Osteoporosis (ऑस्टियोपोरोसिस) is a disease where increased bone weakness increases the risk of a broken bone. It is the most common reason for a broken bone among the elderly. Bones that commonly break include the vertebrae in the spine, the bones of the forearm, and the hip. Until a broken bone occurs there are typically no symptoms. Bones may weaken to such a degree that a break may occur with minor stress or spontaneously. Chronic pain and a decreased ability to carry out normal activities may occur following a broken bone. Siddha Spirituality of Swami Hardas Life System has introduced a new method, which can be applied as an efficient remedy to make recovery faster. So, let us know osteoporosis, symptoms, causes, diagnosis, prevention, treatment, and free Siddha energy remedies.
Osteoporosis definition (ऑस्टियोपोरोसिस परिभाषा)
Thinning of the bones, with a reduction in bone mass, due to depletion of calcium and bone protein. Osteoporosis predisposes a person to fractures, which are often slow to heal and heal poorly. It is most common in older adults, particularly postmenopausal women, and in patients who take steroids or steroidal drugs.
Unchecked osteoporosis can lead to changes in posture, physical abnormality, and decreased mobility. Treatment of osteoporosis includes exercise, especially weight-bearing exercise that builds bone density, ensuring that the diet contains adequate calcium and other minerals needed to promote new bone growth, use of medications to improve bone density, and sometimes for postmenopausal women, use of hormone therapy.
Osteoporosis Symptoms (ऑस्टियोपोरोसिस के लक्षण)
It has no symptoms; its main consequence is the increased risk of bone fractures. Osteoporotic fractures occur in situations where healthy people would not normally break a bone; they are therefore regarded as fragility fractures. Typical fragility fractures occur in the:
- The vertebral column (कशेरुका स्तंभ)
- Rib (पुसली)
- Hip (कमर)
- Wrist (कलाई)
Fractures are a common symptom of osteoporosis and can result in disability. Acute and chronic pain in the elderly is often attributed to fractures from osteoporosis and can lead to further disability and early mortality. These fractures may also be asymptomatic. The most common osteoporotic fractures are of the:
The symptoms of a vertebral collapse are sudden back pain, often with radicular pain and rarely with spinal cord compression or cauda equina syndrome. Multiple vertebral fractures lead to a stooped posture, loss of height, and chronic pain with resultant reduction in mobility.
Fractures of the long bones acutely impair mobility and may require surgery. Hip fracture, in particular, usually requires prompt surgery, as serious risks are associated with it, such as deep vein thrombosis and pulmonary embolism, and increased mortality.
Fracture risk calculators assess the risk of fracture based upon several criteria, including:
- Bone mineral density (अस्थि खनिज घनत्व)
- Age (आयु)
- Smoking (धूम्रपान)
- Alcohol usage (शराब का उपयोग)
- Weight (वजन)
- Gender (लिंग)
Recognized calculators include FRAX and Dubbo.
The term “established osteoporosis” is used when a broken bone due to osteoporosis has occurred. Osteoporosis is a part of frailty syndrome.
Falls risk (गिरने का खतरा)
The increased risk of falling associated with aging leads to fractures of the wrist, spine, and hip. The risk of falling, in turn, is increased by impaired eyesight due to any cause, balance disorder, movement disorders (e.g. Parkinson’s disease), dementia, and sarcopenia (age-related loss of skeletal muscle).
Collapse leads to a significant risk of falls; causes of syncope are manifold but may include cardiac arrhythmias (irregular heartbeat), vasovagal syncope, orthostatic hypotension (abnormal drop in blood pressure on standing up), and seizures.
Removal of obstacles and loose carpets in the living environment may substantially reduce falls. Those with previous falls, as well as those with gait or balance disorders, are most at risk.
Osteoporosis Risk factors (ऑस्टियोपोरोसिस जोखिम कारक)
Risk factors for osteoporotic fracture can be split between non-modifiable and potentially modifiable. In addition, osteoporosis is a recognized complication of specific diseases and disorders.
Osteoporosis becomes more common with age. About 15% of white people in their 50s and 70% of those over 80 are affected. It is more common in women than in men.
About 22 million women and 5.5 million men in the European Union had osteoporosis in 2010. In the United States in 2010, about eight million women and one to two million men had osteoporosis. White and Asian people are at greater risk. The word “osteoporosis” is from the Greek terms for “porous bones”.
Nonmodifiable (परिवर्तन योग्य नहीं)
- The most important risk factors for osteoporosis are advanced age and female sex; estrogen deficiency following menopause or surgical removal of the ovaries is correlated with a rapid reduction in bone mineral density, while in men, a decrease in testosterone levels has a comparable effect.
- Ethnicity: While osteoporosis occurs in people from all ethnic groups, European or Asian ancestry predisposes for osteoporosis.
- Heredity: Those with a family history of fracture or osteoporosis are at an increased risk; the heritability of the fracture, as well as low bone mineral density, is relatively high, ranging from 25 to 80%. At least 30 genes are associated with the development of osteoporosis.
- Those who have already had a fracture are at least twice as likely to have another fracture compared to someone of the same age and sex. Early menopause/hysterectomy is another predisposing factor.
- Build: A small stature is also a non-modifiable risk factor associated with the development of osteoporosis.
Potentially modifiable (संभावित रूप से परिवर्तनीय)
- Excessive alcohol: Although small amounts of alcohol are probably beneficial, chronic heavy drinking probably increases fracture risk despite any beneficial effects on bone density.
- Vitamin D deficiency: Low circulating Vitamin D is common among the elderly worldwide. Mild vitamin D insufficiency is associated with increased parathyroid hormone (PTH) production.
- Tobacco smoking: Many studies have associated smoking with decreased bone health, but the mechanisms are unclear. Tobacco smoking has been proposed to inhibit the activity of osteoblasts and is an independent risk factor for osteoporosis.
- Malnutrition: Nutrition has an important and complex role in the maintenance of good bone. Identified risk factors include low dietary calcium and/or phosphorus, magnesium, zinc, boron, iron, fluoride, copper, vitamins A, K, E, and C.
- High dietary protein from animal sources: Research has found an association between diets high in animal protein and increased urinary calcium, and have been linked to an increase in fractures.
- Underweight/inactive: Bone remodeling occurs in response to physical stress so physical inactivity can lead to significant bone loss.
- Endurance training: In female endurance athletes, large volumes of training can lead to decreased bone density and an increased risk of osteoporosis.
- Heavy metals: A strong association between cadmium and lead to bone disease has been established.
- Soft drinks: Some studies indicate soft drinks may increase the risk of osteoporosis, at least in women. Others suggest soft drinks may displace calcium-containing drinks from the diet rather than directly causing osteoporosis.
- Proton pump inhibitors that decrease stomach acid, are a risk for bone fractures if taken for two or more years, due to decreased absorption of calcium in the stomach.
Medical disorders (चिकित्सा संबंधी विकार)
Many diseases and disorders have been associated with osteoporosis. For some, the underlying mechanism influencing the bone metabolism is straightforward, whereas for others the causes are multiple or unknown:
- In general, immobilization causes bone loss.
- Hypogonadal states can cause secondary osteoporosis.
- Endocrine disorders that can induce bone loss include Cushing’s syndrome, hyperparathyroidism, hyperthyroidism, hypothyroidism, diabetes mellitus type 1 and 2, acromegaly, and adrenal insufficiency.
- Malnutrition, parenteral nutrition, and malabsorption can lead to osteoporosis. Nutritional and gastrointestinal disorders that can predispose to osteoporosis include undiagnosed and untreated celiac disease, Crohn’s disease, ulcerative colitis, cystic fibrosis, surgery, and severe liver disease.
- People with rheumatologic disorders such as rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, and polyarticular juvenile idiopathic arthritis are at increased risk of osteoporosis.
- Renal insufficiency can lead to renal osteodystrophy.
- Hematologic disorders linked to osteoporosis are multiple myeloma and other monoclonal gammopathies, lymphoma, leukemia, mastocytosis, hemophilia, sickle-cell disease, and thalassemia.
- The disorders include osteogenesis imperfecta, Marfan syndrome, hemochromatosis, hypophosphatasia, glycogen storage diseases, homocystinuria, Ehlers–Danlos syndrome, porphyria, Menkes’ syndrome, epidermolysis bullosa, and Gaucher’s disease.
- People with scoliosis of unknown cause also have a risk of osteoporosis. Bone loss can be a feature of complex regional pain syndrome. It is also more frequent in people with Parkinson’s disease and chronic obstructive pulmonary disease.
- People with Parkinson’s disease have a higher risk of broken bones. This is related to poor balance and poor bone density.
Certain medications have been associated with an increase in osteoporosis risk; only glucocorticosteroids and anticonvulsants are classically associated, but the evidence is emerging with regard to other drugs:
- Steroid-induced osteoporosis (SIOP) arises due to the use of glucocorticoids – analogous to Cushing’s syndrome and involving mainly the axial skeleton.
- Barbiturates, phenytoin and some other enzyme-inducing antiepileptics – these probably accelerate the metabolism of vitamin D.
- L-Thyroxine over-replacement may contribute to osteoporosis, in a similar fashion as thyrotoxicosis does. This can be relevant in subclinical hypothyroidism.
- Several drugs induce hypogonadism, for example, aromatase inhibitors used in breast cancer, methotrexate, and other antimetabolite drugs, depot progesterone and gonadotropin-releasing hormone agonists.
- Anticoagulants – long-term use of heparin is associated with a decrease in bone density, and warfarin have been linked with an increased risk in an osteoporotic fracture in long-term use.
- Proton pump inhibitors – these drugs inhibit the production of stomach acid
- Thiazolidinediones (used for diabetes) – rosiglitazone and possibly pioglitazone, inhibitors of PPARγ, have been linked with an increased risk of osteoporosis and fracture.
- Chronic lithium therapy has been associated with osteoporosis.
Osteoporosis Diagnosis (ऑस्टियोपोरोसिस निदान)
The diagnosis of osteoporosis can be made using conventional radiography and by measuring the Bone Mineral Density (BMD). The most popular method of measuring BMD is dual-energy X-ray absorptiometry.
In addition to the detection of abnormal BMD, the diagnosis of osteoporosis requires investigations.
Conventional radiography (परम्परागत रेडियोग्राफी)
Conventional radiography is useful, both by itself and in conjunction with CT or MRI, for detecting complications of osteopenia, such as fractures; for differential diagnosis of osteopenia; or for follow-up examinations in specific clinical settings, such as soft tissue calcifications, secondary hyperparathyroidism, or osteomalacia in renal osteodystrophy.
The main radiographic features of generalized osteoporosis are cortical thinning and increased radiolucency. Frequent complications of osteoporosis are vertebral fractures for which spinal radiography can help considerably in diagnosis and follow-up.
Dual-energy X-ray (दोहरी-ऊर्जा एक्स-रे)
Dual-energy X-ray absorptiometry (DEXA scan) is considered the gold standard for the diagnosis of osteoporosis. Osteoporosis is diagnosed when the bone mineral density is less than or equal to 2.5 standard deviations below that of a young (30–40-year-old), healthy adult women reference population. The World Health Organization has established the following diagnostic guidelines:
|Category||T-score range||% of young women|
|Normal||T-score ≥ −1.0||85%|
|Osteopenia||−2.5 < T-score < −1.0||14%|
|Osteoporosis||T-score ≤ −2.5||0.6%|
|Severe osteoporosis||T-score ≤ −2.5 with fragility fracture|
Chemical biomarkers are a useful tool in detecting bone degradation.
The U.S. Preventive Services Task Force (USPSTF) recommend that all women 65 years of age or older be screened by bone densitometry. Additionally, they recommend screening younger women with risk factors.
In men the harm versus benefit of screening for osteoporosis is unknown. Prescrire states that the need to test for osteoporosis in those who have not had a previous bone fracture is unclear.
Osteoporosis Prevention (ऑस्टियोपोरोसिस की रोकथाम)
Lifestyle prevention of osteoporosis is in many aspects the inverse of the potentially modifiable risk factors. As tobacco smoking and high alcohol intake have been linked with osteoporosis, smoking cessation and moderation of alcohol intake are commonly recommended as ways to help prevent it.
In people with celiac disease adherence to a gluten-free diet decreases the risk of developing osteoporosis and increases bone density. The diet must ensure optimal calcium intake (at least one gram daily) and measuring vitamin D levels is recommended, and to take specific supplements if necessary.
Studies of the benefits of supplementation with calcium and vitamin D are conflicting, possibly because most studies did not have people with low dietary intakes.
While some meta-analyses have found a benefit of vitamin D supplements combined with calcium for fractures, they did not find a benefit of vitamin D supplements alone.
Vitamin K deficiency is also a risk factor for osteoporotic fractures. The gene gamma-glutamyl carboxylase (GGCX) is dependent on vitamin K.
Physical exercise (शारीरिक व्यायाम)
A 2011 review reported a small benefit of physical exercise on bone density of postmenopausal women. The chances of having a fracture were also slightly reduced (absolute difference 4%). People who exercised had on average less bone loss (0.85% at the spine, 1.03% at the hip).
Osteoporosis & Free Siddha Energy Remedies (ऑस्टियोपोरोसिस और नि:शुल्क सिद्ध ऊर्जा उपचार)
Siddha energy remedies to be applied from day one of the Osteoporosis confirmed, which include:
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