Osteoporosis,Causes and Physiotherapy treatment

According to WHO( World Health Organisation), Osteoporosis is a systemic skeletal disease characterized by low bone mass & microarchitectural deterioration of bone tissue leading to enhanced bone fragility & a consequent increase in fracture risk.

 

Osteoporosis is far commonest Metabolic Bone Diseases. It occurs when the Rate of Bone Resorption exceeds Rate of Bone Formation. This weakness in bone and brittleness results in the reduction of BMD due to a deficiency of Vitamin D and Calcium.

Deficient calcium absorption from the intestine.

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Stimulates parathyroid gland

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Parathyroid Hormone resorbs Calcium from bone

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OSTEOPOROSIS

Classification:

Primary Osteoporosis :

• Type 1 - Postosteoporosis
• Type 2 - Senile osteoporosis

Secondary Osteoporosis 
Due to some diseases such as Endocrine, Malignancy, prolong intake of medicine eg: steroids, antiepileptics, etc.

Causes for osteoporosis:

• Senility
• Post immobilization eg: the bedridden patient.
• Postmenopausal.
• protein Deficiency - Inadequate intake, Malnutrition, Excess Protein Loss
• Endocrinal - Cushing's disease, Cushing's syndrome, Hyperthyroid state
• Drug induce - Long-term steroid therapy, Phenobarbitone therapy.

Features of Osteoporosis :

• Loss of bone mass leads to loss of strength.
• DorsoLumbar spine is most frequent site.
• Osteoporosis is Colle's fracture and fracture of the neck of the femur.

Diagnosing Osteoporosis

There is no method of determining the actual structure of bones without removing a piece during a biopsy (which is not practical or necessary).it is very difficult to, Instead, the diagnosis of osteoporosis is based on special x-ray methods called densitometry. Densitometry will give accurate and precise measurements of the amount of bone (not their actual quality) in different parts of the body. This measurement is called bone mineral density or BMD.

Treatment of Osteoporosis

The principal objective of the treatment is: 

1. Alleviation of pain
2. prevention of fracture
3. Regular check-up of the level of BMD after 50-55 years or menopause women.
4. Good nutrition diet to control malnutrition.
5. Additional calcium intake to curb bone loss.
6. Vitamin D to facilitate Calcium absorption from the gut.
7. Hormone Replacement Therapy in Postmenopausal Women.
8. Selective Oestrogen Receptor Modulation(SERM)
9. Calcitonin secreted by the thyroid gland.
10. Osteophos(containing sodium alendronate)
11. Exercises - Weight-bearing is the major stimulus to bone formation.
12. Bracing - Taylor Brace may be useful in the Prevention of pathological Fractures in the severe Osteoporotic spine.

-By Nishi Shah