Falls on ice, especially while carrying grocery bags and packages, and improper snow-shoveling techniques – putting stress on the back and neck rather than on the legs — remain among the more obvious sources of spinal stress, injury, and pain.

In fact, a 17-year study published in the American Journal of Emergency Medicine, estimates 11,500 snow-shoveling-related injuries are treated in United States hospitals annually, with more than 50 percent of them caused by ‘acute musculoskeletal exertion’ and another 20 percent, slips or falls. Adding to spinal dangers are those occasions when pushing a car out of a snow rut or climbing a ladder and reaching up precariously to hang December holiday lights.

Many people also are unaware that the very coldness of winter temperatures takes a toll on the spine when outdoors. Muscles tend to tighten in the frosty weather and symptoms of chronic conditions – like sciatica, which is a painful compression of nerve roots in the lower back, and degenerative arthritis of the spine – can become a bit more acute.

A study appearing in the European Journal of Pain reports surveying nearly 6,600 people in Finland and finding that 50 percent of respondents experienced some form of musculoskeletal pain at temperatures of about 7 degrees Fahrenheit. Another study, published in the International Archives of Occupational and Environmental Health and focused on Swedish construction workers, indicates that those working regularly outdoors in winter temperatures are at increased risk for developing neck and lower back pain.

The spine is a complex, columnar structure, whose myelin sheath, secured by bony vertebrae, protects the central nerve bundle linking communication between the brain and the rest of the body. Injury at any point along the length of this structure can have serious, life-changing consequences, including chronic, debilitating pain; loss of sensation; compromised physical or mental functions; decreased quality of life; and even death. Experts say the lumbar region – lower back – is the most frequently traumatized area of the spine. Spinal injuries can include stretched or damaged muscles and ligaments supporting the spine, rupture of one or more spinal discs, spinal and cervical fractures, and, in the most serious cases, paralysis.

Based on research published in a 2022 edition of Spinal Cord, the authors write, “Worldwide, traumatic spinal cord injuries have a considerable impact in terms of mortality and morbidity and represent a relevant burden for health care systems due to the expensive and complex medical support required by patients with spinal cord injury, in addition to [the] economic consequences deriving from loss in productivity. This condition is a leading cause of disability especially among younger people, with a high impact on years lived with disability.”

Of particular concern to me are winter activities – like sledding – that many people consider “innocuous” and often engage in without protective gear, such as helmets. A 2018 University of Wisconsin study in the Journal of Neurosurgery debunked theories that the “weight and bulk” of helmets make the wearers’ necks more prone to cervical fractures. The scientists, instead, determined that helmets significantly reduce instances of cervical fractures in crashes.

Although the Wisconsin study focused on motorcyclists, the American Academy of Orthopaedic Surgeons has recommended fitted helmets – at least for children under age 12 — in its guidelines for sledding safety. The organization also suggests sliding down snow hills, whether by sled, inner tube, or other method, be done in a sitting position facing forward, and in an area free of hazards like trees, streets, parking lots, or ponds.

Meanwhile, a much earlier study in the Journal of Trauma and Acute Care Surgery suggests even the sitting position predisposes tobogganers to spinal injury if they are thrown off the board or hit a hard bump on the way down.

And experts dismiss skiers’ claims that helmets obstruct the field of vision as simply an “excuse.”

Of course, people cannot expect to eliminate all winter hazards from their lives, but I offer these tips to minimize risks and help keep wintertime as safe as possible:

• Stretch and do some warm-up exercises before engaging in strenuous outdoor activities like clearing snow from the porch or driveway.

• Follow all guidelines for shoveling snow. That means putting all the lifting stress on the back, pushing rather than lifting snow whenever possible, avoiding throwing snow up and over the head and back, and taking frequent breaks.

• Use protective gear, including a helmet, when enjoying winter activities and sports like tobogganing, sledding, skiing, and ice skating.

• Wear warm clothing and dress in layers during cold temperatures outdoors. Make sure the lower back is covered. Tuck shirt into your pants. Footwear should be conducive to safe walking on snow and ice.

Stay active in the winter, despite the temptation to cocoon on the couch. Walking or swimming at a local indoor pool are great ways to maintain the strength of one’s core and back muscles.

But should you experience any type of back pain or suspected cervical or spinal injury following activity, contact an orthopedic specialist as soon as possible to minimize the risk of developing a more serious or chronic condition.

Atlantic Spine Center is a nationally recognized leader for endoscopic spine surgery with several locations in NJ and NYC. www.atlanticspinecenter.com

Kaixuan Liu, MD, PhD, is a board-certified physician who is fellowship-trained in minimally invasive spine surgery. He is the founder of Atlantic Spine Center.

1. Smoking

Smoking increases brain activity that makes people less resilient when it comes to responding to back pain. Smoking also causes premature aging of discs by decreasing blood supply to the discs in the back, thus leading to pain in the lower back.

2. The incorrect mattress

Old mattresses start to form dips from years of use. The dips in the mattress cause the spine to curve, leading to constant stiffness or pain. A mattress that is too firm can cause strain on pressure points in the knees, hip, shoulders, and back, which can cause backaches. If the mattress is too soft, your spine is not supported well enough, and the spine can fall out of alignment.

3. Your purse or wallet

Structural imbalances in the spinal column can occur when you sit on your wallet. This can happen because one side of your body is higher than the other, and an excess amount of physical stress is placed on the lower spine. This can lead to lower back pain and numbness. Carrying a heavy purse or bag on one shoulder can also cause a neck and spinal tilt that can lead to backaches. Remove your wallet from your back pocket when you are sitting down, and regularly switch your purse from one shoulder to another. 

4. Your wardrobe

There are unexpected items in your wardrobe that could be causing your back pain. Skinny jeans, heavy bags, strapless bras, high heels, and backless shoes are all clothing items that may be influencing your pain. Try to limit the amount of time you spend in these clothes to promote optimal wellness.

5. Dehydration

When you are dehydrated, the spinal discs lose water, and your spine is in distress. When this happens, the spine takes on the full shock of your movements, which can lead to pain. Avoid drinks with caffeine and drink plenty of water to avoid dehydration.

6. Your cell phone

Constantly hunching your neck over to look down at your phone compresses and tightens the muscles and tendons in the front structure of your neck. This creates imbalance and results in reduced mobility, shoulder and neck pain, a curvature formation at the upper back, and even headaches.

7. Incorrect ergonomic work set up

Many people have been working from home due to the pandemic. Working from home has led to slouching and hunching in front of our handheld laptops or work from home setups. Slouching can lead to neck and shoulder pain, back problems, and stiff hips. Make sure to sit all the way back in a computer chair and keep your thighs horizontal to your knees at hip level.www.nynjspine.comGbolahan Okubadejo, MD, FAAOS, leads The Institute for Comprehensive Spine Care, with offices in the greater New York City area, as a spinal and orthopedic surgeon. Board-certified and fellowship-trained, Dr. Okubadejo specializes in the treatment of degenerative spinal disease, spinal deformity, and cervical, lumbar, and thoracic conditions.Dr. Okubadejo earned his undergraduate degree at Brown University in Providence, Rhode Island, and his medical degree at Johns Hopkins University School of Medicine in Baltimore. He completed his internship and orthopedic surgery residency at Barnes-Jewish Hospital at the Washington University School of Medicine in St. Louis. Dr. Okubadejo completed a spinal surgery fellowship at the University of Pittsburgh Medical Center in Pittsburgh.Dr. Okubadejo is a published research author and has presented his findings at several major spinal conferences around the globe. While a surgical resident, he won the Leonard Marmor Surgical Arthritis Foundation Resident Award for the best research project. In 2017, Dr. Okubadejo formed the company 360 Dynamized Core, which is focused on creating innovative, spine-safe core fitness products and routines. The first patented product, 360 CoreBoard, launched to the market in 2020. Find out more at 360coreboard.comDr. Okubadejo believes in the power of preventive care, minimally invasive surgical procedures, open communication with patients, and personalized care. When he’s not caring for patients, he enjoys traveling, learning about different cultures and the arts, and playing golf.

The spine is made up of bones (vertebrae) stacked on top of each other, with jelly-filled discs that act as cushions between the vertebrae. Its natural shape is a gentle S-curve that leaves room for nerves and blood to run smoothly through the spine’s central canal. With the support of muscles and ligaments, the spine is designed to support the entire body evenly. When the spine’s alignment is compromised. the body tries to compensate for the imbalance by bending or flexing the spine and hips and tensing the muscles of the calves, hips, and back. This is a recipe for fatigue and strain and uneven wear and tear on back ligaments, joints, and vertebral discs.

There are many ways to hurt your back. Poor diet, lack of exercise, and lazy posture contribute as do the way you sit, turn, and lift. But high heels, worn regularly over years, also can play a significant role in causing changes to the anatomy like thickening tendons, shortened calf muscles, even curvature of the spine. Other problems include sciatica or pinched nerves, muscle spasms, and displacement of parts of the upper spine that cause the back and shoulders to hunch forward. 

There are two primary anatomical reasons that high heels can cause back pain. The first is that high heels force all the muscles from your foot to your back to tighten. The plantar fascia, one of the main ligaments of the foot, forms the arch on the sole of your foot. It connects to the calf muscles which connect to the hamstrings which connect to the pelvis and lower back. So when your shoe causes the plantar fascia to stretch, everything from your foot to your back tightens up putting strain on the lower back and causing pain.

The second anatomical problem is that wearing high heels forces you to walk on the balls of your feet. In flat shoes, your weight is evenly distributed across the foot. But in heels, your weight and center of gravity are shifted forward, the upper body has to lean back to maintain balance, and the resulting prolonged arching causes back pain.

Wearing high heels alters the shape of your spine, and it can’t do its proper job of absorbing shock when you walk. Over time, uneven wear on vertebral discs, joints, and ligaments causes pain.

The best way to reduce or avoid damage from high heels is to stop wearing them. But unless you already have serious back problems, you don’t have to give them up entirely. You can do a few simple things to reduce the strain on your feet and spine. I recommend these tips:

• Stretch before and after wearing high heels. Stretching the plantar fascia and calf muscles will loosen the hamstrings and reduce the risk of back pain. Try rolling your foot on a golf ball or get a professional foot massage like reflexology.
• Avoid wearing high heels every day. Try alternating days with flats or lower heels.
• The higher the heel, the more the risk of damage. Avoid heels more than 2 inches high. If you must wear higher heels, do so only for limited periods.
• Choose shoes with rounded rather than pointed toes. Make sure your shoes fit properly and have leather insoles to reduce slipping.

You don’t have to live with pain or the risk of permanent damage to be fashionable. Pay attention to your body. Don’t let minor discomfort escalate to a serious problem. Treat your feet and back well and they’ll support you for the long haul.

Atlantic Spine Center is a nationally recognized leader for endoscopic spine surgery with several locations in NJ and NYC. http://www.atlanticspinecenter.com, www.atlanticspinecenter.nyc

Kaliq Chang, MD, is an interventional pain management specialist board-certified in anesthesiology in practice at Atlantic Spine Center. 

There’s a great deal of focus on the obesity-related conditions – heart disease, stroke, type 2 diabetes, and certain cancers – that are among the leading causes of preventable, premature death, but often overlooked are the effects obesity can have on the spine. Excess weight places a great deal of additional strain and pressure on back and spine tissues. It shifts your center of gravity and taxes all of the muscles and joints at the core of the body.Back pain is often attributed to the normal effects of aging. While it is true that aging tends to weaken the spinal column – the stack of bones (vertebrae) and gel-filled cushions between them – excess weight accelerates the process, triggering a range of spinal disorders:

• Disc degeneration occurs when the discs between the vertebrae weaken, they lose moisture, and begin to collapse.
• Herniated disc, also known as a ruptured or slipped disc, occurs when a tear in the tough outer layer of the disc allows some of the soft inner material to protrude out of the disk. If the protruding material compresses a nerve, the symptoms of a herniated disc are felt wherever that nerve travels.
• Spinal stenosis is a narrowing of the spinal canal that can compress the nerves that travel through the spine.
• Osteoarthritis, which occurs when the protective cartilage that cushions the ends of the vertebrae wears down, can be triggered or exacerbated by excess weight putting additional stress on the spine.

The spine is designed to support the body’s weight but excess weight makes it difficult for the spine to do its job properly and these conditions cause a variety of troublesome symptoms including chronic pain, numbness, and tingling in the neck, back, arms or legs.It isn’t always possible to eliminate wear and tear on the back, but there are steps you can take to reduce your risk. These include general best practices for good health including weight management, regular exercise, and not smoking.Maintaining a healthy weight or losing weight can reduce stress on the spine and other joints as well. Losing just four pounds reduces 16 pounds of pressure on the spine. But losing weight is not the only avenue to improved back health.I want to highlight these important factors:

• Regular exercise – cardiovascular exercise and weightlifting – strengthen the supporting muscles of the back, pelvis, and thighs and activities like yoga and tai chi stretch the muscles and improve flexibility. Exercise can also improve posture and improve the unnatural curvature of the spine that often results from obesity.
• Good nutrition can also help your spine. Foods that are high in calcium and vitamin D, such as dairy foods and leafy green vegetables, can help prevent the bones in your spine from becoming thin and brittle.
• Use proper lifting techniques. Do not bend at the waist. Bend your knees while keeping your back straight and use your strong leg muscles to help you support the load.
• Practice good posture when walking, sitting, standing, and sleeping. For example, stand up straight with your shoulders back, abdomen in, and the small of your back flat. Sit with your feet flat on the floor or elevated. Sleep on a firm mattress and sleep on your side, not your stomach.
• Stretch often when sitting for long periods of time.
• Do not wear high-heeled shoes.

Obesity takes a toll on the spine, and as more and more adults are carrying excess weight, we are seeing an increase in spinal disorders, particularly those that cause lower back pain. The best remedy is to lose weight but the good practices I’ve outlined can also improve back health for everyone at any weight.Atlantic Spine Center is a nationally recognized leader for endoscopic spine surgery with several locations in NJ and NYC. http://www.atlanticspinecenter.com, www.atlanticspinecenter.nycKaixuan Liu, MD, PhD, is a board-certified physician who is fellowship-trained in minimally invasive spine surgery. He is the founder of Atlantic Spine Center. 

Loss of bone mineral density (BMD) – the condition known as osteoporosis – is one way bones can become fragile, and screening patients for osteoporosis is the current standard for determining fracture risk in older adults. However, low bone mineral density is not the only cause of bone fragility, and the majority of older adults who sustain a fragility fracture do not meet the diagnostic criteria for osteoporosis. Physicians currently lack validated means of assessing fracture risk in these patients.

In the largest prospective study of its kind, researchers from Beth Israel Deaconess Medical Center (BIDMC) and the Institute for Aging Research at Hebrew SeniorLife used high-resolution tomography imaging to assess whether other bone characteristics besides bone mineral density can be used to determine fracture risk.

COMPACT BONE VS. SPONGY BONE

The team found that assessing the microstructure of the two different types of bone tissues – compact bone and spongy bone – may be useful to predict the incidence of fragility fractures in those who would not otherwise be identified as at risk. The study is published today in The Lancet Diabetes and Endocrinology.

“Older women are at particularly high risk of fracture. In fact, the number of women who will experience a fragility fracture in any given year exceeds the number who will experience a first-time stroke, breast cancer or myocardial infarction combined,” said co-lead author Mary L. Bouxsein, PhD, Director of the Center for Advanced Orthopedic Studies at BIDMC. “Improved methods to identify those in whom fractures are common but whom standard clinical testing does not identify as high risk would allow us to target treatment to this important group and ultimately reduce fracture burden.”

MORE THAN 7,000 OLDER WOMEN  WERE IN THE STUDY

The multi-national study included more than 7,000 older women and men from five North American and European countries. Participants – eight research cohorts at the Mayo Clinic, the Framingham Study in Massachusetts and sites in France, Canada, Switzerland and Sweden that comprise the Bone Microarchitecture International Consortium – underwent scanning measurements of the bones of the arms and legs.

While just eight percent of participants met the diagnostic criteria for osteoporosis, 11 percent of participants experienced a fracture.

Those who experienced fracture were more likely to be older, female, have a lower BMI, use osteoporosis medications and have a previous fracture. Participants who sustained fractures had worse bone measurements for nearly all parameters compared to those who did not fracture.

The scientists’ analysis demonstrated that several measures of bone density and structure at different sites on the bone – including the density of the compact bone tissue and the thickness of the spongy bone tissue at the wrist – were predictive of fracture. Failure load, the stress under which bone begins to fracture, was the bone characteristic most strongly associated with risk of fracture.

DEFICITS IN DENSITY AND STRUCTURE THROUGHOUT THE BONE

“Results from this large international cohort of women and men suggest deficits in density and structure throughout the bone contribute to fracture risk independently of bone mineral density and current risk assessment tools”, said Lisa Samelson, PhD, who is an epidemiologist at the Institute for Aging Research at Hebrew SeniorLife and Harvard Medical School, and lead author of the study. “Further, assessment of these bone characteristics may be useful in those who would not otherwise be identified as being at high risk for fracture.”

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Additional authors include co-senior authors Douglas P. Kiel of the Institute for Aging Research at Hebrew SeniorLife; Serkalem Demissse of Boston University, and Claes Ohlsson of the University of Gothenburg, Sweden. A complete list of contributors is available online at http://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30308-5/fulltext

This work was supported by the National Institutes of Health (NIH) (National Institute of Arthritis Musculoskeletal and Skin Diseases [NIAMS], R01AR061445; National Heart, Lung and Blood Institute [NHLBI] Framingham Heart Study, Contract No. N01-HC-25195, (HHSN268201500001I). Additional support was provided by Friends of Hebrew SeniorLife and a research grant from the Investigator Initiated Studies Program of Merck Sharp & Dohme.

More than 600,000 knee replacements are performed annually in the U.S., according to The Journal of Bone & Joint Surgery. That number is expected to swell to 3 million by the year 2030, the publication’s study reported, partly because people are working longer and obesity is on the rise.

But while knee replacements are becoming a popular elective surgery, some studies estimate 20 percent or more of recipients aren’t pleased with the result. Medical experts question whether replacement surgery is being done too soon – or whether some people need a new knee at all.

SURGERY SHOULD BE A LAST RESORT

Surgery should only be done as a last resort. A knee replacement can be life-changing, but they can also be painful, wear down prematurely and become infected.

If you have debilitating pain and difficulty walking because of degenerative arthritis, surgery may be your best option no matter your age. Otherwise, there are sound reasons to avoid a knee replacement, or at least to postpone it until a more appropriate time.

THREE REASONS TO AVOID OR DELAY KNEE REPLACEMENT SURGERY

• Plastic debris. A total knee replacement consists of metal moving on plastic. The plastic wears down over time, and that can be a pain – physically and financially – to patients who may have to get the prosthesis replaced once, twice or more. The plastic debris accumulates in the knee joint. The more active you are, the heavier you are, the more debris. The white cells, which attack foreign invaders, start attacking the surrounding bone. When it’s time to replace the plastic joint, we also have to replace the bone – and that’s a significant and unpleasant surgery.
• A prosthesis doesn’t last 30 years. This is a key reason why I think younger replacement candidates should wait as long as possible. A total joint replacement in a 70-year-old patient will typically last 15 years. With the average life expectancy being 85, chances are this would be the only knee replacement that patient would need. But for a 40-year-old who’s more active, it may only last 10 years. And remember, recovery is challenging. So it’s better to wait for technology to catch up. As it does, the better the knee replacements will be.
• Other remedies may work. Many people experiencing chronic knee pain are overweight or obese. A healthy diet and exercise program can bring the weight down and take pressure off the knees. Also, a hinged knee brace, supplements that aid in repairing worn cartilage, and injections such as cortisone or hyaluronic acid could reduce pain and restore quality of life.

There are ways to at least buy time. And there are patients who were told they needed a knee replacement, but with conservative therapy options, happily discovered otherwise and returned to their favorite activities without pain.

Dr. Victor Romano (www.romanomd.com) is an orthopedic surgeon in Oak Park, Ill., and the author of Finding The Source: Maximizing Your Results – With and Without Orthopaedic Surgery. He is board-certified in orthopedics and sports medicine with over 25 years of experience in the field. He graduated cum laude from the University of Notre Dame and completed medical school at the University of Loyola-Chicago.

Although hip replacement surgery is great at relieving pain and restoring mobility, dislocation is a common complication of the procedure. The risk of this is highest in patients who have had a second hip replacement, and that procedure is known as “revision surgery.”

Now, though, research conducted by Dr. Geoffrey Westrich and colleagues at Hospital for Special Surgery, in New York City, and other joint replacement centers indicates that a newer type of artificial hip known as a “modular dual mobility” implant could be a good choice for patients who need a revision surgery.

The study represents good news for patients who need to have their original hip replacement taken out.

Their study was presented at the annual meeting of the American Association of Hip and Knee Surgeons in Dallas.

“Although the concept of dual mobility was originally developed in France in the 1970s, the technology is relatively new in the United States,” said Westrich, director of research of the Adult Reconstruction and Joint Replacement Service at HSS. “Our study found that the newer technology with modular dual mobility components offered increased stability, lowering the risk of dislocation, without compromising hip range of motion in patients having a revision surgery.” (See “Better Hip Replacements.”)

“Currently, there are few large-scale outcome studies on the modular dual mobility device in revision hip replacement,” Westrich said. “We set out to determine the rate of dislocation and the need for another surgery following revision hip replacement using this implant.”

The investigators’ study included 370 patients who underwent revision hip replacement with the dual mobility implant between April 2011 and April 2017. The average patient age at the time of surgery was 65.8 years. Clinical, radiographic and patient reported-outcome information was collected.

To be included in the final report, patients needed to be seen for follow-up for at least two years after their surgery, and the average follow-up was 3.3 years. “At the latest follow-up, we found that surgery with the dual mobility implant resulted in a very low rate of instability for the revision patients, namely 2.9 percent, with good functional improvement and a low rate of reoperation,” Westrich noted. “While longer-term follow-up is needed to fully assess the newer device, in our study there was clearly a benefit provided by the dual mobility implant in the first few years following revision surgery.”

And many foods contain more than one top bone health nutrient. Whole foods that are unprocessed and organic are best, since pesticides inhibit the growth of nutrients within a plant. It’s also recommended that we regularly alter our menu choices to derive bone health nutrients from a wide variety of foods.

Following are the seven top nutrients for bone health and the foods that are highest in each.

TOP BONE HEALTH NUTRIENT: VITAMIN D

Dried Shiitake Mushrooms, Mackerel, Wild Sockeye Salmon, Canned sardines, Tuna, Eggs

TOP BONE HEALTH NUTRIENT: MAGNESIUM

Bean sprouts, Collard greens, Organic corn, Kale, Oats, Wild Rice

TOP BONE HEALTH NUTRIENT: CALCIUM

Collard Greens, Kale, Spinach, Dandelion Greens, Seaweed (like Hijiki) and Sea Vegetables, Black beans, Nuts and Seeds (Almonds, Brazil Buts, and Black Sesame Seeds, among others), Yogurt

TOP BONE HEALTH NUTRIENT: MANGANESE

Artichokes, Asparagus, Beet Greens (tops), Rye, Avocados, Blackberries and Blueberries

TOP BONE HEALTH NUTRIENT: BORON

Avocados, Broccoli, Celery, Dried Parsley

TOP BONE HEALTH NUTRIENT: ZINC

Alfalfa sprouts, Brussels Sprouts (cooked), Black and Pinto Beans

TOP BONE HEALTH NUTRIENT: VITAMIN K

Cabbage (all colors), Beef (grass-fed only), Natto (Japanese fermented soy)

According to a news release from Duke University Medical Center, although such problems can diminish with the return of full mobility, the findings indicate that patients and doctors should be prepared to manage a variety of complications over time, even as the surgeries themselves are considered a success.

“Our study focused on a younger group – current and former military personnel ages 18-50 – and compared their medical records both before and after surgery,”

said Daniel Rhon, D.Sc., an adjunct professor at the Duke Clinical Research Institute and lead author of a study published online Sept. 28 in the British Journal of Sports Medicine.

“Even among this younger group, the number and frequency of these hidden complications that arose after elective hip surgery suggests we should be taking a more wholistic approach, proactively assessing patients for risks other than the standard surgical complications we more commonly look for,” Rhon said.

Rhon and colleague – including senior author Chad Cook, Ph.D., program director of Duke’s Doctor of Physical Therapy Program – conducted the observational study by examining Military Health System records of 1,870 former and current service members undergoing arthroscopic hip surgery between 2004-2013. Patient records were collected for the 12 months prior to and 24 months after surgery.

In their analysis, they identified incidences of mental health disorders, chronic pain, substance abuse issues, cardiovascular ailments, metabolic syndrome, arthritis and sleep problems that were noted in the patients’ medical records both before and after their elective hip surgeries.

The number of ailments increased sharply after the procedure: mental health disorder increased 84 percent; chronic pain diagnoses soared 166 percent; substance abuse ticked up 57 percent; cardiovascular disorders rose 71 percent; metabolic syndrome cases rose 86 percent; arthritis spiked 132 percent; and sleep disorders jumped 111 percent.

“Hip arthroscopy is becoming more common even among younger people, and it can be quite successful in resolving chronic, painful conditions,” Cook said. “But it’s important to be prepared for a lengthy recovery. These are surgeries where people are prohibited from fully bearing weight for several weeks, so they can’t exercise, they can’t sleep comfortably, they are in pain.”

Rhon said disruptions in sleep can be particularly problematic. Without proper rest, the sense of pain escalates, leading to a negative spiral of fatigue and pain that then depresses mood, energy levels and general health.

“These issues are compounding on each other,” Rhon said. “Our study serves as an important alert to both doctors and patients. Armed with this knowledge, we can be vigilant in addressing these problems earlier and potentially stopping others from developing.”

A release from the university explains that brittleness of the bones, or osteoporosis, is characterized by porous and weak bones, which can cause them to break even when subjected to low loads, such as a fall from standing height. The proportion of the population with osteoporosis increases with age, and a majority of women over 80 years of age have the disease.

The release quotes Mattias Lorentzon, a chief physician and professor of geriatrics at Sahlgrenska Academy, University of Gothenburg, as saying, “Today there are effective medications administered to treat osteoporosis, but because bone fragility is rarely detected before the first fracture, there is a pressing need for preventive treatments,”

This is the first time that researchers have shown that it is possible to cut age-related bone loss in elderly women in half if they receive health-promoting bacteria, known as probiotics.

Double-blind, randomized study

The study was conducted at Sahlgrenska University Hospital in Mölndal, Sweden. Ninety elderly women, 76 years old on average, ingested a powder that contained either health-promoting bacteria or a placebo every day for a whole year. A random method determined which women received the active treatment with the Lactobacillus reuteri 6475 bacteria and which received powder without bacteria. Neither the researchers nor the women knew who received the active powder during the study.

“When we finished the study after a year, we measured the women’s bone loss in their lower legs with a CT scan and compared it with the measurements we made when the study began. The women who received the powder with active bacteria had lost only half as much bone in the skeleton compared with those who received inactive powders,” says Anna Nilsson, a chief physician and associate professor at Sahlgrenska Academy, University of Gothenburg. “Another positive outcome from the study was that the treatment was well tolerated and did not produce more side effects than those experienced by women who received the placebo.”

A paradigm shift

Research has shown that intestinal bacteria affect the skeleton in mice, but this is the first study in which probiotics were used to reduce bone loss in older people. The discovery could have important implications in the future: “Older women are the group in society most at risk of osteoporosis and fractures. The fact that we have been able to show that treatment with probiotics can affect bone loss represents a paradigm shift. Treatment with probiotics can be an effective and safe way to prevent the onset of osteoporosis in many older people in the future,” says Mattias Lorentzon.

Lactobacillus reuteri 6475 is a bacterium believed to have multiple health-promoting properties, and similar bacteria are already used in a variety of supplements on the market. The bacterium is naturally found in the human gastrointestinal tract. Bacteria in the stomach and intestine have received considerable attention in recent years because there is evidence that the composition of our bacterial flora is associated with diseases such as diabetes and obesity. The mechanisms, that is, the ways that the bacteria produce different effects in the body, are not yet clearly understood.