Taking Ownership of Skeletal Health
Practitioners at the Musculoskeletal Institute help patients prevent bone fractures before they occur
Reviewed by: J. Mica Guzman Jr., MD, MBA, DABFM, CAQSM and Tammy Noel, MSN, FNP, ONP-C
Written by: Lauren Schneider
According to the American Orthopaedic Association (AOA), over 2 million adults in the United States experience a fragility fracture each year. Not only can these events cause impaired mobility, but they can have serious mental health consequences due to the subsequent decrease in one’s independence.
Fortunately, bone fractures are not inevitable, says Tammy Noel, MSN, a Family Nurse Practitioner at the Musculoskeletal Institute at UT Health Austin. “If we can identify at-risk patients early and get them started on correct medications and lifestyle modifications, we can prevent fragility fractures from happening.”
A Home for Fracture Prevention and Treatment
The Musculoskeletal Institute participates in the AOA’s national Own the Bone initiative, a multidisciplinary program which seeks to address a gap in preventative care affecting fragility fracture patients and those who may be susceptible to bone fracture in the future. Through this initiative, both patient groups can identify and manage the underlying factors that make their bones more vulnerable to fracture.
“Initially, the majority of the patients that we saw already had fractures, but now we’re getting referrals for individuals who have recently been diagnosed with osteopenia or osteoporosis and people who are just interested in their bone health and what they can do for fracture prevention,” says J. Mica Guzman, MD, MBA, a sports medicine specialist who serves as the Primary Care Clinical Director for the Sports and Injury Clinic within the Musculoskeletal Institute.
He adds that anyone concerned about their risk of fracture can visit the clinic without a referral and mentions that the following populations may be at higher risk for fragility fractures:
- Individuals with a family history of fractures
- Individuals with a history of eating disorders
- Individuals with a history of smoking or excess alcohol use
- Individuals with a history of long-term glucocorticosteroid treatment
- Post-menopausal women, or those over the age of 65
- Men over the age of 70
Dr. Guzman recommends that patients at risk for fragility fracture monitor their bone health over time by receiving a DEXA scan every few years. Short for Dual X-Ray Absorptiometry, this imaging technique can quantify the density of calcium and other minerals in the bone. A lower bone density is associated with a higher risk of fragility fracture.
Other services related to fracture prevention at the Musculoskeletal Institute include laboratory services and consultations regarding medication and nutrition. The team, also consisting of nutritionist, social workers, physical therapists, can also coordinate referrals to other specialists such as endocrinologists and rheumatologists to best address a patient’s condition.
Bone Health at any Phase of Life
Noel and Dr. Guzman note that the value of fracture prevention is not limited to select patient populations and offer the following measures to promote lifelong bone health:
- A balanced diet that includes vitamin D and calcium
- Exercise, especially weight-bearing activities and those targeted at improving balance
They also recommend consulting a physician to address serious bone health worries. “Regardless of a person’s age, if they have any concerns regarding bone health, they should come in and seek us out,” says Dr. Guzman.