People with SCI are at higher risk for developing osteoporosis, but proper diet and exercise can help you maintain bone density.
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Osteoporosis is a Common Condition After SCI
Osteoporosis is a condition where the bones become weak and brittle, increasing the risk of fractures. It affects about 80% of people who have a spinal cord injury (SCI).
Bone density loss usually occurs below the level of injury. Bone loss can start as early as six months after the injury.
Osteoporosis is one of the most common secondary complications of SCI.
The Legs are Most Vulnerable to Bone Loss
The bones in the legs are especially prone to losing density after SCI. On average, people with SCI lose 30-40% of their bone density in the legs within the first few years after injury.
The most affected areas are the regions just above and below the knee, such as the femur (thigh bone) and the tibia (shin bone). These bones are normally exercised through walking, running, and other activities. When these activities are reduced or eliminated due to SCI, the bones lose their strength and mass.
How to Preserve Bone Density
There are several ways to prevent or slow down bone loss after SCI. Some of them are:
Weight-Bearing Exercises
Weight-bearing exercises are activities that put pressure on the bones, stimulating them to grow and maintain their density. For people with SCI, this can include regularly standing using a standing frame or a standing wheelchair, which can support the body weight and help align the spine and joints.
Another option is functional electrical stimulation (FES) cycling, which uses electrical impulses to activate the muscles and cause them to contract and relax, mimicking the movement of pedaling a bike.
A third option is low-intensity body vibration, which involves standing or sitting on a platform that vibrates at a certain frequency and amplitude, creating small forces on the bones.
Medications & Supplements
Some medications and supplements can help prevent bone loss by affecting the balance between bone formation and resorption (the process of breaking down old bone tissue).
Calcium and vitamin D are essential nutrients for bone health that can be taken as supplements or obtained from food sources. Bisphosphonates (such as Fosamax) are drugs that inhibit bone resorption and reduce the risk of fractures.
Teriparatide (brand name Forteo) is a synthetic form of parathyroid hormone that stimulates bone formation and increases bone density.
Healthy Lifestyle Choices
Some lifestyle factors can also affect bone health after SCI. Reducing caffeine and alcohol intake can help prevent bone loss, as they can interfere with calcium absorption and increase urine output, leading to calcium loss.
Quitting smoking can also help, as smoking can reduce blood flow to the bones and impair their healing. Avoiding excessive weight gain or loss can also prevent bone loss, as being overweight or underweight can affect hormone levels and metabolism, which in turn affect bone health.
Your Diet Matters
Eating a balanced diet that contains enough calcium and vitamin D can help prevent bone loss after SCI. Calcium is a mineral that is needed for building and maintaining strong bones. Vitamin D is a vitamin that helps the body absorb calcium from food and regulate its levels in the blood.
Foods that are rich in calcium include dairy products (such as milk, cheese, and yogurt), leafy green vegetables (such as collard greens, kale, and spinach), and fortified foods (such as cereals, juices, and soy products).
Foods that are high in vitamin D include egg yolks, fatty fish (such as salmon and trout), cod liver oil, and fortified foods (such as milk and orange juice).
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References
Silver, Jackie, et al. Osteoporosis and Spinal Cord Injury. (2017) University Health Network and Mt. Sinai Hospital Osteoporosis Center.
Svircev, Jelena. Osteoporosis and Fractures in Persons with SCI: What, Why, and How to Manage. (2012) Northwest Regional Spinal Cord Injury System.
