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preventing compression fractures

8 Steps That Can Help You Prevent Painful Compression Fractures

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Research shows that one-quarter of post-menopausal women eventually suffer from compression or collapsing of some vertebrae, the bones that comprise the spinal column. Compression fractures can not only increase one’s risk of future fractures, but they can also compromise one’s ability to function and may cause disabling chronic back pain.

Although these injuries are common, they can usually be prevented, delayed, or mitigated by adopting a healthy lifestyle that includes:

1. Engage in resistance training, such as weight training, yoga, or Qigong every other day, ideally for 30-60 minutes per workout.

There is good news for those who struggle to find those 30-60 minutes: a 10-year study that was completed in 2015 measured the bone mineral density (BMD) of 741 participants pre and post-yoga regimen. Participants who routinely engaged in 12 yoga poses each day for just 12 minutes showed a reversal of osteoporotic bone loss.

2. Do weight-bearing exercises like running, walking, or hiking, for at least 30 minutes each day.

Weight-bearing exercises work against gravity and stimulate bone cells to produce more bone.

3. Get your Vitamin-D levels tested to ensure that they’re between 50-70 ng/mL.

If your levels are low, consider getting more sunshine (exposing some of your skin for 15-30 minutes each day) and taking a supplement. Most people need between 3,000 to 5,000iu of supplementation, but some may need up to 10,000 international units. If you take Vitamin-D supplementation, your 25-hydroxy Vitamin-D level should be checked twice a year.

4. Check your calcium and magnesium intake.

Women should consume a total daily amount of calcium between 1200 and 1500 mg, with no more than 600 mg from supplemental calcium. Taking in more than this amount in supplemental form can lead to an increased risk of heart disease and kidney stones. Good sources of dietary calcium are sardines, white beans, almonds, oranges, leafy greens, and dairy.

Taking magnesium can increase bone mineral density and reduce fracture risk.

5. Consider bioidentical hormone replacement therapy.

Before prescribing medications, we at Kaplan Center explore the possibility of using bioidentical estrogens and progesterone or estrogen analogues like Evista to prevent bone loss.

6. Talk with your doctor before using medications to treat bone loss.

Because most of these medications work by decreasing bone breakdown, this can potentially cause more brittle, unhealthy bone, and result in fractures of the femur and jaw necrosis. We generally reserve medication treatment for those with severe osteoporosis or a history of pathological fractures. Before considering bisphosphonates, like Fosomax, Actonel, Boniva, Reclast, or a newer injectable, Prolia, it is recommended to complete dental procedures before starting treatment for osteoporosis. Report any persistent jaw or thigh pain to your healthcare provider immediately.

Another treatment option is Miacalcin, a synthetic version of the hormone, calcitonin. It has been shown to build bone more in the spine than in the hip, offering users some pain relief. Two alternatives to the bisphosphonates and Miacalcin are Forteo and Tymlos, synthetic versions of a hormone called parathyroid hormone which also builds bone. Some of these drugs, however, carry warnings about an increased risk of bone tumors called osteosarcoma.

7. Consider Bone-Density Imaging

It’s important to evaluate the effectiveness of any medications or hormone replacement therapies you may use because each individual inevitably has their own unique response to a given treatment. A bone-density test can help measure the therapeutic benefits of any treatment path you have chosen.

8. Vitamin K supplementation.

Research on Vitamin K and postmenopausal bone loss has shown that it can have a positive effect on bone strength. This 2022 meta-analysis that looked at 16 randomized controlled trials and included 6,425 subjects concluded that “Vitamin K2 supplementation has a positive effect on the maintenance and improvement of [bone mass density lumbar spine] in postmenopausal women, and it can also reduce the fracture incidence”. Supplements are a great way to improve your health, but you should always discuss any new supplements or medications with your provider to ensure that it would be a good option for your unique health profile.

In sum, there’s a lot you can do to keep your bones strong! So, do it!

If you would like to talk to a Kaplan provider about any of the treatments above, please give us a call at 703-532-4892.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article was originally published online in May, 2018. Its content was reviewed and updated in May, 2023.

Additional References

Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients. 2013 Jul 31;5(8):3022-33. doi: 10.3390/nu5083022. PMID: 23912329; PMCID: PMC3775240.

Rondanelli M, Faliva MA, Tartara A, Gasparri C, Perna S, Infantino V, Riva A, Petrangolini G, Peroni G. An update on magnesium and bone health. Biometals. 2021 Aug;34(4):715-736. doi: 10.1007/s10534-021-00305-0. Epub 2021 May 6. PMID: 33959846; PMCID: PMC8313472.

SCIM_Broken_heart

Broken Heart Syndrome: When Sudden Loss or Stress (Literally) Breaks Your Heart

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Have you ever suffered a broken heart?

Everyone can understand the intense pain, heartache, and distress that comes with dealing with a broken heart, especially when it’s due to a loss of a family member or dear friend. Unfortunately, these extreme stress situations can rob us of our health. We know how closely intertwined our emotional and physical states are, but can a person actually die of a broken heart?

What causes broken heart syndrome?

Stress-induced cardiomyopathy (SICM), also known as takotsubo cardiomyopathy and/or “Broken Heart Syndrome,” is a real cardiac condition triggered by extreme stress or anxiety from a traumatic event. Along with the loss of a loved one, other emotional or physical stressors like natural disasters, car accidents, sudden financial loss or gain (think lottery!), domestic violence, or even a sudden shock, could all provoke an attack.

A study published in JAMA Network Open confirmed that pandemic-related stress has caused an increase in stress-induced cardiomyopathy.

What happens when someone has broken heart syndrome?

In such cases, a rush of stress hormones causes one part of the heart to bulge, forcing the rest of the heart to work harder. As a result, the heart is unable to pump blood normally. Under these circumstances, a person will experience symptoms similar to a heart attack, like chest pain and shortness of breath, but with no signs of coronary artery disease.

Luckily for most, with treatment, the heart is able to return to its normal state. But SICM can also be fatal.

Questions? Give Us a Call!

703-532-4892 x2

How is broken heart syndrome treated?

Treatment for Broken Heart Syndrome/SICM typically includes medications that are used to treat heart attack victims, like beta-blockers, which relieve the excessive strain on the heart. However as research continues on SICM it questions whether this form of treatment is actually effective, as this study published in the New England Journal of Medicine concluded: “Although it has been proposed that beta-blockers might prevent takotsubo cardiomyopathy events, the condition developed in 32.5% of the patients in our study while they were taking these agents. Of 57 patients with recurrent takotsubo cardiomyopathy, 29 were taking beta-blockers at the time of the second event. These data suggest that beta-blockers are not effective in preventing takotsubo cardiomyopathy.”

Another study, published in the American Journal of Cardiology, led by Dr. Harmony Reynolds of NYU Langone Medical Center, looked at the parasympathetic nervous system (responsible for helping the body calm down) as a major player in SICM and proposed that treatments such as meditation, yoga, and breathing exercises, may be beneficial in preventing attacks by strengthening the mind-body relationship.

Dr. Reynolds’ research also aims at explaining why as much as 90% of patients diagnosed with SICM are post-menopausal women. Some suspect that the reason for this may be the loss of estrogen during menopause (estrogen is cardio-protective in that it improves blood flow to the heart; as levels drop one’s risk for a cardiac event increases).

And while Broken Heart Syndrome is relatively rare in the big picture, only counting for 1-2% of patients with heart attack symptoms, the pain you feel after suffering a loss can also cause other negative health effects. Not getting enough sleep or proper nutrition (both common occurrences while coping with a loss or stressful situations), can suppress your immune system, and put you at a greater risk for developing other illnesses.

While there is no way to predict how your body will react to a traumatic event, there are things you can do to put yourself in the best position for coping with stress and recovering from a cardiac event.

1) Know the signs and symptoms of a cardiac event.

Heart disease is one of the leading causes of death for men and the #1 cause of death for women in the United States. Typical symptoms include chest pain or discomfort, dizziness, shortness of breath, breaking out into a cold sweat, and/or heart palpitations. Women may present different signs and symptoms than men, like abdominal pain or nausea, shortness of breath with or without chest pain, back, neck, jaw, and arm pain.

While there may be no warning for sudden cardiac arrest, anyone experiencing any of the symptoms above should call 911 immediately.

2) Take care of yourself.

This includes eating a healthy, anti-inflammatory diet and maintaining a regular sleep schedule. If you are having difficulty falling or staying asleep don’t put off talking to your physician. A healthy sleep pattern is absolutely essential for good health. If you are a smoker, quit.

3) Keep up with a regular exercise routine.

Physical activity is anything that gets you moving. If you have never engaged in regular exercise start with a simple and easy to keep walking routine. However, try not to work out when stress or emotions are running high; a study of over 12,000 people showed that heavy exercise while angry or emotionally stressed tripled the incidence of a heart attack.

4) Take up a mind-body therapy.

Meditation, yoga, and breathing practices, such as Pranayama, can prompt a cascade of physiological effects including decreases in blood pressure, stress, and heart rate, and increases in immune function, mood, and vitality.

5) Talk with a therapist or grief counselor.

Speaking with a professional can help you navigate the more complex emotions surrounding the loss of a friend or family member, or coping with a current or past trauma.

6) Speak with a doctor about your health concerns

Even if you’re not sure if your symptoms are related to your emotional state keeping your doctor informed is extremely important, particularly if you suffer from any chronic medical conditions.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Low Sex Drive

Dealing With a Low Sex Drive and How to Solve It

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A low sex drive can be a source of frustration for many women (and men). It is normal for our interest in sex to ebb and flow over the course of our lives because of its dependence upon our medical, physical and emotional wellbeing. Furthermore, many couples experience moments in their relationship where sex will naturally decline as other priorities take hold. But if you find your lack of desire for sex distressing or believe it’s affecting your relationship, then you should consider the common sources.

Understanding the causes of a low libido

Loss of sexual desire is one of the most common sexual health problems that women experience. A recent study found that nearly one-third of women aged 18 to 59 suffer from a lost interest in sex. Causes of a reduced sex drive include:

Medical conditions

Medical conditions such as hypothyroidism (an underactive thyroid), coronary artery disease or depression are known to lower libido in both men and women.

Medications

A number of medications including antidepressants (e.g. Prozac, Zoloft) have side effects that include a reduced sex drive.

Major life changes and partner relationships

Relationship strains, conflicts or fights may have the effect of lowering interest in sex. Additionally, major life changes like pregnancy or childbirth can also affect your desire for sex.

Menopause and perimenopause

As women transition to menopause, the amount of estrogen in the body declines. This can result in a reduced libido or vaginal dryness which itself may cause sex to be painful or uncomfortable. Other symptoms of menopause such as hot flashes, sleep changes or mood problems may also contribute to a lower sex drive.

Emotional and psychological factors

In many cases, the emotional and psychological factors around sex and relationships can affect our sex drive. Factors such as stress, low self-esteem or poor body image may all impact how we feel about sex.

To get a better understanding of the issues that are specific to your own case, it might be useful to speak to a healthcare professional.

When to make an appointment

If you’re concerned about your low desire for sex or are having difficulty figuring out the root cause, make an appointment to speak to one of our specialists. Our doctors will take the time to discuss your own experiences, obtain a full history and ask questions surrounding your medical and emotional health. If necessary, we may suggest diagnostic tests to rule out possible medical conditions.

Treatment options

Whether it’s a medical problem, emotional issue or the effects of menopause at play, our staff can discuss a range of treatment options that are tailored to you. Options may include:

At The Kaplan Center we understand that sexual health is a part of overall good health. Our goal is to provide support to our patients and help them achieve the best possible outcomes for all of their health concerns.

References

https://www.mayoclinic.org/diseases-conditions/low-sex-drive-in-women/symptoms-causes/syc-20374554

https://www.webmd.com/sex-relationships/features/loss-of-sexual-desire-in-women#1

Hormone Levels and Risk of Alzheimer’s

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Last month at the Alzheimer’s Association International Conference in Chicago, studies were presented in relation to lower hormone levels contributing to the possible risk of dementia.

One study, “Women’s Reproductive History and Dementia Risk”, which looked at 15,000 women in California, showed that women were less likely to develop dementia later in life if they started menstruating earlier and went through menopause later. Menopause at age 45 or younger increased risk by 28%. Also, the risk of Alzheimer’s for women who had 3 or more children was 12% lower than those women who had one child.

Another study out of the U.K., Women’s Pregnancy History May Influence Alzheimer’s Risk through Alterations in Immune Function, of 133 elderly women, supported these findings. They looked at the number of months of pregnancy in their lives and found the higher the number, the lower the rate of Alzheimer’s.

One presenter remarked that the intense fluctuations of hormones related to menopause may be associated with an increased risk of Alzheimer’s.

While it’s not clear if estrogen replacement protects against dementia after menopause, there is supportive evidence that if given to women in their early 50’s, estrogen and progesterone prevent the hormonal fluctuations, hot flashes, and sleep disturbance that could be associated with dementia. The benefits of giving hormones after 65 are murky, in that there may be an increased risk of dementia, heart disease, and breast cancer. In this age group, it is recommended to look at each case individually, depending on other medical conditions, and to use the lowest possible dose with a safer delivery system, like transdermal estrogen and natural micronized progesterone. Some conditions that could benefit from hormone replacement later in life include multiple sclerosis, chronic pain syndromes, osteoporosis, or the continuation of severe hot flashes.

woman getting an acupuncture treatment

5 Things You Didn’t Know Acupuncture Could Treat

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Acupuncture and pain relief go hand in hand. Every month new research is published confirming that acupuncture can effectively relieve a variety of pain conditions from migraines to back pain. In fact, there has been so much research in support of its efficacy that in the battle to fight opioid dependency, some major medical organizations are now rewriting their directives to recommend acupuncture and other non-pharmacological treatments along with, or in place of, more conventional treatments.

  • As of January 1, 2018, the Joint Commission, an independent, not-for-profit organization that accredits and certifies nearly 21,000 health care organizations and programs in the United States, mandated that accredited hospitals are required to provide acupuncture and other non-pharmacological pain management modalities as a strategy option for managing pain.
  • The guidelines of the American College of Physicians’ (ACP), updated in 2017, now “strongly recommend” physicians to look first at non-drug therapies, such as acupuncture, massage, and other mind-body techniques, for treating acute, sub-acute and chronic cases of low back pain.

Acupuncture treatment, which involves inserting very thin needles under the skin, is especially appealing because it is relatively safe and has very few side effects. And while most people are most familiar with its role in treating pain, there are also many lesser-known conditions that acupuncture treats effectively.

Here are 5 conditions you didn’t know that acupuncture could treat:

1. Environmental Allergies
An article in the American Journal of Rhinology and Allergy recommended acupuncture as an adjunct therapy for allergic rhinitis. The sniffling, sneezing, and runny nose that some people can experience in one season, or even all year long, can sometimes be managed with antihistamines. But for those who are not satisfied with conventional medicine or suffer from side effects of medications acupuncture can be beneficial. Studies have shown people with acupuncture had reduced allergy symptoms and required less antihistamine medication compared to control groups. Studies have even shown that acupressure on specific points on the face and ears can be helpful with no needles at all.

2. Symptoms of Menopause
Acupuncture can reduce the frequency of hot flashes and night sweats, symptoms that the majority of women experience during the period of menopause. A recent study showed a reduction in symptoms by 40%. Maximum benefits are experienced after eight treatments, and the benefits lasted for 6 months after the treatments stopped. While acupuncture alone can help reduce the symptoms of menopause, some cases may require a combination of acupuncture and Chinese herbal medicine for increased effect. The hormone balancing effect of acupuncture can also help with other symptoms of menopause including insomnia and mood changes.

3. Healing Scars
There are several ways to heal scars using Chinese medicine. Acupuncture needles can stimulate healing, and moxibustion, a warming treatment, can increase circulation. Liniments (soothing lotions to reduce pain) such as Zheng gu shui, aloe vera, or Vitamin E can be applied to encourage healing.  Older scars and scar tissue can also be worked on even if they are decades old. This can help with increased mobility and decreased appearance. Direct scar treatments should not be used until after 1 month after an injury or post-surgery to avoid infection.

4. Stress Reduction
We don’t need to explain the experience of stress. Unfortunately, this is all too common for most Americans. It is at the root of a whole host of problems from digestive problems, menstrual cramps, depression, and chronic pain.  Acupuncture has long been known to produce relaxation, reduce muscle tension, and increase mood. Recent studies have shown in biological models exactly why this is happening. We know that acupuncture releases endorphins, our body’s natural opioids. These are largely responsible for the pain-relieving effect. But these neurotransmitters also produce a relaxation response. Researchers at Georgetown University have shown that acupuncture in clinical models releases endorphins and lowered stress hormones including the sympathetic NPY peptide pathway. This is important evidence that suggests acupuncture can protect against the stress response.

5. Reduce Wrinkles
Cosmetic acupuncture* (also known as facial rejuvenation) is for people who are looking for a natural, alternative way to reduce the signs of aging and improve inner vitality for a healthy appearance to their face. Acupuncture provides a non-toxic, non-surgical way of looking and feeling your best at any age. The main benefit is a brighter and healthier-looking complexion. It reduces the appearance of fine lines, wrinkles, and dull skin by increasing circulation to the face, nourishing the skin and stimulating natural collagen production. It relaxes tension in the facial muscles for a more relaxed face. It’s not just a cosmetic process, you also get the benefits of an acupuncture treatment that has been shown to boost the immune system, reduce pain, relax and calm the body. Initial visits are ninety minutes and follow-up sessions are one hour. It generally takes six sessions and one month to start building collagen. Many report a glow to the skin after the first session. It’s recommended to get a series of twelve sessions, with weekly visits initially, and then every other week or once per month for maintenance. Acupuncture can be a complement to other cosmetic treatments, but people should consult their providers as to how long to wait after fillers, injections, and other dermatological treatments. A 30-minute consult is available for more information.

* Cosmetic acupuncture patients must have received a diagnostic exam by a licensed physician within the last 6 months and provide a documented recommendation for the treatment.