People with AS are at higher risk of osteoporosis
Osteoporosis is a condition that weakens bones, making them fragile and more likely to break.
Recent research shows that AS patients have a higher prevalence of both osteoporosis and osteopenia. High disease activity and hip involvement are risk factors of bone loss in patients with AS.
What is osteoporosis?
During childhood, bones grow and repair very quickly, but this process slows as you get older. Bones stop growing in length between the ages of 16 and 18, but continue to increase in density until you're in your late 20s. You gradually start to lose bone density from about 35 years of age. Women lose bone rapidly in the first few years after the menopause.
Losing bone is a normal part of the ageing process, but for some people it can lead to osteoporosis and an increased risk of fractures. People with inflammatory conditions such as AS are at higher risk of developing osteoprosis.
Osteoporosis is often referred to as the ‘silent disease' because, although almost 3 million people in the UK are estimated to have osteoporosis, few know they have it until they break a bone.
Your GP can use an online programme such as the Fracture Risk Assessment Tool to help assess your risk of fracture. They may also refer you for a GP may refer you for a bone mineral density scan, known as a DXA scan.
A DXA scan is a quick, safe and painless procedure that usually takes about five minutes, depending on the part of the body being scanned. The scan measures your bone mineral density and compares it to the bone mineral density of a healthy young adult and someone who's the same age and sex as you.
The difference between the density of your bones and that of a healthy young adult is calculated as a standard deviation (SD) and is called a T score. A T score of:
- above -1 SD is normal
- between -1 and -2.5 SD is defined as decreased bone mineral density compared with peak bone mass
- below -2.5 is defined as osteoporosis
This video from Torbay and South Devon Rheumatology Department explains more about having a DEXA scan.
There are medications that can help strengthen bones. The National Osteoporosis Society has useful information on medications.
There are also simple steps you can take to lower your risk of osteoporosis and improve your bone health.
Your bones will be stronger if you do regular weight-bearing exercise. This is any kind of physical activity where your feet and legs bear the weight of your own body. Brisk walking is ideal.
For most benefit you should exercise regularly, aiming for 30 minutes at least 5 times a week.
Muscle strengthening exercises are also important as they will help give strength to the supporting muscles around bones. Check out the NASS Back to Action guide for ideas or see if there is a local NASS group near you.
Food and diet
Calcium is important for maintaining strong bones. Adults need 700mg a day, which you should be able to get from your daily diet. Calcium-rich foods include leafy green vegetables, dried fruit and yoghurt.
Vitamin D is also important for good bone health. Your body needs a good supply of vitamin D in order to absorb the calcium you are eating and drinking. Vitamin D can be found in eggs, milk and oily fish. Vitamin D is also made by your body after exposure to the sun.
Smoking and drinking
Smoking is associated with an increased risk of osteoporosis. It's another good reason to try to give up. Enjoying the odd drink is fine but drinking too much alcohol can damaging your bones and increases your risk of fracture.
This video from Torbay and South Devon Rheumatology Department explains more about treatment.