What Are Bone and Joint Disorders?

Disorders that affect the musculoskeletal system are common and range from mild problems, such as gout, to more severe problems such as rheumatoid arthritis and osteoarthritis. The most common symptoms are pain and physical disability, which can have a major impact on people's lives. Some 30 percent of North Americans have symptoms related to their bones and joints, but people rarely die from these conditions. Treatments for bone and joint disorders include medications, physical therapy, surgery, and nutritional therapy.

Who is at most at risk of bone and joint disorders?

Adult bone mass is determined by the amount of bone formed during childhood, with accumulation (known as peak bone mass) complete by age 35. Bone mass is influenced by a number of factors: up to 80 percent of bone mass is influenced by genetic factors, while about 20-40 percent is environmental.

Diet and lifestyle A life-long diet low in calcium and vitamin D is one of the major risk factors for many bone disorders. Smoking and heavy alcohol consumption, which are often accompanied by poor nutrition and lack of physical activity, are also associated with low bone density. Gout is often associated with a rich diet and heavy alcohol consumption.

Age Bone and joint disorders are more common among middle-aged and older adults. The onset of rheumatoid arthritis most commonly occurs between ages 40 and 60, and osteoarthritis between ages 60 and 80. Gout most commonly develops between the ages of 40 and 50 in men and over 60 in women. Asian and Caucasian women over age 65 have a particularly high risk of developing osteoporosis. On the other hand, African-American women tend to have a higher bone mass than Caucasians and a lower risk of osteoporosis.

Gender Osteoporosis is more common in women since they have less bone mass than men to begin with. Women who have short intervals between pregnancies or several children are at increased risk of this disease. In addition, because of the levels of estrogen - necessary to retain calcium in the bones - decrease in women after menopause, their risk increases at this stage. Women have twice the risk of developing rheumatoid arthritis as men. However, gout is twenty times more common in men.

Family history Both osteoporosis and gout are conditions in which a family history increases the risk of developing the disease. A history of a maternal hip fracture after age 50 is also considered a risk factor for osteoporosis.

Treating osteoporosis

One of the most common bone diseases, osteoporosis involves a gradual loss of bone tissue, leaving the bones less dense and more prone to fracture. Osteoporosis is very common in North America, affecting over 45 million people. It is possible to slow the progress of the condition by making changes to your diet and lifestyle.

Take adequate calcium The body does not manufacture calcium, and it is lost from the body every day. It is therefore important to maintain adequate daily intake.

Take adequate vitamin D This vitamin is needed for normal calcium absorption by the body, as well as playing a role in the uptake of calcium into bone. It is important that you get sufficient vitamin D from your diet as well as from exposure to the sun.

Quit smoking Studies have shown that smokers have poorer bone density than nonsmokers. Quitting smoking, even later in life, may help limit bone loss. Research shows that while hormone replacement therapy protects women from bone fractures, this may not be the case in female smokers, as tobacco may have an antiestrogenic effect. In addition, smokers tend to drink more alcohol and exercise less.

Limit alcohol intake Those who drink alcohol heavily are more prone to bone loss and fr4actures, mainly because of poor nutrition but also due to their increased risk of falling.

Exercise regularly Regular physical activity helps increase bone mass and reduce bone loss. Weight-bearing exercises such as walking, dancing, and weightlifting are best.

Checking bone density

A DEXA scan is currently the most widely used method of measuring bone-mineral density of the spine and extremities. Scanning takes a few minutes and is a sensitive and accurate test of bone density. The report compares your values with those of a young person and with a person of your age with normal bone density (age-related bone loss is normal). You are at risk of osteoporosis if you take medication, such as steroids, that affects your bones; if you have a history of menstrual cycle cessation; if you have inflammatory bowel disease; or if you had early menopause. In such circumstances, ask your doctor about having a baseline bone scan which can be repeated over time.

Preventing and treating osteomalacia and rickets

Osteomalacia and rickets (the name given to osteomalacia when it occurs in babies and children) are caused by a deficiency of vitamin D in the body.

Increasing vitamin D

Deficiency is due to inadequate dietary intake of foods containing vitamin D, or to insufficient sunlight, which is necessary for the conversion of vitamin D in our skin to its active form (a form that the body can use). There are few dietary sources of vitamin D, but many common foods, such as margarine, dairy products, and orange juice, are fortified with the vitamin. Good natural sources of vitamin D include cod liver oil, egg yolks, butter, canned salmon and sardines (with bones), herring, green leafy vegetables, and tofu.

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