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 a condition which usually results due to a decrease in bone density. In this condition, the bones become weak and brittle. Fractures are a common result of osteoporosis. Usually, symptoms or signs do not show up until the condition progresses to its advanced stages.

Since osteoporosis is usually irreversible and incurable, preventing the fractures is considered to be extremely important.

Who is at risk of osteoporosis?
All men and women have some risk of developing 'thinning' of the bones (osteoporosis) as they become older, particularly over the age of 60. As mentioned above, women are more at risk than men. The following situations may also lead to excessive bone loss and so increase your risk of developing osteoporosis. If you:

Are a woman who had the menopause before 45 years of age
Have already had a bone fracture after a minor fall or bump
Have a strong family history of osteoporosis.
Have a body mass index (BMI) of 19 or less (that is, you are very underweight)
Have irregular periods
Have taken, or are taking, a steroid medicine (such as prednisolone) for three months or more
Are a smoker
Have an alcohol intake of more than four units per day
Lack calcium and/or vitamin D (due to a poor diet and/or little exposure to sunlight).
Are mostly inactive
Ways To Treat Osteporosis

Osteoporosis in women can be treated using Hormone Replacement Therapy (HRT). The therapy makes use of either a combination of progestin and oestrogen or simply, oestrogen. However, it is possible that certain combinations have side-effects that might give rise to other medical conditions. Therefore, proper consultation with an orthopedist is an essential pre-requisite so that the condition of osteoporosis as well the side effects may be addressed before proceeding with Hormone Replacement Therapy.

There are a number of medications that can be used which have long-term effects on osteoporosis. However, the schedule for intake of these medicines should be followed diligently. Failing to adhere to the schedule could lead to serious complications. For example, the intake of Risedronate medications (prevent bone loss) should be scheduled once every month, failing which can cause ulcers in the food pipe. Raloxifene has effects which are similar to oestrogen but does not exhibit any serious side effects. Teriparatide can be used to treat osteoporosis in people who have a high risk of suffering from bone fractures.

Don't rely entirely on medication as the only treatment for your osteoporosis. These practices also are important:

Exercise. Weight-bearing physical activity and exercises that improve balance and posture can strengthen bones and reduce the chance of a fracture. The more active and fit you are as you age, the less likely you are to fall and break a bone.
Good nutrition. Eat a healthy diet and make certain that you're getting enough calcium and vitamin D. Being underweight or losing a lot of weight unintentionally is associated with poorer bone health and a higher risk of fracture   even if you're taking a bisphosphonate.
Quit smoking. Smoking cigarettes speed up bone loss.
Limit alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.

How To Cure Osteoporosis?

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?

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!

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?

Our bones are composed of calcium deposits, and with age, the amount of deposits gradually reduce, leading to porous bones called in medical terms as osteoporosis - osteo for bone and porosis for porous. As the bones grow porous, they are more brittle and prone for fracture. In severe conditions, a person's limb length can also be altered, leading to stooped and shortened stature.

Osteoporosis is more common in females, especially after menopause, as there is a strong hormonal connection to osteoporosis. An advice for females post 40 is to include calcium and vitamin d supplements, thereby delaying the onset and reducing the severity of this condition.

Once it does set in, there are various medications available; however, as with most allopathic medications, there are side-effects. Well-known as it is, homeopathy treats the individual and not just the disease. Listed below are some common treatments, which improve calcium and phosphorus metabolism, reduce bone loss, and improve bone mass.

Calcarea carbonica - This works well in patients who have issues with calcium absorption, get tired easily, are anxious and stressed out easily. Cold often worsens the pain and there could be swelling of joints and neck and back pain. There is also a strong craving for sweets in these people.

Calcarea phosphorica - This works very well in cases where the spine has been affected. Patients with softened spine and curved body benefit very well from this. This also can be used where there is associated anemia and increased bone pain due to cold weather. At an emotional level, people with general dissatisfaction and a strong desire to travel and wanting a change of situations can also benefit from this.

Calcaria iod - In addition to bone loss, where there is muscular and fat deficiency, this supplement has been proven to work well.

Silicea (silica) - Delicate people who are often very nervous and get tired easily and have a low resistance to infection get benefited from this medication. The spine is the most affected, and there might even be fractures and pus or fistula formation. It helps in healing broken bones and removing bone splinters. This works well in cases where calcium assimilation is affected by improving calcium assimilation.

Symphytum - Popularly known as 'knit bone,' this medicine is believed to help unite fractured bones very effectively by promoting strong callous formation. Not just new fractures, this also helps in patients who have pain in old healed or partially healed fractures.

To conclude, there are many remedies that can help treat osteoporosis and its consequences, the above being the few popular ones.

Homeopathy For Prevention And Treatment Of Osteoporosis

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