Osteoporosis, a condition that makes your bones become less dense and more likely to fracture, can lead to significant pain and disability. Nationwide, more than 53 million people either already have osteoporosis or are at high risk due to low bone mass.
Published studies have found an increased risk of bone loss and fracture in individuals with rheumatoid arthritis. Here are three reasons why people with rheumatoid arthritis are at increased risk for osteoporosis:
- Glucocorticoid medications often prescribed for the treatment of rheumatoid arthritis can trigger significant bone loss.
- Rheumatoid arthritis causes pain and joint problems, which discourages people from staying active but also increases their osteoporosis risk.
- Studies also show that bone loss in rheumatoid arthritis may occur as a direct result of the disease. The bone loss is most pronounced in areas immediately surrounding the affected joints.
Strategies for preventing and treating osteoporosis in people with rheumatoid arthritis are similar to those recommended for people who do not have RA. According to the NIH Osteoporosis and Related Bone Diseases National Resource Center, there are five areas of focus.
- Nutrition. Make sure to eat a well-balanced diet that’s rich in calcium and vitamin D to promote bone health. Good sources of calcium include low-fat dairy products; dark green, leafy vegetables; and calcium-fortified foods and beverages. The Institute of Medicine recommends a daily calcium intake of 1,000 mg (milligrams) for men and women up to age 50. Women over age 50 and men over age 70 should increase their intake to 1,200 mg daily. Make sure you get enough vitamin D, which helps your body absorb calcium. Egg yolks, saltwater fish and liver are good sources of vitamin D. Ask your orthopaedic specialist if you need to take a vitamin D supplement.
- Exercise. Weight-bearing exercise makes your bones stronger. Walking, climbing stairs, dancing and strength-training are different types of exercise to try. Exercise helps keep your joints moving. Preventing bone loss and maintaining flexibility reduces your chances of falling and breaking a bone.
- Healthy lifestyle. If you smoke, quit. It’s never too late to give up smoking. Not only is it bad for your lungs and heart, it also leads to bone loss. Women who smoke may go through menopause earlier, which means their estrogen levels decrease. Estrogen is known as a bone-preserving hormone. Drinking too much alcohol resulting in earlier reduction in levels of the bone-preserving hormone estrogen and triggering earlier bone loss. In addition, smokers may absorb less calcium from their diets. Alcohol also can have a negative effect on bone health. Those who drink heavily are more prone to bone loss and fracture, because of both poor nutrition and increased risk of falling.
- Bone density test. A bone mineral density test measures bone density in various parts of the body. This safe and painless test can detect osteoporosis before a fracture occurs and can predict one’s chances of fracturing in the future. The BMD test can help determine whether medication should be considered. People with rheumatoid arthritis, particularly those who have been receiving glucocorticoid therapy for 2 months or more, should talk to their doctor about whether a BMD test is appropriate.
- Medication. Like rheumatoid arthritis, osteoporosis has no cure. However, medications are available to prevent and treat osteoporosis. Several medications are available for people with rheumatoid arthritis who have or are at risk for glucocorticoid-induced osteoporosis.
Source: NIH Osteoporosis and Related Bone Diseases National Resource Center