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Osteoporosis

Overview

Osteoporosis is a state in which bone is fully mineralized but the bone is abnormally porous and the strength of the bone is less than normal for a person of that age and sex. In this disease, the bone mass reduces due to defect in the formation of osteoid and there is abnormal reduction of bone mass. 


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Causes

It can be of following types:-

  • Due to age related changes, this is called as PRIMARY OR SENILE OSTEOPOROSIS. Sedentary habits of old age with diminished muscular stress and fats in diet leads to demineralization of the bone.
  • Due to some indirect causes like endocrine, drugs (corticosteroids, alcohol), malignancy causes bone gets weaken. This is called as SECONDARY OSTEOPOROSIS.
  • In the females, menopausal endocrine changes also cause a severe generalized osteoporosis. This is called as INVOLUTIONAL OSTEOPOROSIS.

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Signs & Symptoms
  • Commonly patient complaint of diffuse back pain over the whole lumbar spine.
  • Tenderness is also diffuse or it may be localized if there is a compression fracture.
  • Gradually, there is a development of kyphosis in the thoracic spine.
  • There may be presence of fracture of neck of femur. (commonly present in old age)
  • Although there is weakening of bone but the serum calcium and phosphate levels would be normal.
  • In secondary osteoporosis, patient present with primary problem. For e.g. in case of steroid therapy, moon face patient.

 

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Prevention

Prevention of osteoporosis should begin prior to bone loss. Care should be taken to minimize the trauma. Regular exercises should be done. Women should be treated with estrogen therapy, preferably at the beginning of menopause to prevent the development of osteoporosis. 


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Treatments
Conservative Treatment Modern Medicine

DIET

  • Food rich in Vitamin D and Calcium helps in building stronger bones.
  • Vitamin C and Vitamin E will also be helpful.

MEDICINES

  • Non Steroidal Anti – inflammatory drugs to relieve pain.
  • Glucosamine and Chondroitin encourages the production of articular cartilage and also acts as an anti-inflammatory agent. But the glucosamine found to increase the level of sugar in the blood in animals, so patient with diabetes should consult the physician first.

 

Physiotherapy Modern Medicine

 

PHYSIOTHERAPY

  • Relaxation of muscles and relief of pain and stiffness through moist heat packs, short wave diathermy, interferential therapy, wax therapy or laser therapy.
  • General range of motion exercises.
  • Strengthening exercises which include quadriceps and hamstrings strengthening.

 

Surgery Modern Medicine

SURGERY

In severe cases, where is excessive loss of movement, surgery is recommended. Surgery improves the movement and overall function of the joint.

  • Osteotomy – It is the cutting of the bone.
  • Chondroplasty – It is the repair of the cartilage surgically.
  • Arthroplasty – It is the replacement of damaged bony ends with an artificial joint made up of metal and plastic.
Lifestyle changes and Diet Modern Medicine

The ultimate goal of treatment of osteoporosis is prevention of bone fracture through increase in bone density and strength. It includes:

  • An osteoporotic person should quit smoking and should also reduce excessive alcohol intake
  •  Calcium supplements should be taken to build strong and healthy bones. And also an adequate intake of vitamin D is also preferred as vitamin D helps in the absorption of calcium from the intestines.
Physiotherapy Modern Medicine

Pain relieving modalities like short wave diathermy, interferential therapy can reduce the pain. Exercises do not increase the bone density but it decreases the risk of falls by increase in muscle strength and by improving the balance.

Medication Modern Medicine

Analgesics to relieve pain can be given. Bisphosphonates can also be given; it reduces the risk of fracture. Hormone replacement therapy to post menopausal women in the beginning of post menopause period can reduce the risk of osteoporosis.

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