Osteoporosis means "porous bones," Osteoporosis is defined as a systemic skeletal disease characterized by by the loss of the normal density of bone and microarchitectural deterioration of bone tissue leading to bone fragility and increased risk of fracture.
Osteoporosis is one of the most common disease conditions affecting older people and women. Any bone can be affected by osteoporosis, but the most common sites are bones in the hip, spine, wrist, ribs, pelvis and upper arm. Osteoporosis is a chronic condition of multifactorial etiology and is usually clinically silent until a fracture occurs.
Primary causes
· Estrogen deficiency
· Changes associated with aging
Risk Factors
1. Age : > 45 yrs in Female and
2. 60 yrs in Male
3. An inactive and sedentary Lifestyle - lack of exercise
4. Low Vitamin D in take
5. Low calcium intake
6. Low estrogen levels resulting from Surgical menopause with the removal of the ovaries which accelerates the process of bone loss to a rapid level.
7. Either an Asian or Caucasian. White women and Asian women face the greatest risk of osteoporosis
8. Under certain medications such as diuretics, steroids, and anticonvulsants
9. Thin and small body frames;
10. Family history of osteoporosis
11. Excessive alcohol consumption;
12. Chemotherapy can cause early menopause due to its toxic effects on the ovaries;
Symptoms
The osteoporosis condition can be present without any symptoms for decades, because osteoporosis doesn't cause symptoms unless bone fractures.
Fractures of the Hip, Spine, Wrist are common.
Fractures of the spine can cause severe "band-like" pain that radiates around from the back to the side of the body. Over the years, repeated spine fractures can cause chronic lower back pain.
Hip fractures typically occur as a result of a fall.
Aches and pains
Loss of height or curving of the spine, which gives the individual a hunched-back appearance of the upper back, often called a "dowager hump”
Diagnosis
A dual energy x-ray absorptiometry scan (DEXA) measures bone density in the hip and the spine .The bone density is then compared to the average peak bone density of young adults of same sex and race. This score is called the "T score," and it expresses the bone density in terms of the number of standard deviations (SD) below peak young adult bone mass. Osteoporosis is defined as bone density T score of -2.5 SD or below. Osteopenia (between normal and osteoporosis) is defined as bone density T score between -1 and -2.5 SD.
Management of osteoporosis
· Life style changes including quitting cigarette smoking, curtailing alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin D;
Take calcium everyday
Calcium > 1200 mg/day + Vitamin D 400-800-I.U./day
Milk 240 ml 300 mg
Curd 240g 400 mg
Paneer 25 g 300 mg
+ 250mg from non dairy sources like Egg yolk/
Salt water fish/Liver
Vitamin D helps the absorption of calcium from the intestines. An adequate calcium intake and adequate body stores of vitamin D are important foundations for maintaining bone density and strength.
Regular physical activity on a long-term basis has a particularly important role in maintaining healthy bones. Exercise can maintain and increase bone strength by increasing bone mass or by slowing age-related bone loss. Muscle strength is also increased, which is important for supporting the joints and preventing falls. Exercise has also been shown to improve co-ordination and balance, which helps to prevent falls and to improve general physical health and well-being. Exercise at least 3 hours per week
Medications that stop bone loss and increase bone strength, such as calcitonin. Anti-resorptive medications inhibit bone removal (resorption), thus tipping the balance in favor of bone rebuilding and increasing bone density.
Medications that increase bone formation such as Forteo.
Hormone therapy (menopausal hormone therapy)
Recommended exercises for people with osteoporosis
Strength training Strength training includes the use of free weights, weight machines, resistance bands or water exercises to strengthen the muscles and bones in your arms and upper spine. Strength training can also work directly on your bones to slow mineral loss. Exercises that gently stretch your upper back, strengthen the muscles between your shoulder blades and improve your posture can all help to reduce harmful stress on your bones and maintain bone density. Resistance exercises - weight machines, free weights, calf raises, knee flexion, hip flexion, hip extensions, resistance bands
Weight-bearing aerobic activities Include walking, dancing, low-impact aerobics, elliptical training machines, stair climbing. These types of exercise work directly on the bones in your legs, hips and lower spine to slow mineral loss. They can also provide cardiovascular benefits
Flexibility exercises. Stretches are best performed after your muscles are warmed up — at the end of your exercise session, for example. They should be done gently and slowly, without bouncing.
Balance exercises- Balance training is an important part of looking after your bones. Working on your balance can improve your stability and help prevent falls, which is important because falls can cause fractures For example-standing on one leg; sitting on an exercise ball; and balancing with a rocker board under your feet. yoga, double leg press, exercise ball, tai chi
Movements to avoid
If you have osteoporosis, don't do the following types of exercises:
1. High-impact exercises, such as jumping, running or jogging.
2. Exercises in which you bend forward and twist your waist, such as touching your toes, doing sit-ups or using a rowing machine.
Some Sample Exercises For Target Areas
· Spine — Back extensions
A simple back extension exercise: Lie on stomach with forehead resting on floor or rolled up towel. Extend arms straight in front of head. Raise head off the floor a few inches. Hold for several seconds. Do three sets of 10 repetitions.
· Hip — Squats, hip adduction/abduction exercises with elastic bands or weights
· Forearm — Bicep curls, wrist curls, reverse wrist curls
Include a variety of exercises for all major groups to promote well-balanced muscle development. Improved muscle strength also enhances coordination and balance to protect against falls.