As if older women didn’t already worry enough about their bone health, new research suggests that anxiety may up their risk for fractures.
Based on an analysis involving almost 200 postmenopausal Italian women, the finding builds upon previous research linking anxiety to a higher risk for heart disease and gastrointestinal problems.
“Our findings are quite surprising because an association between anxiety levels and bone health was not reported before,” said study author Dr. Antonino Catalano, though the study did not prove that anxiety caused fracture risk to rise.
Catalano is an expert in internal medicine, bone metabolism and osteoporosis with the department of clinical and experimental medicine at the University Hospital of Messina in Italy.
As to what might explain the association, Catalano pointed to a number of factors.
“Our opinion is that anxious women are more likely to engage in poor health behaviors, such as smoking or a poor diet,” he said. “Moreover, the negative effects of stress hormones on bone status may be considered as also enhancing fracture risk.”
Catalano added that women who struggle with higher levels of anxiety were also found to have lower levels of vitamin D. “Poor vitamin D status has been previously associated with increased fracture risk,” he said.
The researchers noted that osteoporosis is the most common metabolic bone disease in the world. An estimated 33 percent of women and 20 percent of men will suffer from an osteoporosis-related fracture at some point in their lives.
The research team also noted that 7 percent of the world’s population suffers from anxiety disorders.
To see how the two issues might intersect, the researchers focused on patients attending one Italian osteoporosis clinic in 2017.
On average, participants were nearly 68 years old. All underwent in-depth health screenings to assess, among other things, prior fracture history, arthritis diagnoses, heart and lung health, and smoking and alcohol habits. Bone mineral density exams were also done.
A wide range of mental health concerns were also explored, including depression, tension, insomnia, memory and anxiety levels ranging from moderate to severe.
The investigators determined that women who had the most anxiety faced a noticeably higher fracture risk, compared with women with the lowest degree of anxiety.
Higher anxiety was linked to a 4 percent greater risk for a major fracture over a 10-year period, and a 3 percent greater risk for a hip fracture in the same time frame, said Dr. JoAnn Pinkerton, executive director of the North American Menopause Society.
The study was published online May 9 in the society’s journal Menopause.
Higher anxiety was also linked to lower bone mineral density scores in both the lower back area (known as the lumbar spine) and in the femoral neck area (just below the ball of the hip joint).
The findings should encourage physicians to explore anxiety levels among older women when assessing fracture risk, the researchers said.
Pinkerton highlighted a number of steps women can take to minimize fracture risk as they age.
“Women reach peak bone mass around age 35,” Pinkerton noted. “So it becomes important for perimenopausal women and menopausal women to get adequate amounts of calcium.” Experts recommend 1,200 milligrams a day, between diet and supplements, she said.
Getting sufficient magnesium and vitamin D — from either sun exposure or supplements — is also critical, she added, alongside routine strength and resistance training. That, she said, can include walking, lifting weights or using elliptical machines.
Women should also avoid smoking, drinking too much, being sedentary, taking excessive thyroid replacement medications, and/or medications such as steroids or proton pump inhibitors, Pinkerton said.
For women particularly concerned about anxiety, she suggested turning to “mindfulness, cognitive therapy, self-calming strategies, yoga, or seeking help through counseling or, if needed, medications,” she said.
As for hormone therapy, Pinkerton stressed that while it’s not a treatment for depression or anxiety, “it can sometimes be helpful in women, and is sometimes used alone or in combination, depending on whether women have menopausal symptoms or respond favorably to a trial of hormone therapy.”
There’s more on bone health at the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
SOURCES: Antonino Catalano, M.D., Ph.D., expert in internal medicine, bone metabolism, and osteroporosis, department of clinical and experimental medicine, University Hospital of Messina, Italy; JoAnn Pinkerton, M.D., executive director, North American Menopause Society, and professor, obstetrics and gynecology, University of Virginia Health System, Charlottesville; May 9, 2018, Menopause, online
Back injuries often plague those who lift weights on a regular basis — but with some proactive adjustments to your routine, you can significantly decrease your risk.
From rows to squats, the back plays a critical role in many weightlifting exercises — and developing strong back muscles can help you push yourself farther at the gym for a wide variety of lifts.
As with any part of your body, it’s impossible to keep your back completely safe from injury while you’re working out, but there are some simple steps you can take to significantly decrease your risk. When the price of a setback is not only losing hard-won progress, but potentially developing more serious health issues, prevention is well worth the effort.
With all of that in mind, here are five tips to prevent common back injuries while you lift.
1. TRAIN YOUR POSTURE
As you probably know, poor form greatly increases your risk of injury in any exercise. If you’re working on your back, you’ll want to keep your vertebrae neatly aligned to avoid placing too much pressure on a particular bone or muscle.
If you’re new to lifting, don’t simply mimic what you see others doing at the gym. Instead, ask a trainer or do some research online in order to better understand how you should position your body. If you’re a more experienced gym-goer, it’s still a good idea to check up on your form every now and then. Protect your body by regularly recalibrating your form and squelching any bad habits before they lead to injury.
2. RECOGNIZE THE RISKS
Any weightlifting exercise that involves flexion (forward bending) or extension (backward bending) of the joints in your back puts those areas at risk. These movements often result in sprains (a tear or rupture of a ligament), but they can lead to more serious injuries as well. Extreme extension, for example, can lead to spondylolysis, or cracks in the vertebrae. Similarly, extreme flexion can lead to a herniated disc.
These risks aren’t limited to exercises that specifically target the back. The most common weightlifting-related cause of herniated discs is the deadlift, which — when done properly — doesn’t depend on back flexion or extension for power, but when done incorrectly, puts a dangerous amount of pressure on the vertebrae. Deadlifts can also exacerbate degenerative disc disease, lumbar spinal stenosis, and other chronic conditions affecting the lower back.
3. KNOW WHEN IT’S TIME TO STOP
That twinge you felt while working out might be gone by tomorrow with a bit of stretching and rest. If you push the compromised area through additional stress, however, it can turn into something worse. Don’t ignore what your body is telling you. The burn of a fatigued muscle feels very different from a pull in your back, and “no pain, no gain” only works when you don’t sabotage the body you’re trying to strengthen. If you’re feeling pain when lifting, it’s time to call it a day — plain and simple.
4. MODIFY YOUR ROUTINE
First off, I recommend that you always wear a weightlifting belt when working out, as it can do wonders to stabilize and protect your back during most exercises. However, if a particular movement causes you problems even with the belt on, consider finding an alternative. For most lifts, there are one or more corresponding exercises that can target similar muscles without causing the same pain.
To learn proper posture is one thing, but to fully put it into practice requires some extra work. As any knowledgeable trainer will tell you, a dedicated stretching routine is the key to sustainable lifting. In order to build a strong and resilient back, consult a fitness trainer or orthopedic specialist you trust and create a stretching regimen to maintain the integrity of your back for future challenges. For maximum benefit, stretch both before and after each lifting session.
Osteoporosis patients who take “holidays” from bisphosphonate drugs are at increased risk for fractures, a new study finds.
A six-year follow-up of patients who took a break from the bone-building drugs found 15 percent of them suffered fractures, according to researchers at Loyola University in Maywood, Ill.
“Fracture risk needs to be regularly assessed during the drug holiday and treatment resumed accordingly,” said Dr. Pauline Camacho and her colleagues.
Bisphosphonates, such as alendronate (Fosamax) and risedronate (Actonel), are the most widely prescribed osteoporosis drugs. They are designed to slow or prevent bone loss.
But patients who take these drugs for long periods are typically told to take temporary breaks to prevent rare but serious side effects to the jaw and thighs.
However, there is little data on how long these breaks should last, the researchers explained.
To shed light on the issue, they examined the medical records of patients (371 women, 30 men) with osteoporosis or osteopenia (weak bones but not osteoporosis). Patients took bisphosphonates for an average of 6.3 years before beginning breaks from the drugs.
Over six years, 15.4 percent of the patients suffered fractures after going on their drug holiday. The most common fracture sites were the wrist, foot, ribs and spine. However, foot fractures are not currently considered osteoporosis-related fractures, the researchers noted.
The patients most likely to suffer fractures were older and had lower bone mineral density at the beginning of the study. Patients who suffered fractures were put back on bisphosphonates.
The yearly incidence of fractures ranged from about 4 percent to almost 10 percent, with most occurring during the fourth and fifth years.
“Patients who begin drug holidays at high risk for fracture based on bone mineral density, age or other clinical risk factors warrant close follow-up during the holiday, especially as its duration lengthens,” the researchers said in a university news release.
The study was published recently in Endocrine Practice.
The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more on osteoporosis.
SOURCE: Loyola University Health System, news release, May 4, 2018
Exercise can help prevent many chronic illnesses as well as make it easier to manage health conditions, from diabetes to joint pain.
In terms of prevention, aim for the recommended 150 minutes of exercise, like brisk walking or cycling, each week. Along with eating a healthy diet, this can cut your risk of diabetes by more than a third, plus increase your level of good cholesterol. Exercise also lowers body weight, blood pressure and triglycerides, thus reducing key risk factors for heart disease.
If you’re already managing a chronic illness, exercise may improve symptoms and reduce the amount of medication you need to take. It builds muscle, which helps you move more easily, and reduces stress, which can aggravate many health conditions. Back pain and arthritis improve with the right stretching and exercise plan. If you have diabetes, exercise can improve blood sugar control.
Exercise’s health effects on:
Heart disease: Regular aerobic exercise and interval training in particular are heart-healthy, boosting cardiovascular fitness.
Back pain: Core exercises strengthen the muscles around your spine, creating better support for your spine.
Arthritis: Exercise enhances the muscles that support your joints, making movement easier; it also eases stiffness.
Diabetes: Exercise helps you use insulin more effectively and lower your blood sugar level.
Asthma: Exercise can help control attacks.
If you’re managing an illness and haven’t been active, talk to your doctor about what exercises are safe, any precautions to take, what kind of discomfort is normal, and what are signs to stop, like feeling dizzy, short of breath or chest pain.
Working with your doctor is especially important when you have diabetes. Because exercise can affect blood sugar, you’ll need to take precautions to prevent blood sugar from becoming too low during workouts.
In terms of intensity, start off slow — that means you should be able to talk, but not sing, when working out.
The Cleveland Clinic has detailed tips on exercising with a chronic condition to help you get started safely.
Few people go through life without having episodes of lower back pain.
For some people, though, it’s a daily struggle.
The American Academy of Family Physicians says back pain may be controlled by maintaining proper posture and sitting, lifting, standing and exercising properly.
Others have to seek medical attention for relief. The academy mentions these warning signs that you should see a doctor about your aching lower back:
- If pain radiates down your leg below your knee.
- If your leg, foot or groin feel numb.
- If you have fever, chills, nausea, vomiting, stomach pain or weakness.
- If you have difficulty going to the bathroom.
- If the pain was caused by an injury.
- If pain is so intense that you can’t move.
- If your pain doesn’t improve or gets worse after two weeks.
- If you notice any muscle atrophy.