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Brittle bones (Osteoporosis)

Brittle bones are usually caused by loss of bone mineral density, which makes the bone thin and fragile and break easily. This condition is otherwise called as OSTEOPOROSIS. Brittle bones are considered to be part of aging. In addition to the aging many other medical diseases, factors can cause brittle bones.

CAUSES:

Bone is a living tissue in which old bone is broken down and replaced by new bone which together occurs in harmony. But as the people age more bone is broken down then is replaced. A normal individual build up their bone mass (bone bank) until the age of 30 and slowly the process bone mass reduction occurs by aging. Normal bone has a structure of Honeycomb, but when a person has osteoporosis the spaces inside the honeycomb become larger resulting in the loss of density of bones.

Risk factors you can’t control causing Osteoporosis

Heredity

Ethinicity

Diabetes,

Rheumatoid arthritis,

Inflammatory bowel diseases and

Some hormonal disorders.

Risk factors you can control

Smoking,

Sedentary life style

Excessive alcohol

Corticosteriod medications

Anti-inflammatory drugs

Postmenopausal osteoporosis is the most common form of osteoporosis. 25% of men above 50 years will have osteoporosis related fracture.

Symptoms

Osteoporosis is referred to as silent disease. In developing countries like India people come to know about the condition after fractures.

Unexplained bone pains, sudden severe back pain, fractures of wrist, hip and spine after trivial injury, Decrease in height, deformity in spine.

Diagnosis

DEXA SCAN:

Bone mineral density test is advised

If you are over 50, post menopausal female, had a broken bone, men aged above 60, with risk factors.

DEXA uses low dose x-rays to quantify the bone density in the hip or spine. The results are given in the form of T-Score.

T-score

Bone density

T-score -1.0 and higher

Normal bone desity

T-score -1.0 to -2.5

Osteopenea (low bone density)

T-score -2.5 or below

Osteoporosis

Treatment

Medical treatment

1. Calcium supplements: Oral calcium preparations in recommended doses can be taken in the form of Calcium citrate or Calcium carbonate.

1-3 years 700mg

4-18 years 1000mg to 1300mg

Above 19 years 1200

2. Vitamin D supplements: Vitamin D aids in absorption of calcium

3. Bone Building drugs: These drugs help to reduce the bone loss and help to bulid bone density.

Oral and injectable Bisphosphonates

4. Hormones: Calcitonin hormone in our body helps to slows down bone loss. Calcitonin preparations are available in the form of Nasal sprays and injections can be given in adjunct in treatment of osteoporosis.

Teraparatide : a synthetic parathyroid hormone analogue helps in building the new bone.

5. Hormone replacement therapy: Estrogen analogues: Once used for treatment of post menopausal symptoms is also helpful for treatment of osteoporosis. But its use is limited as it had concerns about risk of blood clots, stroke and cancer.

Dietary Management:

Calcium rich foods: such as Milk, curd, cheese, Fish like Salmon, tuna, Green leafy vegetables.

Exercise and bone health:

Weight bearing exercise can help to build bone and maintain their strength. Exercising using small weights in different forms of exercises can help. It is found in studies that women who walk mile a day have 4 to 7 years of bone reserve.

Prevention:

1.Strong bones in your youth is like a Bone Bank reserve for your retirement.

Young people in their childhood, teenage can build their strong bones by eating calcium rich food, vitamin D through sunlight, and exercising regularly.

2.Preventing falls: One fall can trigger other. Some modifications in the house like using railings at restrooms, toilets, removing of loose electric cords, loose sheets of clothes.

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