Thin bones.

[CurlieQCarrie]

So last week I twisted my ankle to the point that I was pretty sure it was broken. I opened my office door at work, and my leg kicked out and caught the edge of the door frame as I was coming in. It sent an instant pain up to my chest, so I knew right away that it hurt.

Anyway, the next day it was so swollen and felt warm and looked slightly red. I panicked a little bit thinking blood clot, so I went to the ER. Just a sprain. Better safe than sorry though. The doctor said that though there was no fracture, my bones are thin. I already knew that, of course, but I know it wouldn't take much to snap one.

So my question is this: besides milk/cheese/dairy, is there anything that it recommended to strengthen our bones? I use a standing frame and eat a regular diet. Anything more I can do?

[november]

Unfortunately, a standing frame does not help bone density studies have shown. Many therapists and doctors are uninformed and tell you the opposite. Studies show FES helps some. Do you take calcium and vitamin d supplements as well? I'm on rx strength vitamin d. There are meds to help bones if you have osteoporosis/penia, but I think studies show they may not be effective in SCI.

Sorry about your sprain. Are your bones ok to stand then?

[Duck]

I do not believe standing , does not strengthen bones .

[Maxwe13]

calcium supplements

[SCI-Nurse]

There is no evidence that passive standing alone does anything to prevent or treat osteoporosis in SCI. Active muscle movement, pulling on and stressing the bones, is needed. Studies using FES to achieve this along with standing did show some success. This is also true for the use of medications to treat osteoporosis...used alone they are unlikely to help, but combined with FES they have been show to help. Standing on a vibrating plate of the correct applitude and frequency also shows some promise (due to the spasms that this vibration causes in your leg muscles).

The use of calcium and vitamin D supplements in the absence of other treatments (such as those above) have also not proven to help with osteoporosis in SCI, and high calcium intake can predispose you to urinary stones.

Some people have had some success in the use of the more powerful IV medications used for treatment of osteoporosis in menopausal women. Many of these drugs have fairly high levels of complications, so their use can be problematic for the person with SCI. Suggest you discuss the options in this area with your SCI provider and decide which options you want to try.

This book chapter is a pretty good summary of the options available:

http://www.google.com/url?q=http://w...1USsA7L8Ndf0HQ

(KLD)

[crabbyshark]

What's goin on curlieQcarrie?

What do you all think about this study right here?

1. Ann Intern Med. 2007 Jun 19;146(12):839-47. Effects of the phytoestrogen genistein on bone metabolism in osteopenic postmenopausal women: a randomized trial. Marini H, Minutoli L, Polito F, Bitto A, Altavilla D, Atteritano M, Gaudio A, Mazzaferro S, Frisina A, Frisina N, Lubrano C, Bonaiuto M, D'Anna R, Cannata ML, Corrado F, Adamo EB, Wilson S, Squadrito F. Azienda Ospedaliera Universitaria Policlinico G. Martino, University of Messina, Messina, Italy. Summary for patients in Ann Intern Med. 2007 Jun 19;146(12):I34. BACKGROUND: Observational studies and small trials of short duration suggest that the isoflavone phytoestrogen genistein reduces bone loss, but the evidence is not definitive. OBJECTIVE: To assess the effects of genistein on bone metabolism in osteopenic postmenopausal women. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: 3 university medical centers in Italy. PATIENTS: 389 postmenopausal women with a bone mineral density (BMD) less than 0.795 g/cm2 at the femoral neck and no significant comorbid conditions. INTERVENTION: After a 4-week stabilization period during which participants received a low-soy, reduced-fat diet, participants were randomly assigned to receive placebo (n = 191) or 54 mg of genistein (n = 198) daily for 24 months. Both the genistein and placebo tablets contained calcium and vitamin D. MEASUREMENTS: The primary outcome was BMD at the anteroposterior lumbar spine and femoral neck at 24 months. Secondary outcomes were serum levels of bone-specific alkaline phosphatase and insulin-like growth factor I, urinary excretion of pyridinoline and deoxypyridinoline, and endometrial thickness. Data on adverse events were also collected. RESULTS: At 24 months, BMD had increased in genistein recipients and decreased in placebo recipients at the anteroposterior lumbar spine (change, 0.049 g/cm2 [95% CI, 0.035 to 0.059] vs. -0.053 g/cm2 [CI, -0.058 to -0.035]; difference, 0.10 g/cm2 [CI, 0.08 to 0.12]; P < 0.001) and the femoral neck (change, 0.035 g/cm2 [CI, 0.025 to 0.042] vs. -0.037 g/cm2 [CI, -0.044 to -0.027]; difference, 0.062 g/cm2 [CI, 0.049 to 0.073]; P < 0.001). Genistein statistically significantly decreased urinary excretion of pyridinoline and deoxypyridinoline, increased levels of bone-specific alkaline phosphatase and insulin-like growth factor I, and did not change endometrial thickness compared with placebo. More genistein recipients than placebo recipients experienced gastrointestinal side effects (19% vs. 8%; P = 0.002) and discontinued the study. Limitations: The study did not measure fractures and had limited power to evaluate adverse effects. CONCLUSION: Twenty-four months of treatment with genistein has positive effects on BMD in osteopenic postmenopausal women. ClinicalTrials.gov registration number: NCT00355953.