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!

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?

The bones are a porous matrix which is filled with minerals like calcium and phosphorus which make them strong. Over a period of time, the mineral content is lost and therefore the matrix gets brittle. Bones are more likely to fracture in these people.

Causes/Risk factors:

The bones get fragile and brittle with age in most people, and people over 60 years of age are likely to be affected
Asian women about the age of 45 are prone to osteoporosis
Reduced vitamin D intake (either by sun exposure or through diet) also makes bone porous and prone to fracture
Sedentary lifestyle with minimal or no exercise
Lower levels of estrogen, especially post menopause
Cigarette smoking
Reduced testosterone levels
With fracture, there is severe pain, loss of mobility, and need for prolonged nursing.
Foods which can help control/prevent osteoporosis:

Yoghurt: Derived from milk, it is rich in animal protein and also contains good amounts of vitamin D and B2, calcium, phosphorus, and magnesium. It helps in maintaining estrogen levels during menopause, thereby preventing osteoporosis. They also provide a good supply of gut bacteria, which improves immunity.
Milk: Similar to yoghurt, this is also rich in various minerals that are essential for bone health. The vitamin D in it also improves calcium absorption, thereby prolonging the occurrence of osteoporosis.
Fish and meat: Lean meat and fish are good sources of oils and protein and form an essential part of diet for preventing osteoporosis. Sardines and salmon are ideal as the tiny fish are rich sources of calcium.
Eggs: This contains good amounts of natural protein, minerals, and vitamins essential for bone health. It also helps in estrogen formation, which has a bone-protective effect.
Cabbage: Any form of cabbage is good for preventing osteoporosis. It promotes bone metabolism and has calcium which help in strong bone formation.
Bananas: Another effective food in preventing osteoporosis, it helps improve absorption of calcium and other essential nutrients to ensure bones are formed and maintain health. It also has natural oils, potassium, and vitamins A and C in good quantity.
Almonds: It forms an integral part of preventing osteoporosis by increasing bone density and promoting bone health. It also has good oil content, which is also essential for bone health.
Legumes: Beans and other legumes are rich source of proteins and minerals and therefore prevent onset of osteoporosis.
Chickpeas: Another great source of various minerals and vitamins, it is very low in calories and sugar and is great to lose weight. It also improves bone health by increasing density.

Osteoporosis - How A Healthy Diet Can Reduce Its Risk?

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?

Your bone is a living tissue that constantly undergoes the cycle of breakage and replacement. Osteoporosis is a condition wherein the rate at which new bones form cannot match up to the worn out bones, thus making the bones fragile and brittle. Osteoporosis mainly affects the wrist, hip or spine and can result in a stooped posture accompanied by height shrinkage and back pain caused due to a collapsed vertebra.

Reasons Behind Osteoporosis

Hormones: Lowered estrogen count in women and testosterone in men as a result of ageing or other treatments can result in this condition. Excess thyroid secretion in the body, an overactive adrenalin gland or parathyroid gland can also accelerate bone loss. Women are more vulnerable to osteoporosis during menopause.

Prolonged use of injected: Prolonged use of injected or oral corticosteroid medications such as cortisone or prednisone messes with the bone-building process. Medicines used to combat cancer, gastric reflux and seizures can be responsible as well.

Medical Conditions: Certain medical conditions such as Rheumatoid arthritis, cancer, liver or kidney disease increases the risks of acquiring osteoporosis.

Sedentary Lifestyle: A sedentary lifestyle with not much physical activity along with an excessive consumption of alcohol and tobacco makes you susceptible to osteoporosis.

Treatments for Osteoporosis:

Medication: Commonly prescribed medicines for remedying fractures include bisphosphonates such as Zoledronic acid, Ibandronate, Risedronate and Alendronate.However these medicines are not free of side-effects such as abdominal pain, nausea or heart burn. In case, your regular medicine doesn t work, you can use Denosumab and Teriparatide as alternatives but only after consulting your physician.
Hormone Therapy: Estrogen therapy for women after menopause helps sustain bone density. However such procedures can escalate the dangers of getting afflicted with cancer, heart diseases or conditions such as blood clotting.
Alternative Medicine: Ipriflavone, a laboratory manufactured product, when combined with calcium can curb chances of bone loss and alleviate pain.

Osteoporosis - How It Can be Treated?

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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