Hip Stress Fractures And Osteoporosis Affect Mostly The Elderly, But...
Low bone density makes people over 65 more susceptible to hip stress fractures, although an increasing number of young people have weak bones due to a poor diet and lifestyle.
Risk For Hip Stress Fractures
The risk of stress fractures may increase for a variety of reasons but the following are some of the most common.
Age increases the risk of fractures for the following reasons:
- bone density decreases with age
- vision and sense of balance often declines
- reaction time slows
- muscles weaken as we age and also with inactivity
Chronic Medical Conditions
- Osteoporosis makes our bones more prone to a fracture, even with relatively minor trauma.
- Endocrine disorders (such as hyperthyroidism and gastrointestinal disorders) may interfere with calcium and vitamin D absorption.
- Rheumatoid disorders often lead to inactivity and loss of bone mass.
- Low levels of sex hormones (testosterone and some forms of estrogen) are associated with an increased risk of osteoporosis.
- Parkinson's disease and multiple sclerosis affect the nervous system and increase the risk of falling.
- Decreased mental alertness (dementia and depression) also increase or risk of falling.
About 80 percent of hip fractures occur in women. The drop in estrogen levels that occurs with menopause accelerates bone loss, increasing the risk of hip fractures as a woman moves beyond menopause.
A family history of osteoporosis is a strong predictor of low bone mass. A small-boned, slender frame may put you at increased risk of osteoporosis. Also, Caucasians and Asians have the highest risk of osteoporosis.
Lack of calcium and vitamin D in your diet when you're young lowers your peak bone mass and increases your risk of fracture later in life.
- Eating disorders, such as anorexia nervosa and bulimia, can permanently damage your skeleton.
- A high caffeine intake (over three cups a day) may interfere with the absorption of vitamin D and calcium, resulting in decreased bone density.
Prolonged bed rest or immobility can lead to bone loss. Weight-bearing exercises (such as walking) are also needed to strengthen bones and muscles and make falls and fractures less likely.
Tobacco and Alcohol Use
Smoking and excessive alcohol consumption can interfere with the normal process of bone building and remodeling, resulting in bone loss.
Some medications accelerate bone loss and increase the risk of osteoporosis and hip fracture. Long-term use of medications that may contribute to bone loss include:
- Corticosteroids - such as prednisone
- thyroid medications
- certain diuretics and blood thinners
- proton pump inhibitors - used to reduce stomach acid
Some drugs may also cause dizziness and affect your balance. These include some blood pressure medications, sedatives, tranquilizers, antidepressants, cold and allergy medications, pain relievers and sleep medications. Interestingly, the daily use of childrens aspirin may protect bone health in addition to providing modest pain relief.
The risk of falling also increases when a person is around loose rugs, cluttered floors, poor lighting, exposed electrical or telephone cords and stairs without handrails.
Hip Stress Fracture Symptoms
The symptoms of a hip stress fracture may include:
- Inability to put weight on your leg on the side of your injured hip
- Stiffness, bruising and swelling in and around your hip area
- Shorter leg on the side of your injured hip
- Turning outward of your leg on the side of your injured hip
- Severe pain in your hip or groin
Tests And Diagnosis
An X-ray will confirm the presence and location of a hip stress fracture. Most hip fractures occur in one of two locations along your femur- which is the long bone that extends from your pelvis to your knee:
- The femoral neck. The femoral neck is located in the upper portion of your femur, which is the ball part of the ball-and-socket joint.
- The intertrochanteric region. This region is the portion of your upper femur that juts outward.
You can reduce your risk of a hip stress fracture by taking steps to prevent osteoporosis and to reduce your risk of falling.
Have a Bone Density Test
Women should have a baseline bone density test at menopause and men at age 60... or earlier if they are experiencing a number of risk factors. A low bone density score can be an incentive to take steps to improve our bone health through diet and lifestyle change.
Make the right choices
Our bone mass usually peaks in our 30s and then we begin to lose bone mass. Making the right choices when we are young contributes to a higher peak bone mass and reduces our risk of osteoporosis in later years. These choices include:
- Ensuring adequate calcium and vitamin D in our diet
- Exercising to strengthen bones and prevent falls
- Minimizing alcohol consumption and exposure to cigarette smoke
- Consulting with our doctor regarding the need for osteoporosis medication
Reduce the risk of falling
In addition to ensuring that our bones are strong and healthy, the next best way to avoid hip stress fractures is to reduce the risk of falling. Steps we can take include:
- Fall-proof our homes. Keep our homes well lit and free of hazards that might cause us to trip and fall. Avoid area rugs and exposed electrical cords. Place furniture where we're unlikely to bump into it. Consider installing grab bars in the bathroom, stair treads on steps and handrails along stairways. Use nonslip mats on the bathtub and on shower floors.
- Wear sensible shoes. If we're older, wear hard-soled, flat shoes. Avoid wearing high heels or sandals with light straps. Avoid wearing shoes that are either too slippery or too sticky. Flexible athletic shoes may also impair our balance and contribute to falls.
- Avoid dangerous activities. Use a stepladder or ask for help to reach high places. Avoid lifting unusually heavy objects or engaging in overly vigorous activities until you have build sufficient strength for the activity.
- Get Regular Eye Exams. Ensure that your eyesight is adequate. Have your eyes checked every two years and wear proper glasses if necessary.
- Be aware of medication side effects. Discuss the side effects of medications with your doctor. Weakness or dizziness from medications can increase our risk of falling.
Rehabilitation is often lengthy when recovering from a hip stress fracture. The goal is to gradually place more weight on the injured hip until it can handle our full weight without pain.
Patients will also learn how to sit, stand and walk so they don't re-injure their hip or damage their prosthesis, if they have one.
Recovering patients may need help with daily tasks, such as bathing, dressing and cooking. And a walking aid... such as a cane, walker or crutches, may be useful for awhile.