Welcome to BoulderCentre for Orthopedics & Spine

Bone Health & Fracture Prevention

Did you know that half of Americans over the age of 50 have low bone mass (osteopenia) or osteoporosis? That’s 54 million out of 99 million adults, and that number is growing.

How Strong Are Your Bones?

Osteoporosis is a bone disease in which the body makes too little bone, loses too much bone, or both. As a result, bones become weaker and more likely to break. Osteopenia is a term used for low bone mass. Osteopenia and osteoporosis put you at high risk for broken bones (fractures), which lead to pain, time off work, time away from the activities you love, hospitalization, medical complications, and even death. In fact, there is a 20% – 25% risk of death within one year of a hip fracture, and that risk is increased for five years.

A broken bone, or fracture, is a warning sign that more may come. Half of all hip fracture patients had a previous osteoporosis-related fracture. Your first broken bone puts you at a five-fold increased risk of a second broken bone!

Fractures Can Be Prevented

A broken bone is no accident. Bones break as a result of the forces applied to the skeleton and the skeleton’s ability to withstand those forces. However, you can take steps to reduce your risk of a fracture, and our bone health team is here to guide you through that process.

Meet Our Bone Health Team

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Ilya Igolnikov, MD, is a fellowship-trained physical medicine and rehabilitation specialist. He is passionate about getting you back to the activities you love as well as committed to taking care of the whole patient. As a physiatrist, Dr. Igolnikov recognizes that spine compression fractures are often the first sign of low bone mass, and they represent an opportunity to prevent a patient from suffering a second fracture. Dr. Igolnikov is the physician champion for osteoporosis care at BoulderCentre for Orthopedics & Spine and supervises the program.

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Lori Nacius, PA-C, is an orthopedic physician assistant with a special interest in spine health and bone health. She is an athlete in her own right, and she loves nothing more than helping her patients continue to live an active lifestyle. She is certified by the National Osteoporosis Foundation for the treatment of osteoporosis and prevention of secondary fracture through their Fracture Liaison Service certificate program. Lori consults and treats patients for low bone mass, working with Dr. Igolnikov to ensure the highest standard of care.

Maintaining Healthy Bones

Calcium is the building block of bone, but it also participates in many other important functions in the body. For instance, muscle contraction, nerve function, and brain function all depend on the presence of calcium in just the right amounts. Your skeleton acts as a calcium bank. If your diet is insufficient in calcium intake, the body will withdraw calcium from the bones to preserve essential function. Dietary calcium is critical to bone health and for maintaining strong bones, but calcium alone is not enough.

Vitamin D

Like calcium, vitamin D is critical to bone health. It is made in the skin and interacts with nearly every cell in the body. Vitamin D plays a role in our immune function and heart function as well as regulates gene expression. It also plays an important role in regulating calcium absorption from the food we eat and the maintenance of calcium and phosphorus levels in the blood. Vitamin D deficiency can lead to osteoporosis.

Weight-Bearing Exercises

Your skeleton is living tissue and responds to the demands you place on it. Increased load-bearing by the skeleton signals the body to build bone and make it stronger, while lack of physical load signals the body to resorb bone. Weight-bearing exercises, like walking, running, and weight training, are critical to maintaining healthy bones that can withstand forces.

Fall Prevention

Falls from standing height result in more than 500,000 osteoporosis-related fractures each year. Strength, balance, and gait training can all contribute to reducing a person’s risk of falling, which will reduce the risk of fracture. Our physical therapists are experts at assessing a patient’s risk of falling as well as at designing customized programs to meet each patient’s individual needs.

Testing & Risk Assessment

While most osteoporosis can be attributed to age, 20% – 30% of women and up to 50% of men have osteoporosis due to another medical condition, medication, or another underlying cause. All patients—especially younger patients—should be evaluated for a secondary cause of osteoporosis. Our physician assistant, Lori, will order testing and look for clues in your medical history to ensure that the appropriate diagnosis is made and the right treatment is used.

A DEXA scan, which stands for dual-energy X-ray absorptiometry, is a special radiologic test to examine bone density. DEXA is an important part of assessing fracture risk and bone health, but it does not tell the whole story. We use DEXA as one piece of the puzzle in assessing your fracture risk.

Medication to Treat Osteoporosis & Low Bone Mass

For many patients, healthier bones mean taking the steps above of getting adequate calcium and vitamin D and performing weight-bearing exercises. However, for those at high risk of fracture, there are medications that can reduce the incidence of fracture by 50%. That’s the same risk reduction as wearing a seatbelt while driving! These medications are the most powerful tool we have in reducing fracture risk, and newer agents are now available that can dramatically increase bone density. Lori will work with you to determine whether a medication is indicated as well as weigh the risks and benefits with you.

To schedule an appointment with Lori Nacius, PA-C, please schedule an appointment online or call 303.449.2730.

Bone Health Resources