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Lovely bones

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Lovely Bones

People with MS have a greater risk of developing thinning of the bones (osteoporosis). As there are often no symptoms, it may only be discovered when you break a bone in a minor accident. MS nurses Pauline Shaw and Debbie Quinn put together these tips for keeping your skeleton healthy and strong.

1. Take regular exercise

Regular, moderate weight-bearing or resistance (for example using weight equipment in a gym) exercise not only keeps bones strong but may also improve bone strength. Exercise that focuses on balance and coordination will improve core stability and reduce the risk of falls.

If you can, it’s good to get a variety of exercise. Walking, dancing, gardening and even housework are all good ways of exercising. Tai chi, Pilates and yoga are gentle, low-impact forms of physical activity that can improve flexibility, strength and coordination. Joining a local keep-fit class can make it more fun and help with motivation.

If you have difficulty exercising, a physiotherapist can give advice on suitable exercises and equipment to improve walking and balance. For more advice see the book Exercise and Osteoporosis available from the National Osteoporosis Society at www.nos.org.uk.

2. Eat a healthy, calcium-rich diet

Eating a balanced diet and maintaining a healthy weight is good for your general health but eating calcium-rich foods in particular will help maintain your bone density.

Calcium is essential to keeping bones and teeth strong as well ensuring your muscles and nerves work well.

The daily recommended amount of calcium is 700 mg for adults. Most people should be able to get this from their diet. Good sources of calcium include:

  • low-fat milk, cheese, yoghurt and other dairy foods
  • green leafy vegetables, such as broccoli, cabbage and kale (but not spinach)
  • soya beans
  • tofu
  • soya drinks with added calcium
  • nuts and seeds
  • bread and anything made with fortified flour
  • fish where you eat the bones, such as sardines and pilchards or canned salmon
  • tap water (particularly in hard water areas)

3. Get lots of sunshine and vitamin D

Vitamin D is vital to help the body absorb calcium. We get most of our vitamin D from sunlight on our skin. Most people can get enough vitamin D by exposing their face and arms to sunlight for 5-15 minutes daily during the summer months. However, if you are out in the sun take care to cover up or protect your skin with sunscreen before you turn red or get burnt.

Your body stores enough vitamin D to keep your bones healthy through the darker winter months.

Small amounts of vitamin D are found in some foods including oily fish, such as salmon and sardines, and cod liver oil. Lower amounts are found in eggs, fortified fat spreads and breakfast cereals and in powdered milk.

To maintain bone health, the Department of Health recommends a daily 400 IU (10 micrograms) vitamin D supplement for:

  • pregnant and breastfeeding women
  • people aged 65 and over
  • people with low sun exposure such as those who stay indoors a lot, or cover up when outside

4. Stop smoking

Smoking is associated with an increased risk of osteoporosis. People with MS who are at risk of osteoporosis are encouraged to cut down or stop smoking completely. Your GP can give you information on local stop-smoking services.

5. Cut down on your alcohol

A high alcohol intake reduces your body’s ability to produce new bone material and can increase risks of falls.

6. Avoid falls

You can reduce the risk of falling by checking your home and work environment for hazards you may trip over, such as trailing wires. You can find more suggestions in the free MS Trust publication Falls: managing the ups and downs of MS.

 

What else might make your bones weaker?

Family history

If you have a family history of osteoporosis or a parental history of hip fracture, you may be at greater risk of developing osteoporosis, so make sure your GP and other health professionals are aware of this.

MS symptoms

Several of the more common symptoms of MS make you more likely to fall, including fatigue, visual problems, mobility and balance, bladder and bowel problems, concentration and forgetfulness. An occupational therapist or MS nurse can help you manage these symptoms.

Medication

Some drugs such as steroids, anti-epileptic drugs (often used in MS to treat pain) and certain antidepressant drugs can affect your bones and increase the risk of osteoporosis. Talk to your neurologist, MS specialist nurse or GP and do not stop any medications until advice has been given.

Concerned about your bone health?

Talk about your concerns and any risk factors with your GP, MS nurse or neurologist and ask for referral to a bone specialist who can carry out further tests and give advice on any treatments that may be necessary.

We also publish a couple of books that might be of interest:

Falls: managing the ups and downs of MS includes tips and suggestions for avoiding falls.
Living with fatigue looks at ways you can manage your energy levels so that you can avoid falling when tired.

This article is from our free quarterly newsletter, Open Door. Sign up to receive your copy by post or email, or read the latest edition in full.