Osteopathy Journals and Research by Darren Chandler

 

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  1. What is osteoporosis and what can you do

    Osteoporosis is a condition that makes bones more brittle and prone to breaking (fracture). Although osteoporosis can effect men and younger people, post-menopausal women are most at risk. One of the best ways to help maintain healthy bones is to exercise regularly – which encourages the bones to absorb calcium and other mineral salts that keep bones strong.

    Weight bearing exercises and weight resisted exercises are best for strengthening bones and muscles and as well as helping to keep bones in good health may also reduce the likelihood of falls as you age. Weight bearing exercises are those where your body is supporting its own weight, such as walking or housework or carrying groceries. Weight resisted exercise involves pushing or pulling against an additional weight, like a dumbbell or barbell or resistance equipment in a gym. Engaging in activities that are too high intensity or involve too much impact can cause injury and fractures to the bone.

    The younger you start lifting weights the better

    Any one can benefit from weight training but it has been demonstrated that younger women who trained using weights have stronger bones later in life, this essentially means that you can lay down extra bone when you’re younger to help prevent fractures later in life – a kind of insurance scheme for your body. A life time of active living not only protects your bones but also keeps your heart healthy and may protect you from other diseases such as cancer and type two diabetes.

    But starting exercise at any age will help

    Everyone can benefit from increasing their activity levels. Studies have shown that people who have already been diagnosed with osteoporosis can improve their bone health significantly through weight bearing exercising, the key is getting good advice on how to move well and how to self-manage.

    Some more benefits of lifting weights

    Strong muscles burn more calories, so if you need to control your bodyweight, lifting weights can help. It also helps with balance and can help you to regulate your sleep patterns.

    ‘I don’t want to look muscled’

    It takes women a lot of heavy weight lifting, and sometimes the use of controlled substances like steroids and hormones, to achieve the physique of the heavily muscled power lifter. Women don’t normally have enough testosterone in their bodies to develop bulging muscles, but can, with regular, moderate training achieve lean, toned and strong muscles.

    ‘I hate gyms’

    No problem. There are plenty of other exercises you can do that don’t involve a visit to the gym. Dancing, yoga, tennis, pilates, walking, running, gardening and even housework count – all you are aiming to do is increase your heart rate and make yourself feel a little warmer. You can do it in several short blocks of 15 minutes or more but aim for at least a total of 150 minutes per week over at least 5 days per week for the best results. If you’re unused to exercise, start slowly and build up to this target.

    I don’t know where to start - can osteopathy help?

    This is where your friendly local osteopath can help. They can screen you for any health concerns that might affect your ability to exercise, help to resolve any injuries or pain that might be holding you back and advise you on what exercises might suit your goals best. Many can teach you how to exercise correctly, avoiding injuries and how to gradually build up as your ability and fitness levels improve.

    Further tips

    • Diet: your diet should include vitamin D and calcium. Don’t consume too much of anyone nutrient, especially if taking supplements. Try and get the nutrients from a variety of different food sources and of course vitamin D from some safe sun exposure!
    • Avoid prolonged bed rest: being weight bearing strengthens the bones.
    • Be aware of trip hazards and improving balance: Tai Chi classes or specific balance exercises can reduce the risk of falling.
    • Stop smoking: smoking has a toxic effect on the cells that help build bone.
    • Limit alcohol intake: no more than 3 units a day. 
    • Body weight: you need to be carrying a bit of weight! Those with a body mass index LESS than 19kg/m sqd are more likely to get osteoporosis.

     

     

     

  2. Contents

    • Introduction
    • When do hormones matter?
    • How Ovarian hormones work
    • Mood levels and chronic pain
    • Be aware of phytoestrogens

    Introduction

    This blog is a summary of the paper: Ovarian hormones and chronic pain: A comprehensive review (2014). Hassan S, Muere A, Einstein G

    When do hormones matter?

    The conditions reviewed in the paper are those more prevalent between puberty and menopause. This suggests a potential link with ovarian hormones:

    • Musculoskeletal pain:
      • Fibromyalgia
      • Rheumatoid Arthritis
      • Migraine headache
      • Jaw problems (TMD) 
    • Chronic pelvic pain:
      • Irritable bowel syndrome (IBS)
      • Endometriosis
      • Interstitial cystitis

    Many factors can contribute to these conditions only one of which is the menstrual cycle. So if, for example, 60% of your Irritable Bowel Syndrome is due to a food allergy you may not notice a link with your cycle. But if 60% of your Irritable Bowel Syndrome is linked with your hormones then you will notice a link.

    The weight of the research suggests the higher the level of ovarian hormones (especially oestrogen) then the less pain you’ll have. Consequently with lower levels of ovarian hormones (especially oestrogen) you’ll have more pain.

    The only exception to this is endometriosis where naturally occurring oestrogen can encourage endometriosis tissue to grow and shed.

    The use of hormone replacement therapy (HRT) to artificially boost ovarian hormones has been shown to give more pain in one study on jaw pain but is used as a treatment of choice for other conditions e.g. endometriosis.

    How ovarian hormones work

    Most research finds pain and swelling (inflammation) is worse when ovarian hormones levels (especially oestrogen) is low. Consequently they find pain and swelling is better when the hormone levels are high.

    For this purpose we’ve split the menstrual cycle in 2 parts:

    (1) Oestrogen levels slowly increase from day 6 to peak at day 12/13 of the cycle (pre-ovulation). Pain is generally reported as being better during the latter part of this stage as oestrogen levels peak.

    (2) Oestrogen levels tend to drop quickly post-ovulation slumping at day 15 and remain quite low especially just before, during and after the period. Pain is generally reported as being higher during this phase.

    This may not be true in all women as commonly there are variations in the cycle and quantities of oestrogen produced. Also hormone levels constantly wax and wane so don’t always follow a strict their either ‘high’ or ‘low’ reading depending on the phase of the cycle.

    Ovarian hormones (especially Oestrogen) reduces pain by:

    • Brain and nerves: These hormones affect parts of the brain and nervous system that make us aware of pain. Because of this they might also affect the effectiveness of pain medications.
    • Anti-inflammatory: Ovarian hormones fight against swelling (inflammation) acting as an anti-inflammatory. Therefore when the hormones are high swelling and pain goes down. When hormones are low pain and swelling goes up.

    Mood levels and chronic pain

    Depressed mood states, that can be associated with the menstrual cycle, has been associated with chronic pain.

    In some women experiencing changes in mood during their cycle there was no correlation with their mood and oestrogen or progesterone levels. The two strongest causes for a change in mood in this particular group of women were (1) stress levels and (2) how women perceived their health at different stages of the cycle. 

    Be aware of phytoestrogens

    Many people try to boost their oestrogen levels by eating foods naturally high in phytoestrogens. These nutrients can have health promoting as well as health damaging effects(1). If you’re not sure whether taking any supplements or food sources is advisable contact your GP.

    References

    (1) The pros and cons of phytoestrogens (2010). Patisaul H and Jefferson W