Caring For Your Bones

By Datuk Dr Badrul Shah Baharuddin

The COVID-19 pandemic presented its own set of challenges, impacting social, economic, mental and physical well-being. One key health element that took a back seat during the pandemic was bone health. Termed as the ‘silent disease,’ orthopaedic conditions such as osteoporosis often go underreported, underestimated and therefore, remain under-treated. The misconception that bone diseases are often seen in an ageing population further contributes to the ignorance surrounding bone health. 
The lack of priority we place on bone health has become even more prevalent during the pandemic. In fact, more than 90 percent of elective orthopaedic cases in Malaysia were cancelled or postponed due to the anxiety surrounding the pandemic.
Delayed assessments, lack of testing, reluctance in obtaining the right consultation and low levels of physical activity may have consequences on our bone health, both immediate and far-reaching. 
As we move into the new year and a recovery phase, it becomes important that we reorientate the way people think about bone health and make our musculoskeletal health a priority again. Let’s begin first by understanding the impacts the pandemic has had on our overall health. 

Datuk Dr Badrul Shah Badaruddin, Consultant Orthopaedic, Arthritis & Sports Surgeon from ALTY Orthopedic Hospital. Supplied.
Datuk Dr Badrul Shah Badaruddin, Consultant Orthopaedic, Arthritis & Sports Surgeon from ALTY Orthopedic Hospital. Supplied.

How has the pandemic impacted your bones and muscles?

One of the key factors that led to an increased incidence of bone and joints related problems during the pandemic can be attributed to low levels of physical activities. Physical activity is a key factor for maintaining bone and muscle mass and prolonged periods of no movement have a direct impact on your muscles and bones, especially bone mineral density. 
Working from home has been another contributing factor to declining bone health in addition to low periods of physical activity. At ALTY Orthopaedic Hospital we saw an increase in young adults complaining about lower back pain and shoulder spasms that can be linked to working from home. Long hours in front of a screen, poor posture, hunched back and a lack of access to ergonomic seating can all have a direct effect on your spine and back. The pandemic and a change in regular working habits is proof of the impact that poor posture and inactivity can have on our overall health and well-being. 
Another factor that often influences bone metabolism is Vitamin D. The lack of exposure to the sun for months on end during the pandemic has raised the risk of vitamin D deficiency, especially within individuals who do not take daily supplements. The deficiency of this crucial vitamin can lead to several conditions including osteoporosis. Adding to the lifestyle factors that impacted bone health during the pandemic, weight gain can be pointed out as another culprit. Several people have reported weight gain during the pandemic unexpectedly because of a lack of exercise and an imbalanced diet. This sudden increase puts pressure on the joints, increasing the risk of painful joints in addition to other health conditions. 

The care gap and associated issues

In addition to lifestyle habits that were changed overnight, the greatest challenge that the pandemic posed was interruptions to appropriate patient care. With healthcare resources being diverted to manage the spread of infections and treat those who tested positive, several other chronic illnesses were put to curb. Unfortunately, this meant that patients with bone ailments such as arthritis, osteoporosis etc were not given the immediate care they deserved. Prolonged procedures, missed doctor appointments, and closure of physical therapy centres are some factors that could contribute to long-term consequences for patients such as increase in symptoms or disease progression. 
The pandemic also saw a lack of patient follow ups as the fear of contracting infections in a hospital setting rose quickly. This meant that several patients who needed medications or further tests, no longer made the necessary hospital visits. This saw a detrimental effect, especially on fracture patients who need frequent check-ups and physical therapy. 

Get back on track with your bone health 

With restrictions slowly easing and a hope for normal routines to return, it is time to take that healthcare priority list again and give special preference to your bone and muscle health. 
If you have been suffering from aches and pains or have an already diagnosed bone ailment such as osteoporosis, setting up a consultation with your doctor should top that list. During your meeting with the specialist, try to understand the progress of your condition, schedule appointments for assessment and tests (if needed) and set a time for a second follow-up meeting. You can also try to speak with your doctor to see if you need any other additional physical therapies or should make any lifestyle adjustments to reach your health goals. 
Next on the list should be the need to make lifestyle changes, if you haven’t started doing so already. Set up a proper workstation at home if you don’t plan to step into the office soon. Make sure that you invest in a proper table and chair setting, with a laptop stand that allows you to maintain a good working posture. Include 4-5 days of light intensity workouts such as jogging, yoga, swimming and cycling to your daily routine. Not only will these exercises strengthen your joints and work on flexibility, but they will also help to keep you in good shape. 
Adjusting your diet can also play a big role in ensuring good musculoskeletal health. Talk to your physician about including supplements like Vitamin D, calcium, and zinc to your diet. You can also up your intake of whole foods like milk, eggs, salmon, green leafy vegetables, and lean cuts of meat to give your body the nourishment it deserves. 
Finally, take the time to educate yourself more about the importance of maintaining good bone health. To educate Malaysians about common bone ailments such as arthritis, osteoporosis, and spondylitis, ALTY Orthopaedic Hospital put together an ALTY-mate bone care month, where we shared multiple resources, videos with experts and bite sized content on social to make information more accessible. We hope that through this activation, more Malaysians can take charge of their health. 
The COVID-19 pandemic has led to several disruptions, including disrupting our physical and mental well-being. However, it is never too late to take charge of our health. Small steps, taken consistently can contribute to better health goals in the long run.

About the Author: Datuk Dr Badrul Shah Badaruddin is the Consultant Orthopaedic, Arthritis and Sports Surgeon from ALTY Orthopedic Hospital in Kuala Lumpur, Malaysia.

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