Osteoporosis

Yes.

Please send it to us, ideally, before your first appointment. Your physio will write to your GP after the first visit to detail how we will work together with you to address your issue. At the end of treatment program, your physio will write again to the GP with a discharge summary.

Chronic Disease Management plans allow you a Medicare rebate for up to 5 visits over a 12 month period. You can choose which health professional you use those visits at. The 5 visit total is across all allied health disciplines though, unfortunately. So if, for example, you need to see a dietician and a physio for your condition, those 5 visits will be shared between the 2 practitioners.

If you use a care plan to subsidise your physio treatment, you cannot also use your private health fund for the same visit. Rehabilitation for complex conditions usually take greater than 5 visits to manage, and so if you have private health cover, you can use this to subsidise the treatments once you have used up your care plan.

No.

We provide at least a 30 minute appointment and up to 60 minutes for pelvic floor condition assessments. There is also associated paperwork which is a compulsory government requirement.

Medicare rebates do not adequately recompense for this time spent.

The gold standard measurement to diagnose osteoporosis is a DXA scan. The diagnosis of your bone health will be based upon a T-score. This score is essentially how many standard deviations your bone density is away from healthy young adult population average.

Normal = T-score of greater than -1
Osteopenic = T-score between -1 and -2.5
Osteoporosis = T-score below -2.5

The most common diagnostic scans are typically done at the hip and spine but sometimes the forearm as well if either of other regions has osteoarthritis or other joint conditions.

In Australia, 1 in 4 women over the age of 50 are osteoporotic and this grows to 1 in 2 women over the age of 80. In fact, 66% of Queenslanders over the age of 50 have low bone mass.

According to the Australian Institute of Health and Welfare website (last update 17th June 2024), around 853,600 (3.4%) people in Australia were estimated to be living with osteoporosis or osteopenia, according to self-reported data in the 2022 Australian Bureau of Statistics (ABS) National Health Survey (NHS) (ABS 2023).

In 2022, the prevalence of osteoporosis and osteopenia collectively:

• increased substantially with increasing age, from 0.7% of people aged 35–44, to 17% of people aged 75 and over
• was higher among women compared with men (5.5% and 1.1%, respectively)
• was highest for women aged 75 and over (26%)
• changed little by remoteness or level of disadvantage (also known as socioeconomic area) (ABS 2023).

After adjusting for different population age structures over time, the prevalence of osteoporosis increased from 1.6% in 2001 to 2.7% in 2022 (ABS 2023)

Exercise is the only form of treatment that will help with maintaining or improving bone mass whilst also helping to improve balance and spatial awareness to reduce the likelihood of falls.

Genetic predisposition is the most influential factor when it comes to bone health. However, there are modifiable risk factors including physical activity and diet.

Osteoporosis is largely a preventable disease. Risk factors associated with the development of osteoporosis include increasing age, being female, family history of the condition, low vitamin D levels, low intake of calcium, low body weight, smoking, excess alcohol consumption, physical inactivity, long-term corticosteroid use and reduced oestrogen level (Ebeling et al. 2013).

Primary prevention of osteoporosis involves taking calcium and vitamin D supplements, behaviour modification such as regular weight-bearing and resistance exercise, keeping alcohol intake low and not smoking, and fall reduction strategies, such as addressing vision impairment or making home modifications (RACGP 2018).

The goal of the prevention and treatment of osteoporosis is to maintain bone density and reduce a person’s overall fracture risk (RACGP 2018).

The earlier you get onto improving your bone health the better.

Your bones rapidly grow during childhood and adolescents, so this is the most important time to build your ‘bone bank’, your bone mass continues to increase and consolidate until you hit peak bone mass which typically occurs by the time you hit 30 years of age.  There is then a steady age-related loss of bone; this is greater in women than in men due to menopause.  For women, around 40% of your peak bone mass is lost by the age of 80. Whereas, the lifetime loss in men is around 25% of your peak bone mass, the bone loss in men is a relatively steady process but it accelerates after 70 years of age.

Osteopenia is also known as low bone mass, this is the range between normal bone mass and osteoporosis. This is considered a warning zone for action to maintain and if possible build your bone mass.

Osteoporosis is defined by the world health organisation as a disease characterised by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. It is typically known as a silent disease, as it is often not picked up until it is too late and a fracture occurs.

The most common fracture sites are the hip (which typically occur after a fall), spine (this type of fracture is normally an insufficiency fracture) and the wrist (these tend to occur earlier in life and can be the first sign of low bone mass).