By: Haylie Smart | Category: Health & Fitness | Issue: June 2023
Dr. James Webb
For over 18 years, Dr. James Webb’s practice has helped people of all ages treat osteoporosis. He is glad to help educate people on the disease for those who may be unfamiliar with it.
“Osteoporosis is a general term for weakness in the bones,” he said. “Where the bones are more prone to fractures under normal activities, rather than [major] accidents.”
Whereas most people will lose bone density as they approach their 80s and 90s, not everyone will fracture because they still have good bone quality. In the past, osteoporosis has been wrongly viewed as the “grandma’s disease,” but Webb says he has a patient who is in her early 20s. “She has a genetic form of osteoporosis and gets fractures just from being a mom,” he said.
Osteoporosis is a difficult disease to predict as far as wondering who is most likely to develop it. Webb says the only real tool in determining if someone will develop the disease prior to a fracture is through a bone density test, which his practice provides. If the heredity form of osteoporosis doesn’t typically run in your family, Webb recommends being screened after the age of 40. If detected early enough, his practice can treat it before it becomes aggressive. But Webb says most of his patients don’t come in to see him until after they’ve had their first fragility fracture, which is a fracture that occurs from everyday life activities, including simply standing. They commonly occur in the hip, wrist, and spine.
“Our philosophy has always been to try and find out what is causing the pain and fix it, rather than mask the symptoms,” he said. “I always focus on freeing patients from pain without surgery or narcotics.”
Webb dubs the disease “the silent killer” because there aren’t really any symptoms of osteoporosis prior to the first fragility fracture. “By the time someone has advanced osteoporosis, they have the signs people associate with [the disease], like the hunchback deformity and being frail. You want to seek treatment before it gets to that point.”
There is a secondary form of osteoporosis many people may be unaware of, and it’s most common in people under age 50. Its common causes come from certain antidepressants, most any steroid, certain acid blockers, anti-seizure medication, blood thinners, and even smoking. Webb urges people who have been taking these medications to consider a bone density test, even if only to form a baseline.
“There is data that shows after two years and five years, the longer you’re on them, there is an escalation of [osteoporosis].”
A growing problem Webb sees is that most doctors don’t perform physical exams on their patients, and instead rely too much on technology. If a patient comes in complaining of lower back pain, the doctor will likely miss that the pain is actually being caused from a vertebral fracture higher up on the spine column because it’s missed 85% of the time in radiology reports. But a simple physical exam would reveal the vertebral fracture as the culprit of the pain.
“Doctors have this misplaced faith in imaging studies and technology,” he said. “Examining the body will tell you what you need to know. Not doing a physical exam is a disservice to the patient. You’re a fool of a doctor if you’re relying only on imaging and lab tests to make a diagnosis.”
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