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Bone Health Series: “Bone Related Issues”

Written by: Colleen Bridges, M. Ed., NSCA-CPT, Parkinson’s disease fitness specialist,
Betsy Lerner, MA English and African American Lit, Parkinson’s Disease Specialist and Rock Steady Boxing Certified
Megan Kelly, PT, DPT, LSVT Big and Parkinson’s Wellness Recovery Certified
Cindy Nyquist, LPTA, ATC, Rock Steady Boxing Certified

This week our “Bone Health Series” focuses on bone related issues and how your PD journey may be affected. Nutrition, exercise and the proper supplements provide support bones need to keep you active and independent. However, sometimes genetics, lifestyle and/or injury can add a twist to your story.

Let’s take a look at the common bone issues, after which, we will visit with physical therapists, Cindy Nyquist and Megan Kelley. We will examine how these issues affect a person living with Parkinson’s and the related do’s and dont's of exercise!

  1. Osteoporosis- also known as “the silent disease”

Accelerates when bone loss occurs faster than bone growth or remodeling.

Typically, more women than men are diagnosed with Osteoporosis due to loss of estrogen during menopause. According to Baptist Health, of the 10 million living with Osteoporosis, 8 million are women. However, men can develop Osteoporosis more frequently than Prostate Cancer. Due to medication, lifestyle choices such as smoking, lack of exercise and medical conditions such as Parkinson’s.

It is important that both women and men schedule a Bone Mass Density test (BMD).

The BMD test is painless and usually done on your hip or spine. It uses one of two low-dose x-rays called dual-energy x-ray absorptiometry (DEXA) scans. The BMD test will help your doctor test the minerals in your bones to determine if you have osteoporosis and can help predict future fracture risks. BDM tests are an important way of not only screening for osteoporosis or future osteoporosis, but also tracking its progression.”

As mentioned earlier, Osteoporosis is the “silent disease” so remain alert for the following symptoms.

  • Loss of height

  • Receding gums

  • Stooped posture

  • A bone that breaks easily and/or multiple times

  • Back pain caused by a fracture or collapsed vertebrae

Parkinson’s Impact

Frederick Van den Bos et al conducted a research study from 1975-2011 on the impact of Osteoporosis on a person living with Parkinson’s Disease. According to the study, people living with Parkinson’s Disease have a higher risk for low bone-density than age matched controls. Researchers found that people living with Parkinson’s have multiple reasons for the issue such as decreased mobility, muscle strength and low body weight.

2. Osteoarthritis- Known as the “wear and tear” disease Osteoarthritis is not only the most common form of arthritis in senior adults, it is also the most common form of physical disability among adults. According to the National Institute of Health, Osteoarthritis is a degenerative joint disease that happens when the tissues that cushion the ends of the bones within the joints break down over time. These changes usually develop slowly and worsen gradually, causing pain, stiffness, and swelling. In some cases, people living with this disease are no longer able to work or perform daily tasks.

Osteoarthritis is easily identified in the hands and fingers due to the small, bony knobs on the end and middle joints (those closest to the nails) of the fingers. Fingers can become enlarged and gnarled, and they may ache or be stiff and numb. The base of the thumb joint is also commonly affected by osteoarthritis. Other areas affected by Osteoarthritis include the knee, hip and spine.

Symptoms to be aware of include:

  • Knee- There is stiffness, swelling, and pain, which make it hard to walk, climb, and get in and out of chairs and bathtubs. You may hear a grinding or scraping noise when walking or moving. Over time, the knee may start to buckle.

  • Hip- There may be pain and stiffness of the joint. But, sometimes pain is felt in the groin, inner thigh, buttocks, or knees. Osteoarthritis of the hip may limit the ability to move and bend, making daily activities such as dressing and putting on shoes a challenge.

  • Spine- Stiffness and pain exists in the neck or lower back. Additionally, arthritis-related changes in the spine can cause pressure on the nerves where they exit the spinal column, resulting in weakness, tingling, or numbness of the arms and legs. *Please note: these changes can even affect bladder and bowel function.

  • Neck- Chronic pain and stiffness in the neck may be worse with upright activity. There may be a sound or a popping feeling in the neck when moving. Additionally, Involuntary contractions of the muscles (spasms) can cause pain or a loss of movement or headaches that start from the neck.

  • Shoulder- There is a limited range of motion, grinding and/or clicking sound when you move the shoulder.

  • Ankle- One experiences tenderness or pain, reduced ability to move or walk, stiffness and swelling in the joint.

Diagnosing Osteoarthritis

  • Note symptoms and medical history

  • Perform a physical examination

  • Use X-rays and other imaging tests to look at your joints

  • Order laboratory tests to rule out other problems that could be causing your symptoms

The good news is that Osteoarthritis is treatable! Medication is an option but so is EXERCISE, a healthy nutritional plan, weight management, massage and acupuncture! In a future podcast we share other management ideas so you can live a full life.

Parkinson’s Impact Similar to Osteoporosis, the chronic pain an individual experiences with Osteoarthritis will rapidly reduce their ability to perform daily activities with ease. Parkinson’s symptoms already affect movement, so it is crucial that medication be taken on schedule, exercise regularly and follow a healthy diet.

In closing, Bridges For Parkinson’s prioritizes your well-being from head to toe. If you are experiencing pain while performing an activity, we address the issue so you can receive the most benefit from our Parkinson’s-specific exercises. We do not subscribe to the old adage “no pain, no gain!” Moving in a pain free range of motion is our goal for you!

Together, we fight back stronger!



van den Bos F, Speelman AD, Samson M, Munneke M, Bloem BR, Verhaar HJ. Parkinson's disease and osteoporosis. Age Ageing. 2013 Mar;42(2):156-62. doi: 10.1093/ageing/afs161. Epub 2012 Nov 6. PMID: 23132148.

Teder-Braschinsky A, Märtson A, Rosenthal M, Taba P. Parkinson's Disease and Symptomatic Osteoarthritis Are Independent Risk Factors of Falls in the Elderly. Clin Med Insights Arthritis Musculoskelet Disord. 2019 Oct 31;12:1179544119884936. doi: 10.1177/1179544119884936. PMID: 31700249; PMCID: PMC6823975.

Cleveland Clinic- “Foot and Ankle Arthritis”

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