Prevention of osteoporosis is a much better plan than treatment, as often treatment is too late. Many factors contribute to osteoporosis. Firstly we need to understand what naturally occurs in bone as we age. As we go through life bone is constantly being remodelled.It is absorbed and laid down constantly through our lives. As we get older the rate at which bone is absorbed occurs faster than it is laid down.Over years this can lead to weak bones, which is osteoporosis.So, two factors are important in determining whether or not we get osteoporosis.That is how strong our bones are beforebones are before they start to get weaker and then the rate at which they deteriorate.In general in later life bone density tends to reduce by 1% per annum.Women are at higher risk than men of getting osteoporosis because as they reach menopause the drop in Oestrogen results in several years of rapid bone density loss. Video Rating: 0 / 5
With Serious Side Effects of Osteoporosis Drugs Mounting, Health Experts at AheadoftheCurveatMidlife.com Say it’s Time Women Take Charge
Dallas, TX (PRWEB) April 15, 2010
Popular osteoporosis drugs- the bisphosphonates- are beginning to develop a bad track record. Incapacitating joint and muscle pain, possible links to atrial fibrillation, pending lawsuits of jaw necrosis, and now the latest – spontaneous thigh bone fracture, midlife women clearly need safer and more effective options for staving off osteoporosis. Before accepting drug treatment, the health experts at AheadoftheCurveatMidlife.com (http//:http://www.aheadofthecurveatmidlife.com) want women to know that, “Women shouldn’t fear osteoporosis. Osteoporosis is not a normal part of aging, and there is a lot that women who are otherwise relatively healthy can do to take control of their bone health well into the second half of life”. To offer women just such a safe and natural non-drug option, they created a uniquely customized bone strengthening program, Women Doing It for Themselves: 8 Steps to Building Strong Bones for Lifelong Vitality.
Co-developed with integrative healthcare practitioner Dr. Judith Valentine, Ph.D., Women Doing It for Themselves is an innovative virtual program that brings the latest in nutritional research to preventing osteoporosis and maintaining bone health well into the senior years. Combining the cutting edge science of metabolic typing with the web’s ease of personal interaction, Dr. Valentine helps women assess their needs to create an individualized food and supplement program. “While good nutrition isn’t rocket science,” she says, it’s time to lay to rest the myth that osteoporosis is a calcium deficiency disease – it is much more complex than that. There are dozens of nutrients that affect bone health, and different metabolic types need different proportions of them. Mastering the essentials of meeting your own unique needs takes more than reading a book or a one-size fits all program. It takes motivation and guidance to learn and apply lifelong diet and lifestyle changes that will stick. That’s the only approach that works.”
“There is an increasing sense that the pharmaceutical and insurance industries are running health care. Doctors are paid for a 5 minute consult and a prescription, while what’s really needed – a 2 hour wellness education in changing lifelong health with diet, exercise and lifestyle – isn’t currently reimbursable by most insurance,” says Jennifer Montgomery, pharmacist and co-founder of the website AheadoftheCurveatMidlife.com. “To make matters worse these non-drug programs are usually associated with large out-of-pocket expenses, and it is difficult for women to evaluate their effectiveness.”
With health care costs skyrocketing, and physician visits that end with an osteoporosis drug prescription the norm, AheadoftheCurveatMidlife.com wants women to have an affordable option in seeking safe and individualized solutions that succeed. The cost is $ 197. For more details, or to enroll, visit http://www.aheadofthecurveatmidlife.com or email info(at)aheadofthecurveatmidlife(dot)com
Dr. Singer and patient Dell explains how postmenopausal women are at a higher risk for osteoporosis than the average person. Believing that osteoporosis is under-recognized through-out America, Dr. Singer thoroughly advocate for women’s health to get more women to seek bone density examinations in order to get treated at its early stages, thus preventing women from bones damage. Dell, a strong willed patient of Dr. Singer, iterates the need for postmenopausal women to get a bone density checkup because she doesn’t want others to go what she went through. She is receiving therapy and the best piece of advice she could give from her experience is to listen to your doctor. With the treatment Dell feels a bit of recovery but wishes she sought treatment in its earlier stages. For more information contact ua at www.goodnewsbroadcast.com Video Rating: 0 / 5
Dr. Susan E. Brown, Director of the Center for Better Bones, talks about the Surgeon General’s recommendations for treatment of osteopenia and osteoporosis — recommendations that many physicians do not follow. Video Rating: 0 / 5
The traditional treatment for fractures within a vertebral body (one of the bones of the spine) caused by osteoporosis has included pain reduction medication, bed rest, and bracing. Kyphoplasty offers immediate pain relief and stabilization of the vertebral body. It is also effective in treating pathologic compression fractures. Compression fractures of a vertebral body not only cause pain but also cause the spine to shorten and fall forward. Many people develop a ‘hump back’ posture deformity after a compression fracture. The kyphoplasty procedure uses a balloon to straighten the fractured area of the vertebral body. Once this is achieved, bone cement is injected into this newly formed space to obtain immediate stabilization and maintenance of the upright posture. At the conclusion of the procedure, the spine is better aligned and stabilized and pain is dramatically relieved. Kyphoplasty is done through a quarter-inch incision. Small tubes are placed into the fracture with x-ray guidance. The procedure takes about 45 minutes per fractured vertebra. Blood loss is minimal and patients usually leave the hospital the following day. Visit www.LASpineInstitute.com or call 888-774-6376 for more information. Video Rating: 0 / 5
Osteoporosis is a disease in which bones become fragile and more likely to break. Osteoporosis often was thought to be conditions of frail elderly women develop. Osteoporosis leads to literally abnormally porous bone that is more compressible like a sponge, that dense as a brick. This disorder of the skeleton weakens the bone leading to an increased risk of breaking bones (fractures). A broken bone can really affect a woman’s life. It can cause disability, pain or loss of independence. It may make it more difficult to do daily activities without assistance, such as walking. If you have osteoporosis, you have an increased risk of bone fractures (broken bones), especially in the hip, spine and wrist. In most cases, bones weaken when you have low levels of calcium, phosphorus and other minerals in the bones. The process of remodeling of bone resumption to matrix synthesis to mineralization normally takes about 8 months – a slow but steady. The disease is “silent” because there are no symptoms when you have osteoporosis, and conditions may come to attention only after breaking a bone. Osteoporosis can also accompany endocrine disorders or result from excessive use of drugs such as steroids.
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Osteoporosis can cause a person to stoop forward and appear to have a bump on his spine. The most serious and debilitating osteoporotic fracture is the hip fracture. The goal of treatment for osteoporosis is prevention of fractures in the first place. People with osteoporosis most often break bones in the hip, spine and wrist. Most patients with hip fracture who previously lived independently will require help from your family or home care. In the United States, about 10 million people have osteoporosis. Another 18 million people have low bone mass that places them at increased risk of developing osteoporosis. Any bone can be affected, but of special concern are fractures of the hip and spine. One in two women and four men in an age over 50 will break a bone in his life due to osteoporosis. A hip fracture almost always requires hospitalization and major surgery. Normal bone is composed of protein, collagen, and calcium. Bones that are affected by osteoporosis can fracture with only a minor fall or injury that normally would not cause a bone fracture.
Causes of Osteoporosis Common causes and risk factor of osteoporosis include the following: A family history of osteoporosis. Smoking. Anorexia nervosa. Lack of exercise or long-term rest may cause weak bones. Small, thin women are at greater risk. Some drugs, e.g. steroids. Drinking alcohol. Lack of dietary calcium. Inactive lifestyle. Low levels of testosterone in men. Long postmenopausal range. Symptoms of Osteoporosis
Some signs and symptoms related to osteoporosis are: Back pain, which can be serious, if you have a fractured or collapsed vertebra. Broken bones. Loss of height over time, with an accompanying stooped posture. Dull pain in the bones and muscles. Neck pain.
Treatment of Osteoporosis Here is a list of methods of treatment of osteoporosis: A balanced diet rich in calcium and vitamin D. Exercise. You may need strong pain killers (analgesics), for some time, for an osteoporotic fracture. A healthy lifestyle.
Osteoporosis and interventions for vertebral fracture
World osteoporosis month Osteoporosis: Interventions to manage vertebral fractures
Dr (Maj) Pankaj N Surange MBBS, MD, FIP Interventional pain and spine specialist Some important facts about osteoporosis • Osteoporosis is a systemic skeletal disorder characterized by low bone mass, disruption of the microarchitecture of bone tissue, and compromised bone strength which leads to an increased risk for fracture. • Bone strength is a product of both bone density and bone quality. Bone density is expressed as grams of mineral per area or volume; bone quality refers to factors such as architecture, turnover, damage accumulation (e.g., microfractures), and mineralization • Osteoporosis is common among menopausal women but is often clinically silent until a fragility fracture occurs. Osteoporosis is also being recognized with increasing frequency in older men. • After peak bone mass is reached, the bone remodeling process is in a state of equilibrium until menopause. Cessation of estrogen production leads to rapid bone loss of approximately 2% to 3% per year in the spine for up to 6 to 8 years, which accounts for 50% of the total spinal bone loss among normal women .This is then followed by a slower rate of bone loss (0.5%/year), which is attributed to aging. • Even among men, it is now known that estrogen deficiency plays a big role in bone loss, perhaps an even bigger role than played by testosterone . Studies among osteoporotic males have shown a closer correlation between estradiol levels and bone mineral density (BMD) than testosterone and BMD. A finding that men with osteoporosis may have low estradiol yet normal testosterone levels further supported this correlation. • Clinically, osteoporosis is diagnosed when bone mineral density (BMD) is reduced or when fragility fractures (ie, fractures after little or no trauma) occur.
Dual-energy x-ray absorptiometry (DXA) is by far the best standardized technique and is preferred for diagnosing osteoporosis and monitoring responses to therapy. BMD assessment by DXA has been used by the World Health Organization to define osteopenia and osteoporosis
Normal BMD T-score –1
Low bone mass (osteopenia) BMD T-score < –1 and > –2.5 Osteoporosis BMD T-score –2.5
Severe osteoporosis BMD T-score –2.5 with one or more fragility fractures
• The most common misuse of the WHO criteria is applying it to nonwhite postmenopausal populations. The fracture risk/T-score relationship used for these criteria was derived solely from a database of white, postmenopausal women. Thus, the criteria cannot be taken to mean or suggest the same fracture risk when the individual being measured is male, premenopausal, or nonwhite. • The T-scores obtained from peripheral sites do not have the same fracture implication as those obtained with central machines. • Degenerative changes in the spine are exceedingly common among the elderly. These are seen as sclerotic changes in the facets and discs as well as osteophyte formation. They elevate BMD and may lead to falsely normal BMD and T-scores in the spine. • Vertebrae with compression fractures are denser than normal vertebrae and would have higher T-scores. It would be a big mistake to withhold therapy for a patient who appears to have normal T-scores due to compression fractures.
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The most common osteoporosis-related fractures involve the thoracic and lumbar spine, the hip, and the distal radius.
Biochemical evaluation Successful management of osteoporosis requires a careful choice of biochemical tests to determine the presence of secondary causes of osteoporosis. At a minimum, laboratory evaluation should include a complete blood cell count, serum chemistry panel, liver function tests, and serum thyroid-stimulating hormone and calcium determinations. Complete Blood Count
Complete blood count (CBC) tests can detect anemia, which can be seen in many secondary causes of osteoporosis; these include celiac sprue and other malabsorptive states, chronic liver disease, chronic kidney failure, metastatic bone disease, and multiple myeloma. KFT Renal insufficiency often leads to a deficiency in 1–25 OH vitamin D deficiency and secondary hyperparathyroidism, which must be addressed prior to initiation of osteoporosis therapy. Bisphosphonates are contraindicated when GFR falls below 30 mg/24 hours Liver Function Tests
An alanine aminotransferase (ALT) test is the most cost-effective way to screen for liver disease among osteoporotic patients. Elevated ALT levels suggest liver dysfunction, which, regardless of the cause, increases the risk of vitamin D deficiency.
Serum calcium
Postmenopausal women as a group are commonly affected by primary hyperparathyroidism .A serum calcium determination adequately screens for this disorder
Treatment of osteoporosis
The essentials of management for most forms of osteoporosis include the following: • Lifestyle modifications. • Nutritional interventions. • Pharmacologic therapies. • Interventional procedures for vertebral fractures Lifestyle Modifications Safety of the patient’s immediate environment to prevent falls and fractures, eliminating habits that are deleterious to skeletal integrity and that can contribute to falls
Discontinue smoking and alcohol consumption.
Weight-bearing exercise program
In patients with inflammatory diseases who are receiving long-term glucocorticoid therapy and are at risk for osteoporosis, an exercise and physical therapy program is imperative
Nutritional Interventions
Nutritional interventions for osteoporosis should assure that the diet plus supplements provide at least 1200 mg of elemental calcium per day and up to 1500 mg in high-risk patients over the age of 70 with established disease or with steroid-induced osteoporosis. Pharmacologic Therapy Drugs for osteoporosis can be divided into two major classes: antiresorptive and anabolic agents. Antiresorptive agents inhibit bone resorption, mainly through their action on osteoclasts, whereas anabolic agents stimulate osteoblastic differentiation and activity.
Antiresorptive Therapy
Bisphosphonates
These pyrophosphate analogues bind to hydroxyapatite crystals in the bone, are taken up by osteoclasts in the bone, and exert their action by inhibiting the mevalonate pathway, subsequently leading to inhibition of osteoclast function and increase in rates of apoptosis. Oral bioavailability is generally low, only 1% to 3%, and is greatly inhibited by food, calcium, iron supplements, and drinks. Patients must be advised to take this medication in the morning, to withhold food and drinks to ensure good absorption, and to remain upright for at least 30 minutes. • • Bisphosphonates Alendronate 5 mg/d or 35 mg/wk for prevention of osteoporosis; 10 mg/d or 70 mg/wk for treatment of postmenopausal, male, and glucocorticoid-induced osteoporosis
Risedronate 5 mg/d or 35 mg/wk for prevention and treatment of postmenopausal and glucocorticoid-induced osteoporosis Ibandronate:2.5 mg /d or 150 mg/month .or 3mg iv 03 monthly
Raloxifene Raloxifene is a selective estrogen receptor modulator, with agonistic effects on bone. The major efficacy trial for raloxifene was the Multiple Outcomes of Raloxifene Evaluation (MORE) Trial. The LS BMD increase over the 3-year study period was 2% to 3%, and vertebral fracture reduction rates in women with and without preexisting fractures were 50% and 30%, respectively. Calcitonin Because of its modest effect on BMD, and small fracture risk reduction, calcitonin is rarely used as first-line therapy; rather, owing to its mild analgesic effects, this drug is more commonly used now as an adjunctive therapy after an acute vertebral fracture, usually combined with a stronger antiresorptive.
Hormone Replacement Therapy Hormone replacement therapy (HRT) was the original antiresorptive therapy used for osteoporosis. However, current controversies centered on increased breast cancer, and cardiovascular risks have resulted in a marked decline in use for osteoporosis indications.
Anabolic Therapy Teriparatide Synthetic human parathyroid hormone [PTH (1–34)], or teriparatide, is an anabolic agent that has been approved for postmenopausal and male sosteoporosis treatment
Combination Therapy Trials that have studied combination therapy for osteoporosis had BMD and not fracture risk reduction as the primary endpoint. Thus, although the effects appear to be additive, it is unknown whether there is indeed a greater reduction in fracture risk when two agents are combined.
Interventional procedures for vertebral fractures
Kyphophasty and Vertebroplasty
These two surgical modalities have been reported to successfully relieve pain from acute compression fractures and decrease kyphosis slightly .The procedures entail injection of polymethylmethacralate or bone cement directly into the fractured vertebra in vertebroplasty, and into a balloon within the vertebra, in kyphoplasty.
Vertebroplasty is a percutaneous procedure with a low complication rate that provides immediate and long-¬term pain relief to patients suffering from chronic ver¬tebral compression fracture pain. Vertebro¬plasty is a minimally invasive procedure that not only provides immediate relief but continued and prolonged relief that may increase the patient’s daily activity level, which in turn helps provide a better quality of life. In several studies it has been shown that in more than 90% cases it provide immediate pain relief. Some of the potential complications include leakage of the cement into the spine, surrounding structures, and vessels.
dr pankaj nsurange is an Interventional Anesthesiologist and practicing interventional pain management.
special interest in spine interventions and chronic pain management
Guía educativa y preventiva sobre Osteoporosis con el Doctor Jose Goris, Medicina General. 435 Fort Washington Ave Apt 1C New York, NY 10033 – 212-923-1919 Video Rating: 0 / 5
WVIA Call the Doctor-Osteoporosis: Strong Bones for Life Tonight @ 7 on WVIA-TV
• Download a free brochure: bit.ly Memorial Nurse Practitioner, Penny Renwick, discusses early detection and prevention of osteoporosis. Video Rating: 0 / 5
Baptist Smart Medicine: Her Baptist Video Rating: 0 / 5
Osteoporosis is the disorder of the skeleton which reduces the density of the bone. Usually due to this disorder, the bone becomes weak and result into frequent fractures in the bones. Literally we can say that due to osteoporosis, abnormally our bone becomes porous which is compressible like a sponge.
Bone receives strength from its composition of protein, calcium and collagen. Bones which get affected by osteoporosis break even if it gets slight pressure. When there is an imbalance between the old bone resorption and the formation of the new bone, it leads to osteoporosis. In this condition it may be possible that body may be fail in formation of new bone or it may be possible that the old bones may be reabsorbed or it is possible to have both the conditions. Calcium and phosphate are the two essential minerals for the formation of the new bones. If the intake of the calcium is not sufficient or our body is unable to absorb enough calcium from our diet then in this case bone tissue and the production of the bone suffers a lot. Bone may also result into weaker, brittle and fragile bones which can break easily.
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In early course this disease causes no symptoms. In the later stage, it may result into dull pain in the muscles or in the bones like neck pain and low back pain. Later in the course the patient suffering from osteoporosis feels sharp pains which may come on suddenly. This pain does not spread to other areas but it becomes worse when some weight is put on that area. The pain may subside in one week or it may linger even more than three months.
Some of the natural treatments for osteoporosis –
1. Exercise is very important for reducing the problem of osteoporosis. Especially the weight-bearing exercise is vital for the improvement of bone health. You may perform jogging, walking, dancing, running and also weight training. These exercises put more weight on the bones then other exercise like swimming.
2. Intake of vitamin D is very effective in building bone mass. From exposure of the sun we receive vitamin D it synthesizes in our body. It is also found in the food like salt-water fish, egg yolk, liver and fortified beverages.
3. Vitamin K is very essential in improving the bone loss. It is found in leafy vegetables like broccoli, sprouts, lettuce, spinach and Brussels.
4. Calcium is very important in building bone mass. Calcium is found in yoghurt, green vegetables, and soy products, in sesame seeds and in many things.
Osteoporosis is a disease of the bones characterized by a decrease in bone mass and structural deterioration of bone tissue, leading to bone fragility and increased susceptibility to fractures of the hip, spine and wrist.
The word “osteoporosis” literally means “porous bones.” Osteoporosis (pronounced OSS-tee-o-puh-RO-sis) occurs when bones begin to lose some of their essential elements. The most important of these elements is calcium. Over time, bone mass decreases. As a result, bones lose their strength, become fragile, and break easily. In extreme cases, even a sneeze or a sudden movement may be enough to break a bone.
Osteoporosis affects millions of older adults, usually striking after 60. Although it is most commonly found in women, it is not unheard of in men. Osteoporosis can be very far along before it became noticeable. Sometimes the first sign is a broken bone in the hip, spine, or wrist after a bump or fall. As the disease gets worse, other signs may appear such as pain in the back and ultimately, a curved backbone.
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Causes of Osteoporosis
The average rate of bone loss in men, and in women who have not reached menopause, is actually quite small. However, after menopause, the bone loss in women accelerates to an average of one to two percent a year. It is after menopause that the level of the female hormone estrogen in a woman’s body decreases sharply. Estrogen is a hormone that is important in protecting the skeleton by helping the body’s bone forming cells to keep working. So after menopause, this protection can be considered lost as the level of estrogen decreases.
Other causes of osteoporosis are heredity and lifestyle. Whites and Asians, tall and thin women and those with a history of osteoporosis are those at the highest risk of getting osteoporosis. The behavioral causes of increasing the risk of osteoporosis are smoking, alcohol abuse, prolonged inactivity and a diet low in calcium.
Symptoms and Treatment
Usually, osteoporosis does not cause any symptoms at first. Osteoporosis is often called the “silent” disease, because bone loss occurs without symptoms. People often don’t know they have the disease until a bone breaks, frequently in a minor fall that wouldn’t normally cause a fracture. Many people confuse osteoporosis with arthritis and believe they can wait for symptoms such as swelling and joint pain to occur before seeing a doctor. It should be stressed that the mechanisms
Treatment for osteoporosis includes eating a diet rich in calcium and vitamin D, getting regular exercise, and taking medication to reduce bone loss and increase bone thickness. It’s important to take calcium and vitamin D supplements along with any medicines you take for osteoporosis. Even small changes in diet, exercise, and medicine can help prevent spine and hip fractures. Adults who adopt healthy habits can slow the progress of osteoporosis.
Think calcium, eat calcium. Learn to love tofu, tinned sardines and salmon and dark green leafy vegetables. Dairy produce and calcium enhanced foods are good calcium replenishments for bone.
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