Bone Health In Icy Weather

January 29th, 2018

You may not realize it, but the winter months can be really tough on your bones. Less sun, more ice and less exercise can mean disaster. In our Stonehenge Resident Blog Post Series, we ask our residents to write about a topic that they're passionate about. Melvin from Stonehenge Village is an orthopedic surgeon and wants to help us keep our bones healthy throughout the winter. ----- Especially in the Northeast, especially in the winter time, bone health is a particularly important issue that should be paid attention to.  Bone health is important for many reasons – most importantly, maintaining adequate bone health can help slow the progression of osteoporosis.  People with osteoporosis are at much higher risks than others of getting fractures of bones such as their hips, backs, and wrists.  In the winter time, when the ice remains at times too long on the sidewalks, hospitals see a spike in incidences of these fractures.  Wrist fractures can lead to pain and deformity but often allow patients to maintain adequate function with or without surgery.  Fractures of the back (also known as vertebral compression fractures) can also lead to pain and deformity; usually the pain subsides with time, but it can linger chronically.  Hip fractures, often in older patients resulting from simple falls from standing, almost always require surgical treatment.  Patients often become ambulatory again after surgery, but having any of these fragility fractures is usually a sign of poor bone health and lends a poor prognosis to having future fractures and other health-related issues as well.  For example, short-term mortality is increased 15-20% after having a spine or hip fracture – not necessarily because those are in themselves particularly dangerous, but because those indicate poor overall health and higher risk in those patients in general. Since a fragility fracture is a large predictor of future fragility fractures, it is important to mind one’s overall health, which includes an assessment of bone health.  Risk factors for poor bone health include smoking, alcohol use, and premature menopause.  Bone health is often graded in terms of regular bone strength, osteopenia with less than desirable bone strength, and then finally there is osteoporosis.  These are actually measures of bone density, and can be determined through the use of a bone density (DEXA) scan.  Any patient who has had one of these fractures, and older patients in general, should talk to their primary care doctors about obtaining a bone density scan to understand where they lie on the spectrum. Vitamin D and calcium are often used to supplement diets, but in general, it is much more difficult to restore bone density than it is to maintain it.  A great way to maintain it is to do weight-bearing exercises such as walking or jogging if possible.  Most people in colder, darker climates often suffer from low vitamin D levels; in fact on testing, many patients have levels that are barely even detectable.  This results from low exposure to sunlight, which not only can impair bone health, but also lead to decreased endorphins and poorer mental health as well. If you are found to have low bone density, the best thing you can do in addition to starting weight-bearing exercises, is to speak to your primary care physician or an endocrinologist.  There are several new medications such as forteo and bisphosphonates available that not only stabilize but can potentially even increase bone density.  However, these medications come with certain risks and require routine monitoring in specific patients, and are even contraindicated in patients with specific medical issues as well. As with most medical issues, the key to treatment is early detection.  Once detected, steps can be taken to address the issue of poor bone health before it can cause detrimental effects on one’s life.  Ask your primary care doctor for more information on how to keep yourself living healthier for longer.