Patient Education - Medical Articles by Dr. Siddiqui

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Brittle Bones

Osteoporosis is a bone disease characterized by a reduction of bone mass. All women and men become osteoporotic if they live long enough. Osteoporosis increases the risk of fracture in hip, spine and wrist. Bones become "porous" and fragile such that even receiving a hug can fracture the ribs/spine. Bending over, twisting, lifting and minor trauma can also cause fractures, pain and disability. After 30 years of age we all start to lose bone mass, females have an increase in bone loss after menopause due to falls in levels of estrogen. Men tend to develop osteoporosis at a later age, generally after 70 years of age. Risk factors for osteoporosis include the following:

  • Female sex
  • Caucasian/ Asian race
  • Family history of osteoporosis
  • Men and women with small body and thin frames
  • Cigarette smoking
  • Long term use of steroids
  • Low calcium intake
  • Surgery to remove ovaries before menopause
  • Chronic alcoholism
  • Sedentary lifestyle - lack of exercise
  • Long term use of medications- Heparin, Methotrexate, anti seizure medication
  • Excess soda consumption
  • Premature menopause
  • Menopause
  • Hyperthyroidism

Signs and symptoms of osteoporosis: In the early stages of bone loss there may not be any pain and very few symptoms, however as the disease progresses, there may be back and rib pain, which may be severe, loss of height over time leading to a "kyphotic" or stooped posture which if progresses becomes a deformity and is known as Dowagers Hump. Fracture of the vertebrae, wrist, hips or other bones will lead to pain in the respective areas.

Emerging Therapies

A new physical therapy program has been shown significantly to decrease back pain, improve posture and reduce the risk of falls in females with osteoporosis who also have a curvature of the spine. The program combines the use of a device called a Spinal Weighted Kypho-orthosis, which is a harness with a light weight attached and specific back extension exercises. The WKO is worn daily for 30 minutes in the morning and 30 minutes in the afternoon while performing 10 repetitions of back extension exercises.

Prevention: An adequate intake of calcium and vitamin D are very important. All males and females over the age of 65 should take 1500 mg calcium dai ly. One 200m! glass of milk has 250mg of calcium. Other sources of calcium include almonds, broccoli, salmon, soy, tofu and yams. Exercise is a must and can help you to maintain both your bone and muscle mass and should include a combination of strength training and weight bearing exercises such as walking, jogging, running, stair climbing. Posture training is very important, extension exercises are recommended and flexion exercises are to be avoided. Excessive curvature of the spine apart from changing your appearance can also affect your breathing muscles, can cause gait instability and increase the risk of falls and injury by altering your center of gravity. Pain management is important in the event of an acute compression fracture which may cause severe pain and limit your mobility and independence.

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