Bone Pain vs Muscle Loss in Older Adult - What to Treat First?
Osteoporosis (OP) and sarcopenia (SP) are two common old age-related conditions that affect the musculoskeletal system, but they have distinct characteristics and require different approaches to address.Treating the two requires consideration of an individual's overall health and risk factors.
Osteoporosis aka weak bones, is a condition characterized by a decrease in bone density, making bones fragile and more susceptible to fractures.
Risk factors genetics, hormonal changes (such as menopause), insufficient calcium and vitamin D intake, lack of physical activity, and certain medications.
Management of osteoporosis typically involves lifestyle changes such as
- Weight bearing exercises to improve bone strength and density.
- Increasing calcium and vitamin D intake through diet and supplements
- Medications bisphosphonates, RANK-L inhibitors and so on to slow down bone loss.
Sarcopenia, on the other hand, is the age-related loss of muscle mass and strength leading to decreased physical function, increased frailty, and a higher risk of falls.
Risk factors - aging, sedentary lifestyle, inadequate protein intake, chronic diseases, and hormonal changes.
Management of sarcopenia -strategies to maintain or increase muscle mass and strength.
For instance:
- Resistance training exercises to build and preserve muscle mass.
- Adequate protein intake to support muscle growth and repair.
- Balanced nutrition and overall physical activity to maintain muscle health.
- Potential supplementation with amino acids, vitamin D, and other nutrient.
Reason to treat the two conditions simultaneously lies in the fact that it attracts significant, disabling deformities, financial and care giving related implications which becomes inevitable after a fall culminating in a fracture. The interplay between osteoporosis and sarcopenia because strong muscles help support bone health is worth noting. Ideally, a holistic approach to musculoskeletal health is required.
In my clinical practice, it begins with assessment of the severity of patient's co morbid condition, identify individual risk factors, and develop a personalized treatment and prevention plan.
I proactively encourage older adults to participate in low to moderate strength training schedules to help reduce their risk of bone and joint pain and other chronic conditions. The cover picture speaks loudly of biologial ageing pertaining to bone - muscle remodelling.
Strength Training Promotes Knee Health, Lowers OA Risk - Medscape - Nov 02, 2023.
Dr Akshat Khandekar
Family & Geriatric Medicine specialist
Bhopal M.P. India