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Chiropractic Research Review

Management Strategies for Osteoarthritis, Osteoporosis

More than 20 million Americans are affected by osteoporosis (OP); roughly as many suffer from osteoarthritis (OA). This review of these conditions - most commonly found in the elderly - discusses epidemiology, symptoms, risk factors, and management.

Osteoporosis: OP can generally only be noticed on radiography after a 30% loss in bone mass, but dual-energy X-ray absorptiometry can more accurately recognize low bone mineral density (BMD).

Fractures are sometimes the first indication of low BMD, which if in the spine may be noticed by acute back pain and restriction during movements. Preventable risk factors include smoking; excess alcohol consumption; low calcium and vitamin D intake; excessive soft drink/caffeine consumption; low physical activity levels; and an excessively meat-based diet. Genetic factors that warn of increased risk include family history of osteoporosis; fair skin; slight frame; female gender; hysterectomy; and Asian or European descent. The best exercises for preventing bone loss are those involving axial loading, such as walking, running, and climbing stairs. The authors also recommend safety-proofing homes from falls, and the use of prescription drugs as acceptable under extreme circumstances.

Osteoarthritis: OA is the most common joint disorder, affecting over 20 million Americans. There is no known cure for the condition, which usually affects the knees. OA is a disease of the joints, reducing the ability of cartilage to absorb shock and provide low-friction movement. The primary risk factors are age and female gender. Pain while joints are bearing weight, morning joint stiffness, crepitus, swelling, and reduced range of motion are all signs. Chiropractors can manage OA with several methods: transcutaneous electrical nerve stimulation (TENS) and laser therapy have been shown to effectively manage the pain of OA; acupuncture and ultrasound offer less supporting evidence. Glucosamine (three 500-milligram doses daily) and ginger have been shown effective as supplements.

The authors encourage co-management when treating OA and OP, as evidence supports the value of both medical and chiropractic treatment. Health promotion and prevention are the best ways to ward off these conditions.

Note: This study, written by chiropractors for chiropractors, thoroughly discusses current management strategies that appear to be effective in managing osteoporosis and osteoarthritis.

Gleberzon BJ, Killinger LZ. Management considerations for patients with osteoarthritis and osteoporosis: A chiropractic perspective on whats working. Topics in Clinical Chiropractic 2002:9(1), pp. 48-61.

Chiropractic Research Review

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