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The term ‘Osteon’ in Greek means bone and ‘poros’ means hole or passage and so Osteoporosis is the process of bones becoming porous by loss of density. In osteoporosis, there is gradual alteration in the micro-architecture of the skeleton that leads to increase in the bone fragility. In initial phase, Osteoporosis is completely asymptomatic and only identified when a fracture takes place. It is more common in females than males and can be attributed to the following factors:
- Women have less bone mass than men
- They tend to live longer and in take of calcium is less
- After menopause the rate of bone loss speeds up when estrogen levels fall.
Signs and Symptoms of osteoporosis
Most patients remain asymptomatic till they develop a compound fracture(fracture involving multiple parts of the same bone) after minimal injury. The most common site is hip joint, ribs, and upper limb.
- Back pain may also be an associated complaint if it involves the vertebral column.
- In very rare cases there may be height loss
Diagnosis of osteoporosis
- X-ray of the fractured part reveals osteoporosis; However, the changes are evident only after 30-50% of bone density has been lost.
- Blood tests to determine the levels of Alkaline phosphates also called as Bone ALP.
- Osteocalcin levels that contribute to bone formation
- Vitamin D levels in the body
- More advance diagnostic method which is used widely is measurement of bone density, by bone densitometry (DEXA SCAN)
Prevention of Osteoporosis:
- Diet which has large amount of Calcium like leafy greens, skimmed milk, tofu, low fat yogurt and abstinence from food items containing large amounts of phosphates helps in prevention.
- Regular and adequate exposure to Sunlight
- Daily exercise in which you have to carry the weight of your body such as walking, dancing jogging, stair climbing etc.
- Complete abstinence from Alcohol intake and smoking tobacco.
- Sodas (fizzy drinks) contain caffeine which also should be avoided.
Treatment of osteoporosis
Primary goal of the treatment is to increase the bone mass, reducing the incidence of fractures, arresting and reversing bone loss by inhibiting bone resorption and stimulating bone formation and symptom relief especially of pain. At the same time treatment of these diseases depends on the cause for osteoporosis and will include other supportive measures.
Medicinal treatment includes
Biophosphonates, Calcitron Raloxifene, Teriparatide,alendronate and risedronate are some possible drugs of choice for the treatement of osteoporosis.
For women suffering from osteoporosis in Menopausal age HRT (“Hormone replacement therapy) is the choice of treatment where estrogen is the main hormone supplied.
Calcium and Vitamin D supplements may help older patients lowering their risk of fractures.
Complications of Osteoporosis:
- Compound Fractures in spinal column can cause loss of height because the spine cannot bear the person’s body weight leading to characteristic hunched postures.
- Weakened bones can cause disability and loss of mobility.
- If there is involvement of the thoracic cage, there may be cardiopulmonary distress
- Death due to post operative complications especially in old aged patients.
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