history of falls . Osteoporosis can also be caused by medications or other chronic diseases. Steroids like prednisone, cancer medications, acid reflux or “heartburn” medications, the contraceptive injection Depo-Provera, medications used to prevent seizures, as well as anti-depressants or anti-psychotics can cause osteoporosis. Increasingly common medications that increase the risk of osteoporosis are diuretics and blood pressure medications and prolonged use of acetaminophen (Tylenol) . To learn more about medication and osteoporosis risk, visit this link. Inability to absorb vitamins, hormone deficiencies, including thyroid hormone problems, kidney or liver disease, type 1 and 2 diabetes, chronic obstructive pulmonary disease, injuries causing immobility, cancer, HIV/AIDS and neurological problems can all increase risk of osteoporosis .
Osteoporosis can be treated with medications, but the most important treatment should be to include more calcium and vitamin D in your nutritional plan—whether that is from altering your diet, adding supplements, or both. A variety of different medications can be used, treating underlying causes of osteoporosis. One of the most important forms of treatment of osteoporosis is exercise. Physical exercise should be performed most days per week, and include strength training using weights, resistance bands, or your body weight; posture training to reduce spine curvature (kyphosis); balance training (such as standing on one foot, walking in different patterns—such as toe-to-heel, zig-zags, or circles/“figure-eights”, can help improve balance that will be useful to preventing falls in daily activities; and weight bearing aerobic activity, such as brisk walking, dancing, step aerobics, running, and most team sports—including volleyball, soccer, and basketball, which can assist in building bone strength while putting added force on bones . Osteoporosis Canada recommends dance and Tai Chi to promote strength, coordination, and balance, for people with osteoporosis. It may seem counterintuitive to put increased force on bones, but the more force that is put on bones—within reason—the more the bone will adapt to that force and become stronger. 
November is Osteoporosis Awareness Month. So, now that you know more… Share it, and do something today to reduce your risk of this disease, or help you live better if you already have osteoporosis.