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?

Gone are the days when bone ailments and damages were detected based on the experience and superficial conversations made by the physicians. These days with the advent of radio waves, medical science has made significant progress that has enabled a detailed overview of what exactly is going on inside your body and what should be the most relevant treatment in that regard. Magnetic Resonance Imaging or more commonly known as MRIs are a boon when it comes to diagnosing orthopedic and musculoskeletal complaints.

Common Uses of the Procedure:

MR imaging is usually the best choice for examining the:

body s major joints.
spine for back pain
soft tissues (muscles, tendons and ligaments) and bones of the extremities.
MR imaging is typically performed to diagnose or evaluate:

degenerative joint disorders such as arthritis.
tears of the menisci, ligaments and tendons (knee) or rotator cuff and labrum (shoulder and hip).
fractures (in selected patients).
spinal disk abnormalities (such as a herniated disk).
the integrity of the spinal cord after trauma.
sports-related injuries and work-related disorders caused by repeated strain, vibration or forceful impact.
infections (such as osteomyelitis).
tumors (primary tumors and metastases) involving soft tissues around the joints and extremities (such as muscles, bones and joints).
pain, swelling or bleeding in the tissues in and around the joints and extremities.
congenital malformations of the extremities in children and infants.
developmental abnormalities of the extremities in children and infants.
congenital and idiopathic (developing during adolescence) scoliosis prior to surgery.
tethered spinal cord (abnormal stretching in the spinal cord) in infants and children.
The Process:

In this process, X-rays and radio waves are subjected upon the affected region to examine the conditions of the bones, tissues, muscles and also detect the presence of tumours. This is majorly a non-invasive test and is painless. It does not use ionizing rays and therefore does not harm the body in any which way. The MRIs capture a detailed picture of the organs and the internal body structures and then transmit them onto a computer screen for the physician to monitor the inside story.

The Benefits: 

MRI is an imaging technique that does not require exposure to radiation.
MR images of the soft-tissue structures of the body (particularly muscles, bones and joints) are often clearer and more detailed than with other imaging methods. This detail makes MRI an invaluable tool in early diagnosis and evaluation of many conditions, including tumors.
MRI can distinguish abnormal tissues from normal tissues much more accurately than most other imaging tests (x-ray, CT, etc.).
MRI enables the discovery of abnormalities that might be obscured by bone with other imaging methods.
The contrast material used in MRI exams is less likely to produce an allergic reaction than the iodine-based contrast materials used for conventional x-rays and CT scanning.
MR images allow the physician to clearly see even very small tears and injuries to tendons, ligaments and muscles and some fractures that cannot be seen on x-rays and CT.

Orthopedic and Musculoskeletal MRI

Ankylosing spondylitis (AS) is a type of arthritis that affects the spine. This chronic disease is caused due to inflammation of the joints in the spine and usually affects young men. It causes the vertebrae to grow or fuse together, causing a rigid spine. Actually, it affects the discs in between the vertebral column. These discs get swollen, causing a limitation of spine motility. It is an autoimmune disorder and its symptoms are lower back pain and stiffness, which usually moves to the legs.

The deformity due to AS can be mild or severe. In extreme cases, the patient gets a stooped spine. 
Early diagnosis can prevent significant deformity as well as help in controlling the pain and stiffness.
Allopathy doesn t really know the real reasons for this disease and here is where Ayurveda scores.
According to Ayurveda, AS is caused due to aggravated vata or wind, which causes an imbalance in vata dosha.
Ayurvedic treatment
Ayurvedic treatment starts with detoxification and elimination of toxins. It relies heavily on the right diet and lifestyle as well as Ayurvedic herbal preparations. The panchakarma techniques called kati vasti, sarvangadhara and patrapinda svedana are very beneficial too. The basic explanation for the disorder is that AS occurs due to an accumulation of ama or toxins in the body. Where ever ama deposits in the body, pain is caused. Ayurvedic treatments aim at digesting the ama by using herbs as medicine and balancing the aggravated vata.

Herbs used in the treatment of AS are dry ginger (saunth), guggul, turmeric, fenugreek, ashwagandha and giloy. Gugul, curcumin, amlaki, haritaki, and ashwagandha are all very effective in treating AS.
Avoid getting constipated and ensure proper evacuation of bowels.
Include ghee in your diet for lubrication and for lowering the vata dosha.
Apply heat on the affected areas to control the pain and stiffness.
Eat light foods and strictly avoid oily foods and curd which increase ama.
Avoid sleeping during the daytime.
Yoga asanas like pawana muktasana, bhujangasana, dhanurasana, paschimottanasana and vakrasana should be practised regularly.
The practice of pranayamas such as and shodhana, chandrabhedi sheethali and bhramari also helps.
Chewing 2 3 raw garlic buds on an empty stomach in the morning with water helps in alleviating lumbar pain in AS.
Use a powdered preparation of dried ginger root, celery seeds and cumin seeds in equal quantities with rock salt for taste, and have one teaspoon of this mixture with warm water at bedtime to reduce flatulence as well as lumbar stiffness.

Ankylosing Spondylitis (AS) - Ayurvedic Remedies That Help You Treat It!

Physiotherapy plays a pivotal role in helping a person recover after a hip replacement surgery. It brings back the old flexibility and prevents blood clots in the area where the procedure has taken place. After the surgery team gives its green signal, a physiotherapist starts working with a patient for a full recovery. 

Here is a list of some common exercises that a physiotherapist suggests after a hip replacement surgery:

Walking: It is important to use the crutches for a time period of 4-5 weeks post the procedure. Until the surgeon or the physiotherapist advises against using the crutches, it makes sense to use it while walking. It makes sense to retain the normal walking posture by using the crutches rather than limping without it. A physiotherapist reviews the pressure exerted by the arm while holding a crutch, before advising the patient to get rid of the crutches.
Increasing hip flexibility: This is a basic form of exercise where an individual lies on one side of the body with knees and hips bent. A pillow is placed in between the knees. While doing this, it should be ensured that both the feet is kept together and the back muscle is not twisted. The top knee should be slowly raised like an opening of the calm shell. This position should be maintained for 4-5 seconds.
Strengthening the hips: The body should rest on the stomach. The buttocks should be tightened and one leg should be slowly lifted. This position should be maintained for a stretch of 3-5 seconds. The same should be repeated for both the legs.
Strengthening the hip and the stomach muscle: The body should rest on the back with a leg bent. The stomach muscle should be tightened and the bent leg should be lifted carefully while ensuring that the bend does not supersede more than 90 degrees. While keeping the stomach muscle tight, the lifted leg should slowly come down to touch the surface. This act should be repeated for 5-6 times.
Strengthening the thigh muscle: While sitting in a steady chair, an elastic loop should be wrapped around the ankles. The elastic loop should be stretched with one leg while keeping the other foot firmly rooted to the ground. The lifted foot should slowly come down to the normal position. The same act should be repeated for 4-5 times.
Improving balance: An elastic loop should be tied to one leg of a table and the other end of the loop should be tied to one ankle. The table should be held on for maintaining balance. Maintaining an erect position, the tied up ankle should be stretched sideways. The position should be maintained for 3-5 seconds to return back to normal standing position.

How Physiotherapy Can Improve Recovery After Hip Replacement Surgery?

Sciatica is a very common neuropathic pain that is caused by damage to the sciatic nerve, a large nerve that runs from the lower back region down the end of each leg. It is the largest single nerve in the body.
This condition affects around 4 out of 10 people at some point of their lives. The nature of the pain varies from a mild ache to a sharp stinging sensation and may cause feelings of numbness and extreme weakness.

Causes of sciatica
The causes for the onset of sciatica are numerous. Some of them are as follows:
-slipped lumbar disc
-muscle inflammation
-internal bleeding
-pregnancy
-obesity
-awkward sleeping position
-uncomfortable footwear
-spinal injury

How can physical therapy help?
There are many ways of treating sciatica, such as medication, acupuncture and surgery, which can provide relief. The most common and easy treatment method however is physical therapy. A progressive and controlled exercise routine that is specifically tailored to the nature of the condition in consultation with a physical therapist acts as an effective remedy in treating the problem. It alleviates pain and also eliminates the chances of relapse.

Physical therapy exercises used to treat sciatica are of many types. They are a combination of core strengthening, muscular stretching and aerobic conditioning routines, which aim at correcting the root of the problem.

The different types of exercises employed to treat sciatica include the following:
Strengthening exercises
These aim at strengthening the spinal column and the pelvic region, which includes the hips and buttocks. They help in making the muscles and ligaments in this region more robust and allow for improved flexibility and support. Lunges and squats are some of the examples.

Stretching exercises
These provide pain relief through improved agility and flexibility. The most important aspect of these routines is stretching and exercising the hamstring. Hamstring, stretches, calf stretches and tricep stretches are a part of stretching exercises.

Aerobic conditioning
These are cardiovascular exercises of low intensity, which provide pain relief through the release of endorphins and the facilitation of fluid and nutrient exchange. Examples of these are swimming and brisk walking.

Reduce Sciatica Pain With Physical Therapy

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?

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