Osteoporosis occurs much earlier and is more severe in women with mobility limitations than in non-disabled women.
Preliminary studies clearly indicate that low bone mass---specifically osteopenia and osteoporosis---is common in women with disabilities by peripheral bone mineral density (BMD) screening. Further, the findings indicate that women with disabilities do not receive recommendations for diagnostic testing of the spine and hip and, as a result, receive no therapy to prevent or treat osteoporosis. These findings suggest that health care providers, including primary care providers and specialists, are unaware of the prevalence of low bone mass and risk for osteoporosis and osteoporotic fractures in women with disabilities. Moreover, these findings suggest that the osteoporosis risk factors for women with disabilities are either unknown or ignored.
Risk factors associated with osteoporosis and osteoporotic fractures in these studies of women with disabilities have included low BMD, steroid use, and inadequate dietary intake of vitamin D, in addition to immobility, impaired balance and coordination, and lower extremity weakness. There is little information about the risk factors for osteoporosis in women across disabilities or clinical predictors that could be used to identify women with severe disabilities who would be candidates for osteoporosis treatment.
In addition to being a woman with a mobility impairment, past menopause, and getting older, other risk factors for osteoporosis are:
- Having an inadequate diet, particularly with too little calcium and vitamin D
- Getting little or no weight-bearing physical activity
- Cigarette smoking
- Heavy drinking of alcoholic beverages
- Having no menstrual periods while young for at least six months, as sometimes occurs with spinal cord injury
- Taking bone robbing prescription medications such as steroids or anti-seizure drugs
- Taking high doses of L-thyroxine for thyroid disease
- Premature menopause (before age 40) or menopause induced by surgery or other medical treatment
- Being small-boned or thin
- Having a family member with osteoporosis
- Being Caucasian or Asian
Clues that you might have osteoporosis are prolonged, severe pain in the middle of the back, change in the shape of the spine, loss of weight, tooth loss, and fractures.