Associated changes in body shape and consequences
KYPHOSIS
The "Dowager's hump" caused by
vertebral compression fractures is disfiguring. This is
the feature of osteoporosis that is identified by most
patients. The hump causes difficulty in finding clothes
that will fit, let alone look attractive. In severe
cases, the ribs contact the iliac crest and movement
causes pain.
HEIGHT LOSS
The height loss associated with
osteoporosis is one of the aspects of the disease that
is most distressing to many women. They have trouble
reaching high shelves, driving the car, and are at
greater risk for airbag injuries.
PROTRUDING
ABDOMEN
The protruding abdomen which is a
result of the kyphosis is an unrecognized aspect of
osteoporosis. Women do not realize that the curvature of
the spine decreases the abdominal space, and thus the
intestines have nowhere to go except forwards. Many
women think that they are getting fat, and they go on a
diet trying to regain their youthful waistline. If they
do successfully lose weight, it will only increase their
risk for more osteoporotic fractures. It is important
for the physician to explain to the patients that the
protruding abdomen is a consequence of kyphosis, and
that other women with osteoporosis also really dislike
this feature of the disease. Some abdominal
strengthening exercises which do not place stress on the
back can sometimes be helpful, but the patients must not
expect the protruding abdomen to go away. A better
approach is to learn to wear fashions that will not
emphasize the waistline. (Figure 4)
DECREASED
PULMONARY CAPACITY
Patients with kyphosis have
decreased lung volumes. In severe cases this leads to
shortness of breath and pulmonary symptoms of
restrictive lung disease.
REFLUX
ESOPHAGITIS
Patients with kyphosis may develop
reflux esophagitis due to the changes in abdominal
space. Wearing tight clothing can exacerbate the
problem.
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