Osteoporosis
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Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue, leading to fragile bones and an increased risk of fractures. Common sites of osteoporotic fractures include the spine, causing severe back pain. Spinal fractures are typically triggered by everyday activities and result in loss of height, kyphosis, and pain when bending or twisting. Low back pain is also linked to osteoporosis, as fractured vertebrae from weakened bones can press on nerves and cause chronic pain. Treatment focuses on preventing further bone loss and fractures through medications, calcium/vitamin D supplementation, exercise, and lifestyle changes.
Osteoporosis
- 1. OSTEOPOROSIS Dr Smarajit Patnaik Senior Consultant Orthopaedic Surgeon Apollo Hospitals Bhubaneshwar
- 2. • Back pain is one of most common reasons people see a doctor or miss days at work. • Even school-age children can have back pain. • Back pain can range in intensity from a dull, constant ache to a sudden, sharp or shooting pain. • It can begin suddenly as a result of an accident or by lifting something heavy, or it can develop over time as we age. • Getting too little exercise followed by a strenuous workout also can cause back pain. Low back pain
- 3. The lumbar spine, or low back, is a remarkably well-engineered structure of interconnecting bones, joints, nerves, ligaments, and muscles all working together to provide support, strength, and flexibility. • This complex structure also leaves the low back susceptible to injury and pain • Most acute low back pain results from injury to the • Muscles • Ligaments • Joints or discs Low back pain
- 4. Mechanical Lower back pain is often triggered by spinal movement and involves spinal structures, such as the joints, discs, vertebrae, ligaments, muscles or soft tissues. Eg- Kyphosis, Disc bulge, Herniated disc, Ligament / Muscle strains, Sciatica, ETC Organic lower back pain is attributed to disease, Eg- Osteoporosis; loss of bone mass causing vertebral fracture, Rheumatoid arthritis, osteoarthritis, spondylitis ETC Idiopathic refers to an unknown cause. Low back pain causes
- 6. You can Resize without losing quality You can Change Fill Color & Line Color www.allppt.com FREE PPT TEMPLATES Osteoporosis • “Osteo” means bone, and “porosis” means something that has holes in it, like a sponge. • Our skeleton keeps us healthy through a constant process of repair, renewal, and mineral release. This process is called remodeling. • The bone remodeling cycle consists of two distinct stages: • bone resorption (breakdown and removal) and • bone formation (generation of new bone) • Bone Breakdown > Bone Formation = Osteoporosis
- 7. Osteoporosis A disease characterized by: – Low bone mass – Micro architectural deterioration of the bone tissue Leading to: – Enhanced bone weakness – Increase in fracture risk Normal bone Osteoporotic bone Bone Strength = Bone Mass + Bone Quality microarchitecture microarchitecture
- 8. Normal bone
- 10. Osteoporosis Weaker Bones More risk of fractures
- 11. Spinal Compression Fractures and Back/Osteoporosis Pain The most common cause of osteoporosis pain is a spinal compression fracture. It can cause: What? • Sudden, severe back pain that gets worse when you are standing or walking with some relief when you lie down • Trouble twisting or bending your body, and pain when you do • Loss of height • A curved spine is called kyphosis. When ? Lifting a bag of groceries, twisting to get out of a car, or tripping slightly on a rug or sometimes even sneezing!
- 12. LOW BACK PAIN & OSTEOPOROSIS People who develop a spinal fracture are at substantial risk for additional fracture within the next 1-2 years Ref: Damodaran P, Subramaniam R, Omar SZ, Nadkarni P, Paramsothy M., Singapore Med J. 2000 Sep; 41(9): 431-5, “Profile of a menopause clinic in an urban population in Malaysia http://www.outlookindia.com 2004 Osteoporosis Society of India (2003) Action Plan Osteoporosis: Consensus statement of an expert group. New Delhi International Journal of Physical Education, Sports and Health 2019; 6(3): 233-237 DOI: 10.4103/0970-5333.186467 : http://www.indianjpain.org/text.asp?2016/30/2/111/186467 Asian Spine J 2017 Aug; 11(4): 610–617. Over 55% of patients with hip fracture have evidence of a prior vertebral fracture
- 13. LOW BACK PAIN & OSTEOPOROSIS Low back pain (LBP) is experienced in 60%–80% of adults at some point in their lifetime. Spine fractures due to osteoporosis are common – with one occurring every 22 seconds worldwide Ref: Damodaran P, Subramaniam R, Omar SZ, Nadkarni P, Paramsothy M., Singapore Med J. 2000 Sep; 41(9): 431-5, “Profile of a menopause clinic in an urban population in Malaysia http://www.outlookindia.com 2004 Osteoporosis Society of India (2003) Action Plan Osteoporosis: Consensus statement of an expert group. New Delhi International Journal of Physical Education, Sports and Health 2019; 6(3): 233-237 DOI: 10.4103/0970-5333.186467 : http://www.indianjpain.org/text.asp?2016/30/2/111/186467 Asian Spine J 2017 Aug; 11(4): 610–617.
- 14. IN WOMEN, OSTEOPOROSIS > HEART ATTACK STROKE BREAST CANCER
- 15. 1 out of 8 males and 1 out of 3 females in India suffers from osteoporosis, making India one of the largest affected countries in the world. INDIA & OSTEOPOROSIS
- 16. • Risk factors you cannot change: • Female Gender • Age • Body size - Small, thin-boned women are at greater risk. • Ethnicity - Indian women are at highest risk. • Family history - People whose parents have a history of fractures also seem to have reduced bone mass and may be at risk for fractures. Osteoporosis – Risk Factors
- 17. Risk factors you can change: • A lifetime diet low in calcium and vitamin D. • Medications - such as glucocorticoids or some anticonvulsants. • An inactive lifestyle or extended bed rest. • Cigarette smoking. • Excessive use of alcohol. • Sex hormones: abnormal absence of menstrual periods (amenorrhea), low estrogen level (menopause), and low testosterone level in men. Anorexia. Osteoporosis – Risk Factors
- 18. Osteoporosis - Diagnosis • Diagnosis is done by combination of • Physical symptoms • X ray • BMD Test (DEXA Scan)
- 19. Osteoporosis – Can it be treated? Yes Treatment should always accompany lifestyle changes with adequate supplementation with Calcium and Vitamin D3
- 20. • Vitamin D synthesis is less in dark-skinned persons (Indians) • Exposure to sunlight is limited, especially in House lady, Office going population. • Vitamin D, Ca levels, and bone density are low in Indians • Vitamin D adequacy will reduce osteoporotic fractures & risk of other diseases Osteoporosis & Calcium/Vit D3 supplementation Calcium Vitamin D • Most abundant mineral in bone • Intestinal absorption of Ca is not efficient, especially with cereal-based diet. • Intake of dairy Ca is usually inadequate.
- 21. Before Anti-resorptives Prevents further breakdown of bones Anabolic agents Bone forming drug Restores bone microarchitecture Osteoporosis – Treatment Options After
- 22. Osteoporosis – Treatment Benefits • Increase in Bone strength • Reduced risk of fracture • Pain relief Treatment is usually for longer duration and should be continued as per your dr’s advise
- 23. General Guidelines for Managing Low Back Pain & Osteoporosis 1. Active Life style: Stay active within the limits of your pain and avoid activities that worsen the pain. 2. Practice good posture Avoid excessive, prolonged, or forceful bending or twisting of your back. 3. Follow a home exercise program Exercises to stretch and strengthen the back and stomach muscles should be done regularly. 4. Lose weight if you are overweight 5. If you smoke, quit 6. Manage stress Stress can increase muscle tension. Take time out to relax, exercise, and practice relaxation techniques.
- 24. General Guidelines for Managing Low Back Pain & Osteoporosis 7. Modify your environment Certain changes to your workspace, attire, and home can reduce the stress on your back: • Avoid wearing high-heeled shoes. • If you sit for long periods of time, use a stool to bring your knees above your hips. • Avoid having objects, such as a wallet, in your back pocket while sitting. • Use a lumbar support pillow when sitting or driving. • Sleep on a firm mattress. • Avoid sleeping on your stomach. • Sleep on your side or on your back with a wedge or pillow under the lower part of your legs.
- 25. • There is not always an obvious cause of lower back pain, and it often gets better on its own. • Resting, trying hot or cold therapy, taking OTC pain relievers, and gently stretching may help speed up recovery. • However, a person should see a doctor for lower back pain that is severe, does not seem to be getting better, or occurs alongside other concerning symptoms, such as tingling or numbness down the legs. • People with lower back pain should seek immediate medical attention if they also have any of the following symptoms: 1. Difficulty Walking Or Moving The Legs 2. Loss Of Bowel Or Bladder Function 3. Loss Of Sensation In The Legs 4. Very Severe Pain When to see a doctor?
- 26. THANK YOU
- 28. • Shoulder Pain • Osteoporosis may lead to fracture of the upper arm bone at the shoulder joint • This injury is especially common among people 50 or older who suffer from osteoporosis. Joint Pain Many patients tend to have pain in various joints due to micro-fractures caused by Osteoporosis
- 29. Pain - Lifestyle and home remedies • Rest • Give the injury time to heal and help prevent further damage • Ice • Ice reduces both pain and inflammation. • You also can use an ice pack wrapped in a thin towel to protect your skin. • Not to be used for longer than 20 minutes at a time • Heat • Temporary pain relief by applying a heat pack or hot-water bottle to the painful area
- 30. Pain - Lifestyle and home remedies Compression • Use a compression bandage that's lightweight, breathable and self-adhesive • This helps prevent fluid buildup in damaged tissues and maintains knee alignment and stability • It should be tight enough to support your knee without interfering with circulation • Elevation • To help reduce swelling, try propping your injured leg on pillows or sitting in a recliner.
- 31. • Pain relievers and anti-inflammatory drugs • Avoid frequent usage without consulting your doctor Pain - Lifestyle and home remedies
- 32. Take home message With Age increasing there increase risk for Osteoporosis and pain, so its important to, Maintain a healthy weight. Get strong, stay flexible. Be smart about exercise. Consider switching to swimming, water aerobics or other low-impact activities — at least for a few days a week. Visit you doctor for further explanations
Editor's Notes
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- #30: Pain relievers and anti-inflammatory drugs. Don't take over-the-counter medications for more than 10 days without checking with your doctor. Taking them for longer increases the chance of side effects. If over-the-counter medications don't provide relief, your doctor may give you a prescription anti-inflammatory drug or other medication to help ease the pain. Nutraceuticals are dietary compounds which have a role in the balance of anabolic and catabolic signals in joints. Their regulatory function on homeostasis of cartilage metabolism nutraceuticals is increasingly considered for the management and, above all, the prevention of osteoarthritis (OA). Surgery. When other treatments don't work, surgery is a good option
- #31: Pain relievers and anti-inflammatory drugs. Don't take over-the-counter medications for more than 10 days without checking with your doctor. Taking them for longer increases the chance of side effects. If over-the-counter medications don't provide relief, your doctor may give you a prescription anti-inflammatory drug or other medication to help ease the pain. Nutraceuticals are dietary compounds which have a role in the balance of anabolic and catabolic signals in joints. Their regulatory function on homeostasis of cartilage metabolism nutraceuticals is increasingly considered for the management and, above all, the prevention of osteoarthritis (OA). Surgery. When other treatments don't work, surgery is a good option
- #32: Pain relievers and anti-inflammatory drugs. Don't take over-the-counter medications for more than 10 days without checking with your doctor. Taking them for longer increases the chance of side effects. If over-the-counter medications don't provide relief, your doctor may give you a prescription anti-inflammatory drug or other medication to help ease the pain. Nutraceuticals are dietary compounds which have a role in the balance of anabolic and catabolic signals in joints. Their regulatory function on homeostasis of cartilage metabolism nutraceuticals is increasingly considered for the management and, above all, the prevention of osteoarthritis (OA). Surgery. When other treatments don't work, surgery is a good option