What is osteoporosis?

Osteoporosis means porous bones. It is a progressive bone disease in which a loss of bone mass and density may potentially lead to fracture. It can affect all age groups and both males and females. Women are at greater risk of developing osteoporosis than men, mainly due to the rapid decline in oestrogen levels after the menopause.

Bone is a living tissue that is constantly being absorbed and rebuilt. As we get older more bone is naturally lost than is replaced. However In osteoporosis the bone mineral density is reduced even further. The structure of bone begins to deteriorate and the amount and variety of proteins in bone are altered. This causes bone to become more fragile and more at risk of fracture through a minor fall or bump. The spine, hip and wrist are most commonly involved.

What are the symptoms of osteoporosis?

Osteoporosis is often referred to as the silent disease as it may not be diagnosed until a fracture has occurred. Fractures due to osteoporosis can lead to changes in posture (such as developing a stoop in your back), muscle weakness, loss of height and bone deformity of the spine.

Some people may experience pain in their bones and muscles, particularly in their backs. If you do experience any such symptoms and have some of the risk factors of osteoporosis it is important to talk to your GP.

The list of risk factors is extensive. Here are some of the more commonly associated risk factors:

Low back pain continues to be a topical issue within society and one which all of us can relate to. Undoubtedly each of us have either suffered with low back pain ourselves or know someone who does.

While for some it can be an acute episode that resolves over a short period of time for others it becomes an ongoing issue that may develop into a much greater problem, that of chronic low back pain.

We recently listened to a very interesting podcast by Dr. Kieran O’Sullivan, from the University of Limerick, on chronic low back pain. He discusses how we as Chartered Physiotherapists can improve our approach in the care of these patients suffering low back pain.

Some highlights from the podcast include:

By the time someone with chronic (around 3 months or more) low back pain attends the physiotherapist he or she may already have been in contact with several healthcare practitioners and undergone extensive diagnostic testing. Each of these practitioners may have had a slightly different explanation as to the cause of this person’s pain.

Trigger points can be found anywhere throughout the body but often give us most trouble causing neck pain and low back pain, both regions which can be implicated in the development of ‘muscular tension’ headaches.

Trigger points are the tender almost nodular feelings in generally taut bands of muscle. They are very good at creating a sense of vague achy, deep dull or boring pain, even sometimes sharp and ‘nervy’. They also result in stiffening and weakening of muscles such that they cannot do their job in supporting an upright posture for example.

Have a feel of the muscles between the neck and the shoulder, those that may feel tense when sitting all day or stressed. If the muscles feel ropey, stringy or hard with one or two spots that are exquisitely painful to press on, these are likely to be trigger points in your upper trapezius muscle.

The below statement was a recent message taken by our receptionist indicating a level of dissatisfaction from a client of ours, Mrs K. With the intention of resolving the client's concern as soon as possible I met with the attending Physiotherapist and together we reviewed the client case notes. This particular scenario has raised an important consideration about the healing process that I would like to share in this article for the benefit of our readers.

Can you call Mrs K back please, she is not happy that after 4 sessions she is still in pain and wants to know where she goes from here?

Although sometimes used interchangably the titles 'Physiotherapist' and 'physical therapist' are actually quite distinct from each other. Inspired by a recent question from one of our clients I will share some details that should help to explain what the difference is between a Chartered Physiotherapist and a physical therapist.

Definition - Physiotherapist

Physiotherapy is a health profession concerned with helping to restore well-being to people following injury, pain or disability. Using knowledge from our extensive scientific and clinical background Chartered Physiotherapists can help to assess, diagnose and treat conditions and illnesses that affect people of all ages and social groups.

Chartered Physiotherapists use manual therapy including manipulation, mobilisation and massage as well as alternative modalities including electrotherapy and acupuncture. The Chartered Physiotherapist also utilises prescriptive exercise as a rehabilitative tool to help patients achieve their full potential. While traditionally, physiotherapy was regarded as rehabilitative and mainly hospital-based, the profession has expanded greatly into other health care areas. We have invaluable expertise to offer in educational and preventative roles in the community, the workplace and in private practice.

Definition - Physical Therapist

The Institute of Physical Therapy and Applied Science Limited defines Physical Therapy as a holistic approach based on the manual treatment of soft tissue, i.e., muscles, tendons, ligaments and fascia.

It is often the case that the effectiveness of your treatment is a combined effort by our entire team. In this article I wish to share a brief insight in the amazing value of collaboration between healthcare professionals.

Starting with a coffee

Every Monday Katie, Paula, Lorraine and myself sit down to a cup of coffee (and often a treat from the Good Food Shop just next door to the clinic) for a team meeting.

We usually start by running through any household or general administration matters which may need discussing. This ensures the smooth running of the clinic and brings us all up to speed with any changes or advances in what we are doing to deliver our Physiotherapy service. Its essential we are all on the same page and to be consistency amongst us in terms of how we do what we do. It is also a great platform for feedback between team members which provides further opportunity for refinement and improvement our internal systems.

As human beings we are ambulatory creatures, that is we walk upright and are very reliant on our legs to move us about. How the foot strikes the ground and the knock on effect this has up the lower limbs to the knee, hips, pelvis and low back in particular has become a subject of much debate and controversy in recent years.

Lower limb biomechanics refers to a complex interplay between the joints, muscles and nervous system which results in a certain patterning of movement, often referred to as ‘alignment’.

Much of the debate centres around what is considered ‘normal’ and what is considered ‘abnormal’ in biomechanical terms as well as the extent to which we should intervene should abnormal findings be found on assessment.

During your first consultation with us your Chartered Physiotherapist will conduct a thorough physical assessment. This essential first step will assist us in determining what the structural source of your musculoskeletal pain complaint is most likely to be and enable us to provide a diagnosis followed by a planned course of treatment.

Your assessment will involve a combination of you answering relevant questions and your Physiotherapist conducting a hands-on, physical assessment of the affected body area.

Questions we will ask you

Firstly we will need to understand, in as much detail as possible, the history of your condition. Your Physiotherapist will ask you:

• When did the problem start
• Was there an injury sustained, or
• Did the problem arise for no apparent reason

In order to get an impression of how your symptoms respond to certain activities we also need to know:

The current economic climate has been challenging for most of us and consumer trends indicate that a higher proportion of us are being attracted to discounted goods and services as we are becoming far more aware of price.

Of course this is understandable given falling incomes, higher costs in some cases and lower disposable incomes. This approach makes a lot of sense in a retail environment for example where getting a trolley full of groceries, or having your car serviced at a lower price means savings without necessarily having to compromise on quality to any great extent.

But what about healthcare?

I feel we need to consider primary healthcare and related costs from a different perspective.

Exercise will in most cases form an essential part of your Physiotherapy treatment programme. The reason we prescribe you exercise is not to take up more of your valuable time, but to use these exercises to assist us in bringing about pain relief as well as restoring movement, strength and function to the injured part of the body.

There is a vast amount of research supporting the benefit of exercise, and as Physiotherapists we would not be doing our job properly if we did not use this wealth of knowledge to your benefit.

As Chartered Physiotherapists, we have been trained in the use of exercise as a medical treatment and are able to compile a programme of very specific, tailored exercises to suit you as an individual with an injury that is specific to you.