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?

Knee is a hinge joint where the lower leg bone tibia meets the thigh bone femur. During osteoarthritis, cartilage or ligament defects and degenerative arthritis, knee replacement surgery is recommended world-wide to get relief from extreme pain. Knee replacement surgery, also known as knee arthroscopy, is a surgical procedure, in which the affected knee joint is replaced with synthetic material. The most likely candidates for total knee replacement are the patients with severe destruction of the knee joint coupled with progressive pain and impaired function.

Modern technological advances have made computer assisted knee replacement surgery extremely popular around the globe. In this surgery, the surgeon is assisted by a computer to remove the optimum amount and angle of the bone, which otherwise is done by inspecting manually. This is an excellent example of surgery through small incision and it eliminates the chances of human error. A perfect alignment and balance is achieved and hence longevity is also increased to 20 - 30 years. Knee replacement surgery is also specific to gender as the anatomy of male and female patients is different.

There are many types of knee replacements, most common being the total knee replacement or Total Knee Arthroplasty. In addition, there is partial knee replacement, bilateral knee replacement, revision knee replacement and knee arthroscopy.

In knee replacement surgery, the worn out surfaces of joints of knee are replaced with artificial implant of plastic and metal. The lower end of the femur bone is removed and replaced with a metal shell. The upper end of the lower leg bone (tibia) is also removed and replaced with a channelled plastic implant with a metal stem. A plastic ball is also added under the kneecap depending on its condition. These artificial components are commonly referred as prosthesis. The design of these highly flexible implants replicate knee, with the rotating knee replacement implants assist in backward and forward swing of the legs.

Patients whose knee joints have been damaged by either trauma or progressive arthritis should consider total knee replacement surgery. Post-surgical hospital stay after knee joint replacement is usually three to five days. The surgery has a very high success rate and shows dramatic improvement after a month. This improvement is most notable one month or more after surgery. The pain caused by the damaged joint is reduced significantly when the new gliding surface is constructed during surgery. Initially, patient will walk with the help of a walking aid until the knee is able to support full body weight. After six weeks, patient can walk comfortably with minimal assistance. Patients with artificial joints are prescribed to take antibiotics during the course of any elective invasive procedures including dental work. Physiotherapy is an essential part of rehabilitation and it will increase the muscle strength and patient can enjoy most activities, except running and jumping.

Knee Replacement

The symptoms caused due to herniated disc can be very severe and can also cause a bit of disability. The disc of the spine is like a cushion and separates the set of bones on the backside. The discs are shock absorbers of the spine and are mainly composed of 2 parts, a soft jelly centre called the nucleus and a tough outer covering called the annulus.

Effects of Herniated Disk
A herniated or cracked disc is a severe condition and it seems to happen most commonly in the lower back.  It happens when a fraction of the soft centre gets pushed through the destabilized area due to degeneration, trauma or by putting pressure on the spinal cord. 

Nerves are located precisely at the back of every disc and are responsible for controlling everything in our body. While a disc gets herniated, the external covering of the disc tears and creates a bulge. The soft jelly gets shifted from the centre of the disk to the region where the damage has occurred on the disc. Most commonly, the bulge occurs in areas where the nerve is located and it causes strain on the affected nerve. It has been observed that individuals do not feel any painful sensations even if their disc gets damaged.

When is Surgery Recommended for Herniated Disc?
Surgery for herniated disc is recommended only after options like steroid injections, pain relievers, exercise and non-steroid anti-inflammatory drugs do not work. If the pain persists even after these options, then it becomes important to go for surgery. There are certain risks involved in this surgery like infection, bleeding or nerve damage. 

There are chances that the disc may get ruptured again if it is not removed. If you are a patient suffering from degenerative disc disease, then there are chances that problem occurs in other discs. It is very important that a patient maintains healthy weight to prevent any further complications.

The main factor that increases the risk of herniated disc is excess body weight, which causes a lot of stress on the lower back. A few people become heir to a tendency of developing this condition. Even individuals with physically demanding jobs are prone to this condition. 

Activities like bending sideways, pushing, twisting, repetitive lifting can increase the risk of a herniated disk. At times, emergency surgery is also required to avoid paralysis in a patient.

Herniated Disc - What are the Risks Involved in it?

The sciatic nerve spreads down the spine till the legs. The pain in this nerve can feel like sparks running down your leg (by and large only each one in turn) or cause pain in the lower back. Anything that puts weight on or aggravates this nerve can cause pain that shoots down the back of one butt cheek or thigh. The amount of pain can increase gradually. Sciatica may feel like a gentle ache, a sharp sensation or extreme uneasiness. Sciatica can bring feelings of shivering, numbness and weakness.

Sitting, standing up, coughing, sneezing, lifting, or straining for a very long time, might aggravate pain. Now and then, individuals experience numbness or shivering in the leg, too. Some of the most regular symptoms of sciatic pain include:

1. Lower back pain
2. Pain in the back or leg when sitting
3. Hip pain
4. Burning sensation in the leg
5. Numbness or trouble moving the leg or foot
6. Continuous pain on one side of the back
7. Shooting pain that makes it hard to stand up properly

The most common causes of sciatic pain include:

1. Lumbar spinal stenosis (narrowing of the spinal channel in the lower back)
2. Degenerative disk sickness (breakdown of discs, which go about as pads between the vertebrae)
3. Spondylolisthesis (a condition in which one vertebra slips over another)
4. Pregnancy
5. Muscle spasms

Some of the most effective exercises for sciatic pain relief are as follows:

1. Pigeon Pose is a typical yoga posture. It attempts to open the hips. There are various types of this stretch. The first is the leaning back pigeon posture. If you are beginning your treatment, you have to attempt the leaning back posture first.

2. While on the back, raise your right leg up to a right point and hold it with both hands behind the thigh and lock your fingers. Take your left leg and touch your lower leg against the knee. Hold the position for a minute.

3. Sit on the floor with your legs stretched straight before you. At that point twist your right leg, putting your lower right leg on top of the left knee.

Bend forward and incline your abdominal area toward your thigh. Hold for 15 to 30 seconds and after that switch sides.

4. Kneel down on the floor on all fours. Get your right leg and bring it forward so that your lower leg is on the ground. Your right foot has to be ahead your right knee while your right knee stays to one side. Stretch the left leg out the distance behind you on the floor, with the top of the foot on the ground and toes pointing backwards.

5. Lie on your back with your legs facing outward and your feet flexed upward.

Wrap your hands around your knee and delicately pull your right leg over your body toward your left shoulder. Hold it there for 30 seconds and afterward push your knee so your leg comes back to its initial position.

Sciatica Pain and Ways to Deal With It

Your shoulders are one of the most important parts of your body, but sadly it is also one of the most neglected parts. People use their shoulders for day to day activities. Without shoulders it would be very difficult to even do a simple activity like lifting a fallen paper from the ground. Like your other body-parts, shoulders also need proper attention and care.

Why is shoulder mobility so important?
Whether it is about moving a growing child, lifting a barbeque table or about moving heavy luggage, actions require shoulder mobility. If you find it difficult to do these activities it is highly probable that you have shoulder impingement syndrome. This syndrome occurs when the rotator cuff muscles become inflamed and irritated and result in severe pain and difficulty while moving one s shoulder. Weak shoulders also make your posture look bad, it can cause grave strains in your neck and back and make you look hunched which is not at all attractive for your appearance.

Different kinds of shoulder injuries and causes of shoulder immobility:

Rotator cuff injury

Frozen shoulder

Onset of arthritis

Shoulder instability

Injury to the tendons and ligaments

Shoulder dislocation

Torn rotator cuff

Impingement   It refers to the excessive friction of the shoulder muscles against the top part of the shoulder blade.

How can you improve shoulder mobility?

You can improve your shoulder mobility with the help of some exercises. For example, stand straight with your hip and feet apart. Move your hands behind your back and try to interlock your fingers, if you face difficulty in doing so, use a towel instead. Hold this position for a minute or so.
Sit and keep your feet and knees straight pointing towards the direction of your eyes. Touch your shoulder blade by bringing your hands backward, touch your elbow with your other hand and bring it upwards. Sit straight, hold your head up and breathe slowly. Hold this position for a minute and then repeat again.
You can also improve your shoulder mobility with the help of yoga. Yoga is all about relieving your tension and stress, hence it is very beneficial to loosen up tight shoulders and it makes you much healthier by improving shoulder mobility. Stand straight with your feet at least four feet apart and then bend your left foot slightly towards to the right. Make your right foot bend 90 degrees. Raise your right arm towards the left and bend your body. Inhale and exhale. Switch sides after taking five breaths.
Physiotherapy For Shoulder Mobility-

Physical Therapy is not just scientific; it is also very thorough and very methodical in its way of healing and remedying clients with many aches and pains. A therapist is well trained and very careful in massaging and handling delicate parts of the body such as the vertebrae, extremities and in cases of temporomandibular joint neuromusculoskeletal dysfunction. Physical Therapy is a distinct specialization in the practice of physiotherapy.

Before patients are treated with the therapy, it is very important that they undergo a preliminary assessment of what ails them. Their dysfunctions are determined and their biochemical systems are assessed as well. The body's posture as well as the placement is analyzed and almost all areas of the entire body in terms of the position and functioning of the musculoskeletal system is considered just to make sure that the root cause of the problem is discovered and treated. 

The aim of the therapy is to alleviate pain, strengthen the body, and improve movement and usability of the limbs as well as the other areas of the body through the use of the hands. The therapy also utilizes various work-out regimens as well as a home carry over system to make sure that the intervention plan will work as expected. More than just treatment, physical therapy is a means of assisting a patient to recover body movement, strength and function, therefore the need to have a strong determination to improve from the patient is definitely required. Here are some physical exercises to improve shoulder mobility-

First step is to provide adequate rest to the shoulder. Avoid using the affected arm too much. Keep it in a comfortable position. Do not strain the arm.

Cold compressions can help to ease pain and swelling. Alternate applications of hot and cold compressions help to reduce inflammation and provide quicker relief.

Keeping the arm elevated in a swing is recommended. It helps to drain the fluid or oedema and reduce pain.

Other exercises recommended are basic shoulder strengthening exercises. Example of one such exercise is gently pulling an elastic tubing attached to a door knob, towards your body. These can be performed twice daily, starting five times with each arm.

Wall push exercises are those that strengthen shoulders, forearms, biceps and triceps. You must stand at least a feet away from the wall and push against the wall, for a count of 5 to 10.

Shoulder press ups are exercises that can be comfortably done while sitting on a chair. Keep your arms on the armrest of the chair. Instead of putting the weight on your feet, rise up slowly by putting the weight on your hands. Repeat this 5 times twice or thrice daily.

There are isometric shoulder mobility exercises that involve muscle contraction and movement of limbs. It involves strengthening the muscles through extension, contraction, rotation and flexion of shoulder joint.

There are lateral rotation abduction exercises, lateral shoulder raises, lateral shoulder pull down.

There s a range of scapula squeeze exercises that involve strengthening and stabilising the shoulder blades.

Medicine balls and lightweight dumbbells can be used as props to exercise the shoulders.

A bad shoulder not only results in a bad posture but also prevents you from doing day to day activities. Hence it is necessary to take care of your shoulders and exercise daily to improve the mobility.

Shoulder Mobility - How You Can Improve it?

Juvenile arthritis also known as juvenile rheumatoid arthritis and is a chronic, systematic and inflammatory disease, which causes damage to joints or damages of connective tissues. Symptoms include fever, rashes and hepato-spleenomegaly. This disease is persistent and inflammatory in nature and occurs before the age of sixteen. Homeopathy is widely used to cure juvenile arthritis. Here is a list of the best homeopathic medicines used to treat juvenile arthritis along with the symptoms based on which they are prescribed.

 Abrotanum: this homeopathic medicine is used when a child is suffering from juvenile arthritis and is unable to move. Symptoms include soreness and paleness and the condition worsens in the morning. Gouts may occur in the wrists or ankles. Inflammatory rheumatism is indicated before the start of swelling. Marasmus of children may occur signified by marked emaciation, especially in the leg. The skin tends to hang loose and gets flabby. Constipation and diarrhea occur.
 Aconite: aconite is a homeopathic remedy, which is used in arthritis where there is tearing pain in the limbs. Violent pulls in the joints and bones are experienced. Contraction of the tendons and feeling stiff in the flexor muscles are other symptoms. Cramps affect several limbs. Aconite is used in early stages of juvenile arthritis. Atmospheric changes affect the patient, and dark hair, and eyes are developed. The muscle fibres becomes rigid.
 Apis: apis is used in oedematous swellings and synovitis. The knee gets swollen, sensitive, sore and shiny along with stinging pain. The feet also swell and feel extra large. There is a rheumatic pain in the backside and in the limbs. The fingertips and hands become numb, and the patient is tired. Glands are enlarged or indurated.
 Arsenicum album: this homeopathic medicine is used in juvenile arthritis where the patient experiences acute pain in the arms and hands. The pain begins from the elbow and extends to the armpits. There is an acute, pulling and shooting sensation in the wrists. The fingers swell as well along with pain in the finger bones. Cramps occur in the legs and swelling is felt in the palms at night. The hips experience acute pain as well, which extends to the thighs, groins and ankle bones. 
 Belladona: belladona is used for joint and bone pains. The pains generally increase at night and during the afternoon. Any kind of movement or touch leads to aggravation in the pain. Palpitations in muscles are caused. Cramps, spasms and movements which are convulsive are indicated.

Homeopathy is an ideal remedy for treatment of juvenile arthritis. Homeopathy being purely natural has no side effects and puts a check on all underlying causes of juvenile arthritis.

Is Homeopathy a Cure for Juvenile Arthritis?

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