Osteoporosis is a skeletal disorder, which causes fragility of bones. In the absence of proper prevention and treatment modalities, osteoporosis can cause a painless progression and subsequent fractures. Such fractures (broken bones) mostly occur in the hip, spine, or wrist. As per several past data-driven studies conducted in the United States of America, 1.5 million new fractures are witnessed in people with osteoporosis every year. Of these, spine fractures are seen in 700,000; hip fractures in 300,000; wrist fractures in 250,000; and fractures of other bones in 250,000 people.

Possible Causes of Osteoporosis

Hormonal imbalances Pregnancy
Metabolic diseases Cancer
Age beyond 60-65 years
Symptoms of Osteoporosis-Induced Compression Fractures 
Significant upper or lower back pain
Changes in posture
Difficulty with breathing and digestion 
Decreased ability to walk 
An overall decrease in the quality of life Increased tendency for fracture of adjacent vertebrae
Treatment

Compression fractures are usually managed with pain medications; narcotic pain medicines are administered for a few months until the pain decreases. Also, few available medications are known to increase the bone density. It is hoped that by building the bone density, future fractures can be prevented. Another method is immobilization of the spine with a brace that helps decrease pain from a broken vertebra; however, such braces are helpful only for the fractures of the lower back.

Role of Kyphoplasty in the Management of Osteoporosis

Kyphoplasty is a procedure that involves a new technology whereby an osteoporotic compression fracture can be treated with relief in pain, restoration of the lost bone height, and immediate stabilization of the fracture with the injection of bone cement. 

How is kyphoplasty done?

The procedure is carried out via two A  incisions on each side of the affected vertebra. The technique utilizes X-ray equipment to place working tools into the collapsed vertebra. This step is followed by an insertion of an inflatable bone tamp or expander into the fractured vertebra on each side, after which, the balloons are slowly inflated, lifting up the fractured portion of the vertebra to a more normal height. The balloons are then deflated, and cement is slowly injected. Excellent restoration of fractures, which are less than 4-6 months old and better than 90% success at reducing pain associated with the broken vertebra, is seen with kyphoplasty. 

Which patients can benefit from kyphoplasty? 

Patients with a recent vertebral compression fracture due to osteoporosis 
Patients with fractures which are less than 4 months old
Patients with fractures who are on chronic prednisone or steroids 
Complications from this procedure have been primarily related to patients who have been on blood thinner medications. 
Potential complications also include cement leaking out of the vertebra and into inappropriate areas. 

Kyphoplasty In The Management Of Osteporosis!

If you suffer from chronic pain of any kind, it is important for you to know that it is associated and linked with your emotions. Other than your physical activities and personal relationships getting hampered, unwanted feelings like resentment, stress and frustration are also common. These emotions and feelings are capable of making your chronic pain condition more worse. 

The Relationship between your mind and body: Your mind and body work together and cannot be separated. Your mind controls all your thoughts and also affects the way in which pain is controlled or perceived by the body. Pain and the fear of pain may lead you to avoid activities. This may reduce your physical strength and cause disruption in the functioning of your body.

Stress: Stress affects your body both physically and emotionally. It may lead to an increase in your blood pressure, breathing rate, heart rate and muscle tension may also occur. These may lead to fatigue, appetite changes and sleep disruption. Stress also causes depression, anxiety, make you dependent on drugs and make you dependent on other people.

Depression: Depression is common among chronic pain patients. Chronic pain can make cases of existing depression much more worse and the existing pain is also worsened. There are chances of developing depression from chronic pain if depression runs in your family or genes. 

Symptoms of Depression are as follows:

Feeling sad, angry, worthless and hopeless frequently
Lack of energy
Lack of interest in regular activities
Difficulty in sleeping
An increase or decrease in appetite, which may lead to major weight gain or weight loss
Difficulty with concentration
Having suicidal thoughts and thoughts about dying or harming oneself
How to Handle your Emotions during Chronic Pain: A common therapy, which people with chronic pain undertake is called Cognitive Behavioural therapy. You should seek the help of a therapist. In this therapy, you will learn about thinking in a positive way instead of drowning in negative thoughts. Your fear of pain will be reduced and you will learn how to strengthen important relationships. You will be able to develop a sense of freedom from chronic pain. 

If your chronic pain occurs due to an accident or emotional trauma, you may be assessed for post-traumatic stress disorder (PTSD) by your healthcare provider. Many patients suffering from PTSD cannot deal with their pain until the emotional stress is dealt with. If you feel depressed and cannot control your emotions, you need to consult a doctor.

Chronic Pain - Is it Linked to Our Emotions?

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

Body pain and Physiotherapy

Physiotherapy is an effective way to reduce various kinds of body pains. Physiotherapy includes massages, exercises, and heat treatments to relieve pain. This treatment is often recommended as the first option to treat back and neck pain. Physiotherapy is also used to rehabilitate patients after surgery. Different kinds of exercises included in this treatment are also useful to treat sports injuries.  Here are some steps that you can take to relieve your body pain incorporating physiotherapy.

Get appropriate help

It is important to properly diagnose your condition before going for physical therapy. Seek help from a professional and if he/she recommends physiotherapy then only opt for the treatment.

Reduce your severe pain before exercising

If you are in immense pain, work to alleviate the pain before engaging in exercises. Cold/ hot therapy, massage, manual manipulation are some of the methods that can slowly reduce the pain. These are all part of physical therapy.

Exercise

Exercising has numerous health benefits including relieving back pain. As you age, your back tends to get weaker; it is important to workout to prevent future backaches. Stretching, strengthening and low- impact aerobics are ideal for this issue.

You can also try water therapy as water has a therapeutic effect on pain and makes your movements much easier than on land.

Observe your body's reaction to physical therapy

When you have just had a back or neck pain episode and try physical therapy you will feel some initial discomfort, it is expected. After you acclimatize yourself with the routine all kinds of pain will gradually diminish. The initial pain due to physiotherapy is caused because your muscles are stiff and they are being stretched the way they are not used to. However if the pain gradually increases you are probably not right for that particular kind of physical therapy.



Body pain and Physiotherapy

Bones are similar to a porous framework which is filled with minerals that make it hard and strong. With age, there is gradual degradation and the mineralized portion is lost, thereby leading to thinning of the bone. The word osteoporosis literally translates to porous bones, which is due to the gradual demineralisation. In addition to the natural ageing process, there are other diseases that can accelerate the demineralization process.

Women are more prone to demineralisation, and after the age of 40, they should take extra precaution to slow down the onset of the condition. The following are some ways to improve bone health and halt osteoporosis in the long run-

Diet: Ensure that your diet has sufficient amounts of vitamin D and calcium. Though calcium is the essential mineral for bone formation, vitamin D is required for the absorption of calcium, and therefore both these elements play a vital role in maintaining the quality of the bones in our body. Most people require about 1,000 mg of calcium and about 500 units of vitamin D for optimal bone health. This requirement goes up slightly in postmenopausal women.

Sun Exposure: In most people, exposure to the sun allows the body to make vitamin D, but careful sun protection prevents this from happening. Also, with age, the body s ability to form intrinsic vitamin D also declines. The body, therefore, relies on supplements. Most dairy products are good sources of calcium. In addition, spinach, salmon, turnips, and broccoli are some calcium-rich foods. Supplements of calcium carbonate or calcium citrate can be taken if your diet is lacking in calcium. Vitamin D also should be included in the supplementation. The treatment for osteoporosis is incomplete without these two supplements.

Exercise With Weights: The constructive tension that exercise puts on the body helps in bone building, whatever the age may be, which prevents the onset of osteoporosis. Any exercise which improves muscle mass strengthens the bones, and puts stress on the bones is advisable. Since the fractured area due to osteoporosis mainly includes the spine, lower back exercises, yoga, tai chi, and abdominal exercises all work wonders. Pick any of these and do them for 30 minutes three times a week.

Quit Smoking: Continuing to smoke while taking osteoporosis medications is completely useless. Nicotine negates all the effects which defeat the purpose of taking the medication and is as good as taking no medication at all. So if you want the bone thinning to stop, stop smoking.

Alcohol Consumption: While a drink or two per week is permissible, more than this can harm the bones significantly.

Constant Health Watch: Talk to your doctor about how other routine medications (if any) can affect your bone health. Also, identify how frequently you should check your bone mineral density and stick to the schedule.

Bone health and osteoporosis can be managed with some conscious efforts.

Bone Health And Osteoporosis - Know More About Them!

A swelling of breast tissues in men due to estrogen and testosterone hormonal imbalance. This swelling in the chest could often resemble a breast. In babies and newborns, gynecomastia is caused by the estrogen from the mother. Breast buds and tissues are common in baby boys. They go away after a few months naturally. However, in some babies, they tend to stay. The result can be the enlarged breasts.

In teenage years, the estrogen-producing hormones naturally tend to get into an overdrive mode and in many instances, if they are hyperactive the swelling in the chest region can occur during puberty. It usually goes away within 6 months to 2 years. In some extreme cases, the swelling can also be as a result of lung or liver cancer. Also, it depends on a little on lifestyle. Drug abuse and excess alcohol can cause gynecomastia. This may also be common in older adults where the skin loses its natural elasticity and tend to sag. Apart from it, their lifestyle also plays a detrimental part in its forming.

Very few people put on weight uniformly all over their body. Some people put on weight around the abdomen and develop bellies while others put on weight on their thighs. For some, fat could also be deposited on the chest, while it may not be much of an issue for a woman but it can make male breasts protrude abnormally. Clinically, this is known as gynecomastia. Gynecomastia is not a serious condition and does not hamper a man s health but it can damage his self-esteem. In the long run, this can also be harmful for his psychological and emotional health. Thankfully dealing with it is easy.



What are the symptoms and diagnoses?
Gynecomastia is associated with enlarged breasts and in addition to that, it could feel rubbery or firm. Sometimes only one of the regions either the left or right side may experience this problem while the other side stays firm. It is diagnosed purely by a physical examination. Also, the lump may be checked for biopsy.

Treatment
90% of the cases in babies go away on its own. There is no treatment required. However in young adults, if the conditions do not go away then surgery is the most treatable option under the circumstances. Getting medications and drugs that can decrease the tissue structure is not advisable as indirectly you might be playing with the hormones and they can tend to get risky after some time. Also, surgeries of the day are not just like taking out the enlargement. They also do concentrate on the features and shape too. You can technically sculpt the region while opting for such breast reduction surgeries.

However, contrary to popular belief, surgery is not the only recourse. In fact, though surgically removing the fat deposits can have faster effects; these fat deposits may develop again over time. Thus, surgery is not a long-term solution. So, let s look at an alternative form of treatment which is Ayurveda as this can be very effective against gynecomastia. This is a holistic form of treatment that not only addresses the symptoms showcased, but attacks the root cause of the problem. In this case, fat deposits are caused usually by weight gain and slow metabolism, which makes it essential for the person to lose weight in order to treat this condition.

Before you start on weight loss regime, starving yourself is no solution for this. Instead, one must eat food according to one s body type and needs. According to Ayurveda, there are three different types of doshas present in the body. An imbalance of these doshas could contribute towards weight gain and in turn gynecomastia. Depending on your body type, an Ayurvedic doctor will be able to advise you on the type of foods to eat and avoid so as to maintain a balance of the doshas.

In addition to this, you must also exercise regularly. The best time to exercise is in the early morning. This raises your metabolism rates and helps your body utilize energy being created through the day instead of simply storing it as fat. Aim for at least half an hour s exercise each day. There are a number of yoga asanas that target the chest muscles and can help treat gynecomastia. These include the Dhanurasana, Gomukhasana and Natrajasana. These asanas burn fat in the chest and tighten chest muscles. When it comes to yoga, it isn t enough to simply perform the asanas, they must be practiced in the right way. Thus, it is always advisable to practice under a teacher s guidance.

One of the biggest advantages of treating gynecomastia with Ayurveda is the absence of side effects. Unlike surgery, there is no hospitalization needed and you may continue your normal lifestyle as you get treatment. Once treated, there is a very low chance of the condition recurring and hence, this is a permanent solution.

Self-care:
While people do opt for weight reducing measures to keep gynecomastia under check it doesn t always work like that. The reason is these are not exactly what causes the enlargement. They are as a direct result of hormones. Hence weight reduction plans and medications may not work out efficiently. Also, experts would suggest going in for a surgery before going for an exercise regime in a gym. Some people do have a misconception that hitting the gym can take care of the swelling. However, it may not be beneficial and it would give out the desired impact.

For complete treatment of your problem, you can Consult the doctor. 

Weight Loss - Can It Help Reduce Male Breast?

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