Why osteoporosis and osteopenia are fast turning into diseases of the young

Did you know that osteoporosis causes more than 8.9 million fractures worldwide every year? what is frightening is many of these fractures are now taking place among the youth due to deficit diet and poor lifestyle coupled with genetic predisposition. Both osteoporosis and osteopenia are two forms of bone loss conditions, with the latter being a precursor to the former. To distinguish between the two a bone mineral density test is usually performed.

What is the difference between osteoporosis and osteopenia?

A BMD (bone mineral density) t-score between -1 sd and -2.5 sd indicates osteopenia with a high chance of osteoporosis. On the other hand, a t-score of -2.5 sd and below stands for osteoporosis. A higher bone density (above -1sd) is usually indicative of stronger bones. Fragility index is more accurate way to assess the risk of fractures.

In osteoporosis the bone loss or weakening of bones take place over a long period of time, and results in unexpected fractures and severe bone problems. Disfigurement, fractures in the spine, loss of mobility and independence are usual characteristics of this bone disease once it progresses further.

Prevention is better than cure, always!

To keep bones strong and healthy, calcium and phosphate is continuously absorbed by the body. But after 30, the body?s ability to absorb calcium slows down and there?s a decrease in the production of new bones. In contrast, bone desorption (the process of transferring calcium from the bone to the blood) continues unabated.

When the body starts absorbing the store of calcium in the bones to meets its needs, it leads to calcium depletion and is one of the causes of the weakening of the bone.

At present, the age limit (50-60 years) for osteoporosis has seen a drop with many younger people increasingly suffering from the ailment. Factors like unhealthy lifestyle, late-night shifts, smoking and alcohol consumption have been found to be the culprits behind the rise in osteoporosis cases among the young. Recent studies have identified vitamin d deficiency as a major factor for poor bone health and bone mass density in the young.

How to keep your bones strong and healthy? and manage osteo - penia/porosis complications:

Bone loss can be prevented by adopting these very simple but effective ways:

- exercising can help in building strong bones and muscles, while preventing bone loss.

- maintaining a calcium intake of 1000 mg for pre-menopausal women and 1200 mg for women post menopause.

- staying out in the sun for 20 minutes to produce requisite amount of vitamin d for calcium absorption and using supplements of vitamin d.

- there are many safe medicines available to prevent and treat osteoporosis like alendronates, calcitonin, parathyroid, teriparatide preparation etc.

- in osteoporosis induced /associated fractures we have to to modify implants to negate weak purchase of implants in bone and improve mobility. We have been using these modifications in established osteopenia/porosis case in fractures treatment/joint replacement/ arthroscopic fixations and MIS spine fracture management.


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Are Osteoporosis and Osteopenia fast turning into diseases of the young?

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!

Osteoporosis is an age-related condition characterized by low bone density and fragile bones. Lack of calcium and vitamin D are the most common triggers of this condition. These are vital elements for healthy teeth as well. Osteoporosis has a direct relationship with oral health and can trigger a number of issues such as loss of teeth, gum and can cause periodontal disease. The effects of osteoporosis on oral health and affect more women. This risk increases when talking of menopausal women.

The jawbone is one of the areas that bear the brunt of osteoporosis. The loss of bone density in this area can cause tooth loss and make teeth lose. It can also affect the gum ridges that hold dentures in their place. This can result in ill-fitting dentures that need to be frequently changed.
Medication for osteoporosis is also linked to dental health. In rare cases, antiresorptive medicines that are prescribed to strengthen the bones can lead to a condition known as osteonecrosis. This refers to the death of a bone due to poor blood supply. Antiresorptive medication can be administered orally or intravenously with the latter having a higher risk of triggering osteonecrosis. Though it affects the hips and shoulder bones in most cases, it can also affect the jaw bone. It is marked by pain, swelling, infection and exposed bone. Loose teeth, gum infections and numbness or heaviness of the jaw are also symptoms of osteonecrosis of the jaw bone.
The risk of suffering from osteonecrosis cannot be determined beforehand. Hence it is a good idea to see your dentist before or just after starting antiresorptive treatment for osteoporosis and to schedule regular checkups for the duration of your treatment. Dental problems if any should be treated before starting medication for osteoporosis. Osteonecrosis of the jaw bone is most commonly seen after undergoing a dental procedure that affects the jawbone and associated tissues such as a tooth extraction. Ideally, invasive dental procedures should be avoided if you are taking antiresorptive medicines. However, it can also occur spontaneously.
Bisphosphonates are also commonly prescribed to treat osteoporosis. This type of medication slows down the breakdown of bone tissue. However, this can lead to the development of new bones. This is not a troublesome issue when it comes to bones like the hip, leg or arm bones but can be very disruptive if it affects the jawbone. This is because the jaw bone is constantly reforming and reshaping itself.

Osteoporosis - Can It Impact Your Oral Health?

Osteoporosis is a medical condition marked by a decrease in bone density. It results in the brittleness of bones and their fracture. Osteoporosis does not display any signs or symptoms but manifests itself in advanced age.

Homeopathic remedies for Osteoporosis

Silica or Silicea-This remedy is for people who are often nervous, feel sweaty during the night, get easily tired and are a highly nervous lot. The injuries of such people take the time to heal/ are difficult to heal and their spine is weak. Generally, these patients have delicate or refined features.
Symphytum- Meant for those fractures that occur because of mild trauma, this remedy is useful in cases where pain persists in old but healed fractures and also when bones need to be strengthened.
Calcarea carbonica- This remedy is administered to people who are overwhelmed by a lot of work and stress, get tired easily after work and have a proclivity to stress a lot. Generally, these people are overweight and have a lot of body flab and easily get depressed by cold/chilly weather and dampness in the air. They have swollen joints, experience a recurring back pain and get a sweaty head in the night. An interesting characteristic of these people is also that they have a craving for eggs and sweet things.
Calcarea phosphorica- This remedy is meant for people who have a deep, uncontrollable and intense desire for travel. They want a change in their environment and have a general sense of dissatisfaction. People requiring this medication have pain in their neck, upper back and hips. Fractures, if any, are slow to heal and there maybe deposits of calcium in the bones. Post-exercise, these people feel greatly tired.
Phosphorus- Meant for people who experience a burning pain between their shoulder blades, phosphorus as an osteoporosis remedy is given to those people who have an intense desire for refreshing foods like ice cream, beverages, carbonated drinks etc. Such people are usually lanky and their faces often get flushed. They are sensitive, suggestible and susceptible to the imagination. They get easily tired after a round of exercise and work.
Homeopathy Dosage
Unless directed by a homeopathic physician, take doses of low potency like 6X, 6C, 12X, 12C, 30X or 30 C if you are going in for self-medication. Follow the instructions printed on the label.
If you are taking a single dose, ten wait for its response. If the medicine is working, then wait for its full effect to manifest. If there is little or no response, take another dose. If there is no response at all after taking the second dose then change the medicine.

Please note that dosage depends upon the individual and the intensity of his/her ailment,

Osteoporosis - How Homeopathic Remedies Can Help?

Osteoporosis is a disease of the bones. It occurs when the mesh-like structures present inside the bones becomes thin. This is a condition in which the bones become extremely fragile and have a tendency of breaking easily. The broken bones cause extreme pain. There are artificial medicines available in the markets for treating this condition. However, treatment of osteoporosis can be best done by the naturally produced Parathyroid hormone (PTH). 

It is secreted by the parathyroid glands in our body. It is an 84-amino acid polypeptide. The most interesting thing about PTH treatment is that it actually builds new bones. Other medications for osteoporosis only reduce the rate of loss of bones. PTH helps in increasing the amount of calcium in body. It also prevents bone loss due to osteoporosis. It is often considered to be an anabolic agent. If an osteoporosis patient is given low doses of PTH, his or her bones get strengthened. It also helps in increasing the bone mass.

Why a doctor recommends PTH for osteoporosis? Is it better than other drugs?
Traditionally, bisphosphonates were used to treat osteoporosis. However, it has been observed in a number of cases that bisphosphonates only help in slowing down the loss of bone density. However, PTH increases bone mineral density. Therefore, it is a better option for the treatment of osteoporosis. It is usually given to patients who have extremely low bone mass. It has been found effective in cases where other medications failed to show results. Moreover, it also works for postmenopausal women. 

Doctors believe that it can also be used for treating men with osteoporosis who are at high risk for fracture. It improves the microarchitecture of the bone and can do wonders in altering the bone size. Moreover, it has lesser side-effects on the health of the patient. It is known to cause dizziness and nausea and no major discomfort. It has also been noticed that patients who are being treated with PTH develop less back pain. These are also cost-effective for the long term treatment of osteoporosis.

Parathyroid Hormones - Is It a Better Treatment For Osteoporosis?

Osteoporosis is a condition wherein the bones become brittle and weak; so much so that even mildly stressful activities such as coughing, bending over or even a slight fall (such as the one from a high rise chair) can result in fractures. Osteoporosis-related fractures commonly occur in the spine, hip or the wrist. The human body has a continuous mechanism of bone absorption and removal. In case of osteoporosis, the creation of new bones doesn t happen in accordance with the removal of old bones.

Spinal Fractures:

The bones of the spine get extremely vulnerable to breakage and even cracking open. The fractures in the spine, also known as vertebral compression fractures can cause a sharp stinging pain in the back that may make sitting, standing, or even walking a very tardy task.

Risk Factors:

Increasing age

Abnormally less or high body weight

Smoking

Menopause or low levels of sex hormones

Gender: This disorder is more likely to affect women as compared to men. Also women, who are above 50 are more likely to suffer from this debilitating disorder.

Race is a significant risk factor of osteoporosis. If you are of Asian descent, you are more likely to be affected by it.

Having a family history of osteoporosis will put you at a greater risk of this disorder.

Symptoms:

Fractured or collapsed vertebra causing back pain

A stooped posture

A shrunken appearance (as if one has had loss of height)

Very fragile bones, thus increasing risks of fractures

Severe and sudden pain in the back

Difficulty in twisting or bending the body

Lower spine fractures are way more troublesome as compared to fractures in the upper spine. Fracturing more than a bone in the spine also remains a huge possibility.

Diagnosis and Treatment:

Firstly, an X-ray or a computerized tomography (CT scan) will be done to have a closer look at the bones. A bone density test is another commonly used method of diagnosing osteoporosis. 

Steroids and medications: Some medications may be used to prevent or combat osteoporosis. These include alendronate, ibandronate, risedronate and zoledronic acid.

Physical therapy: Just like muscles, bones get stronger too when you exercise. Weight-bearing and muscle- strengthening exercises are the most helpful in this regard and are considered best for the treatment of osteoporosis. Cardiovascular exercises such as walking, jogging or even swimming can prove to be immensely beneficial.

Diet: Make a diet chart that includes high-calcium food items, dairy products such as yogurt, cheese, and low-fat milk, tofu, green vegetables such as collard greens and broccoli, sea fish such as salmon and sardines.

Salt: Limit salt intake

Therapy: Hormone replacement therapy (treatment method consisting of estrogens to alleviate and treat symptoms of osteoporosis) is another method of treatment that can be recommended by the doctor.

Osteoporosis Spine Fractures: Risks, Symptoms and Treatments

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