Bone Health

The Bone Health Program at Care New England

The Bone Health Program is a collaboration of the many resources at Care New England bringing you the best of care. The Department of Orthopedic Surgery & Sports Medicine and the Department of Medicine’s Division of Endocrinology, Metabolism, and Diabetes work together along with Nutrition, Physical Therapy, and Behavioral Medicine to create a comprehensive and seamless network of experts bringing you the best care with a personalized approach.

 

Contact Information:

The Bone Health Program 

Main Office
100 Butler Drive
Providence, RI 02906
P: (401) 729-2800
F: (401) 921-6161

Bone Density Scanning
Providence Location
100 Dudley Street
Providence, RI 02905

Warwick Location
455 Toll Gate Road
Warwick, RI 02886
P: (401) 276-7838

Bone Health evaluations are available in the Warwick and Providence locations. Telehealth visits are also available.

What is Bone Health?

Strong bones are an important part of lifelong healthy living and pain-free function. Bones are strongest around age 30 and then they start to decline. This is intensified by certain medical conditions, medications, or lifestyle choices and can affect both men and women. It can reach unhealthy levels resulting in weak bones, osteopenia, or osteoporosis. Pain, deformity, broken bones, and loss of function are commonly seen. It is never too soon to think about strong bones and healthy living.

Patients that most benefit from a Bone Health evaluation include:
  • Men and women over the age of 65
  • Women under the age of 65 who experience early menopause
  • Patients who experience fractures of the hip, wrist, or vertebral body of the spine
  • Patients receiving chemotherapy or steroid therapy
  • Patients with disorders of the thyroid or parathyroid glands
  • Athletes who experience stress fractures or delayed bone healing
  • Female athletes with dysfunction of the menstrual cycle

Bone Health in Women

Complex, living tissue, our bones provide people group jogging, runners team on morning  trainingstructural support for muscles, protect vital organs, and store the calcium essential for bone density and strength. Because they are constantly changing, our bones can heal and may be affected by diet and exercise. 

From adolescence up until the age of about 35, bone is built and stored efficiently. As one ages, however, the bone begins to break down faster than new bone can be formed. This is especially the case after menopause when the ovaries stop producing estrogen - the hormone that protects against bone loss.

Women are four times more likely than men to develop osteoporosis.

Services we provide:

  • Bone Health screening and assessments
  • DEXA scanning
  • Lab testing
  • Vitamin D assessment
  • Nutrition consults
  • Physical therapy
  • Counseling
  • Injection and infusion therapy
  • Osteoporosis Diagnosis
  • Osteoporosis Risk Factors
  • How to Keep Healthy Bones
There are a variety of tests available which help screen for osteoporosis or osteopenia, but one reliable method is a bone density test which helps:
  • Detect osteoporosis before a fracture occurs
  • Predict your chances of fracturing in the future
  • Determine your rate of bone loss and/or monitor the effects of treatment if the test is repeated at intervals of a year or more

Schedule a bone density test today by calling (401) 276-7838.

Women are four times more likely to develop osteoporosis than men, but there is increased risk among women who are:
  • Caucasians and Asians
  • Small boned and thin
  • Post menopausal
  • Sedentary
  • Excessive exercisers who have experienced loss of periods and/or significant weight loss
  • Smokers
  • Alcohol drinkers
  • Caffeinated beverage drinkers
  • Deficient in dietary or supplemental calcium
  • Members of families with a history of vertebral (spinal) fractures
  • Prescribed certain medications (i.e. steroids, thyroid medication, chemotherapy) and/or who have complicated medical conditions
  • Women who have anorexia or bulimia
What's your personal risk for osteoporosis?

Osteoporosis is a complex disease and not all of its causes are known. However, when certain risk factors are present, your likelihood of developing osteoporosis is increased. It's important, therefore, to assess your risk and to take steps that help prevent bone health problems. Learn how osteoporosis is diagnosed and how to keep bones healthy.  

Questions
  • Do you have a small, thin frame, or are you Caucasian or Asian?
  • Has a female member of your immediate family broken a bone as an adult?
  • Are you a woman?
  • Have you stopped menstruating?
  • Is your diet low in dairy products and other sources of calcium?
  • Are you physically inactive?
  • Do you exercise to the point that you've stopped menstruating or experienced excessive weight loss?
  • Do you smoke cigarettes or drink alcohol in excess?

The more times you answered 'yes,' the greater your risk for developing osteoporosis. Talk to your doctor about steps you might take to prevent osteoporosis, or, if symptoms have appeared, to help slow further bone loss.

For the name of a physician or for further information, call Women & Infants Health Line at 1-800-921-9299

A healthy lifestyle is important for keeping bones strong. The five major keys to prevention are:
Diet

Make sure you have an adequate amount of calcium and vitamin D in your diet. The recommended daily allowance of calcium is 1200mg-1500mg. Vitamin D helps promote the body's ability to absorb dietary calcium. The main source of dietary calcium and vitamin D is in dairy products. For example, an 8-ounce glass of whole or skim milk contains 300mg of calcium, one-third the recommended daily allowance. 

Exercise

Weight-bearing exercises such as walking or jogging and resistance training 2-3 times a week are beneficial. The advantages of exercise last only as long as you maintain the exercise program. Exercise alone cannot prevent or cure osteoporosis.

Estrogen & Alendronate

Both estrogen and alendronate are recognized as components of osteoporosis prevention and/or treatment. Women who have regular menstrual cycles enjoy the natural hormonal protection of their own body's estrogen. Young women without menses, post-menopausal or women who had their ovaries removed before the age of 50 may wish to discuss the pros and cons of hormone replacement therapy (HRT) with their physician.

Alcohol

Limit your alcohol intake. Alcohol leeches calcium, thus reducing bone strength.

Smoking

Smoking - If you smoke, quit. Smoking reduces the blood supply to bones, and nicotine slows the production of bone-forming cells.

What is a Bone Density (DEXA) Scan?

The DEXA scan is a painless imaging study which measures the density of the bone at different areas of the body and can be completed in a short period of time. It involves a low-dose x-ray that measures calcium and other minerals in the bones. The measurement helps show the strength and thickness of bones.

Recommendations and treatment options will be discussed as part of a comprehensive program customized to fit a patient’s needs. A patient’s physician can work with the team in planning treatment and request ongoing support.

 Pediatric Bone Density

The Hologic Horizon A DEXA scan has the ability to scan patients ranging in age from 18 months and older. It is the only DEXA scan in Rhode Island that is capable of serving pediatric patients. The DEXA scan also has the ability to perform full body composition scans as well as general scans (Axial and Appendicular).

Take the next step in feeling better

Bone Health FAQS

Who should receive a bone density scan?
  • If a patient already has established osteoporosis, a scan is mandatory every two years to have an evaluation to assess how they are progressing.
  • Any post-menopausal woman over 65 years of age should receive a scan. Results of the scan determine the frequency of follow up density evaluations.
  • People at high risk of osteoporosis should get early scans, including individuals with cancer or malignancies. Treatments these patients may undergo, including chemotherapy, could cause bone density to deteriorate.
  • Patients who have had premature menopause at an early age are at higher risk of osteoporosis and should receive an evaluation and undergo a bone density scan.
  • Patients with metabolic conditions, such as thyroid disease, they should consider receiving bone density scan evaluations.
  • A young person with an unexpected fracture should get scans because they are at higher risk.
  • Athletes who have had stress fractures
How does the Bone Health program collaborate with other orthopedic partners?

Many patients are referred by the Care New England Department of Orthopedics and Sports Medicine, and all team members are a cohesive unit that share resources, including administrative and intake management functions. Team members from the Department of Orthopedics and Sports Medicine provide second opinions complex situations, and both programs give recommendations for treatment options for patients.

How are these services integrated with other Care New England services?

Providers within Care New England can communicate collaboratively throughout all phases of the patient’s care journey. Patients have sometimes multiple morbidities, and physicians need to be able to connect with each other on patients’ needs easily. Using Epic, they can provide information for all network providers, including test results, communications and notes directly to a patient’s providers. Care New England has built and pioneered a multidisciplinary system to share resources that is unlike any other in Rhode Island.

Meet the Bone Health Team

Dr. Kenneth K. Chen

Director of Endocrinology, Diabetes and Metabolism at CNE and Division Director of Obstetrics and Consultative Medicine at Women & Infants Hospital

Dr. Robert Shalvoy

Executive Chief of Orthopedic Surgery and Sports Medicine, Associate Professor of Orthopedic Surgery, Alpert Medical School of Brown University