For those who suffer from it, the degenerative bone condition known as osteoporosis is one of the more significant aspects of aging.
Most of us lose a little bit of bone mass as we get older, but the bones of people who suffer from osteoporosis become brittle and can break from even mild impact. Osteoporosis has special implications for the feet and ankles, which we will discuss here.
What is Osteoporosis?
Because they are not soft like other tissue, it is easy to forget that our bones are living, organic matter. Just like other soft tissues in our body, bone cells are subject to a constant cycle of degeneration and regeneration.
Older tissue is absorbed back into the body, and new tissue is generated. When we are young, especially during our growing years, bone mass is built (regenerated) faster than the rate at which the tissue is absorbed (degenerated).
At some point in our late teens or early twenties, we reach peak bone mass, after which the rate of replacement slows. From this point on, as we age, we begin to lose bone mass faster than we create it. If this deficit is severe enough, the condition is called osteoporosis.
It is estimated that 54 million Americans have osteoporosis, which occurs in approximately 50 percent of women and 25 percent of men at some point in their lives.
Because people affected by this condition tend to be older, many of them have poor vision and are not as agile as they may have once been. This makes them especially susceptible to foot and ankle injuries, which can often be serious because of their brittle bones.
A younger person may heal quickly after breaking a toe or ankle, with no sign that they were ever injured, but for older people suffering from osteoporosis, such injuries can result in lifelong pain and disability due to lack of proper bone healing.
In addition to being more vulnerable to trauma-related fractures, people with osteoporosis are also more susceptible to stress fractures in their feet.
These types of fractures are rarely due to any sudden violent incident; rather, they occur as a result of prolonged overuse and microscopic trauma. Something as simple as a daily walk for an older person can lead to stress fractures in the foot or ankle.
Young, healthy people may get stress fractures as a result of participation in sports, but older people can get them with much lighter activity due to osteoporosis.
How Does Osteoporosis Develop?
The most common risk factor for osteoporosis in your ankle and foot is age, but there are other risk factors that make some people more vulnerable than others. Women, as statistically shown above, are twice as susceptible as men, and whites and Asians are considerably more likely to suffer osteoporosis than people of other races.
Your physique—how you’re built—also plays a role. The more bone mass you acquire in your youth, the more you can afford to lose later in life. People with smaller body frames are somewhat more likely to suffer osteoporosis when they get older.
Diet—in adulthood as well as in childhood—is another key factor. Low calcium intake, as you may have guessed, can lead to osteoporosis later in life. The same is true for people whose diet does not contain sufficient vitamin D.
Certain gastrointestinal surgeries have been linked to osteoporosis later in life, and people who have part of their stomach or intestinal tract removed need to be conscientious about how they eat, in order to ensure that they get enough calcium.
Other factors that contribute to the development of osteoporosis include excessive use of alcohol or tobacco, sedentary habits (i.e., spending more time sitting than exercising), and long-term use of certain steroid medications.
If you spend most of your day sitting, or if you have more than two alcoholic drinks per day, it may be time to reevaluate your lifestyle.
Symptoms of Osteoporosis in the Feet and Ankles
Unfortunately, there are often no symptoms of osteoporosis until bones begin to break. For this reason, this condition is sometimes known as “the silent disease,” and it can be difficult to catch in its early stages.
There are symptoms in some cases, however; if you suffer from osteoporosis you may have back pain caused by fracture or collapse of your vertebrae.
Osteoporosis is sometimes associated with diabetes, possibly because excess body weight and a sedentary lifestyle can contribute to both conditions.
Osteoporosis can present particular dangers to your foot and ankle. As we age, our balance inevitably deteriorates, making us more susceptible to falls and subsequent fractures.
Also, your toes can unexpectedly be broken if they strike the coffee table as you walk across your living room. The best way to minimize both of these risks is to wear good, sturdy shoes throughout the day, except when showering or sleeping.
Good shoes will protect your toes from injury and make it easier for you to maintain your balance (most indoor falling injuries occur to people who are barefoot or wearing only socks).
How is Osteoporosis Treated?
Most treatment for osteoporosis in your ankle and foot involves improvements in diet, increased exercise, and other changes in lifestyle.
There are medications available, such as alendronate, risedronate, ibandronate, and zoledronic acid, but many of these medicines are associated with side effects, including abdominal pain, nausea, and trouble swallowing.
A drug called teriparatide has been shown to effectively stimulate new bone growth, and may be worth asking your doctor about. Your podiatrist may also suggest special ankle braces to improve your balance.