A Simple Guide to Prolapsed Intervertebral Disc
---------------------------------------------------------------
What is Prolapsed Intervertebral Disc?
-------------------------------------------------------
Prolapsed Intervertebral Disc is the prolapse of the intervertebral disc(which is the disc between 2 vertebrae) as a result of protrusion of the nucleus pulposus out of its weakened ligamentous ring(annulus fibrosus).
It may protrude in a posterior or postero-lateral direction causing pressure to the nerve roots especially at S1, L5 and L4 vertebrae.
What are the causes of Prolapsed Intervertebral Disc?
---------------------------------------------------------------
1.Degeneration of the posterior longitudal ligaments and annulus fibrosus occurs with age resulting in the disc being pushed out between the weakened ligaments.
2.Trauma -direct injury to disc, heavy lifting, sneezing can cuse the disc to pop out of the weakened ligaments and prolapse partially or completely.
3.Spinal tumour rarely pushes the disc out of its intervertebral space
What are the symptoms and signs of Prolapsed Intervertebral Disc?
-----------------------------------------------------------------------------
Symptoms:
1.Low Backache with pain in the lumbar region
2.Sciatica or pain shooting down 1 leg
3.Pain usually follows
severe bending
lifting heavy objects
injury
sneezing or coughing
4.Pain may so bad that the person cannot stand erect.
5.pain is worse when sitting
6.weakness, numbness, difficulty in moving the leg
Signs:
1.Muscle spasm especially spinal extensor muscles
2.Movement of the back and affected led painful and restricted
3.Patient tend to stand stiffly or with slight sciatic scoliosis on the affected side
4.Straight leg raising test is usually restricted on the affected side.
5.Neurological signs such as paraesthesia commonly present on the affected side.
6.Sensory and motor deficit may be present in the affected side
7.Loss of reflex and weakness may help to localise the site of prolapse:
L4 root:
Pain in the medial buttock, lateral thigh, medial tibia and big toe
weakness of big toe and foot dorsiflexion
patella jerk is diminished
L5 root:
Pain in hip, groin,posterolateral thigh, lateral calf and dorsal surface of foot
weakness of the big toe and foot dorsiflexion
no change in patella or ankle reflexes
S1 root:
pain in posterior part of thigh, lower calf border and sole of foot
weakness of knee flexors and plantar flexors
ankle jerk is diminished
How to investigate the cause of Prolapsed Intervertebral Disc?
----------------------------------------------------------------------------
1.Full medical history especially of injuries, type of work, onset of pain,radiation to legs,
2. Full medical examination especially of movement of the back ,any deformity of the spine, straight leg raising test
3. X-ray of the Spine: to exclude osteoarthritis, injury, narrowing of disc space, bone tumor,
4.MRI of spine for slipped disc
5.bone scan for osteoporosis
A definite diagnosis can then be made and the cause of the pain treated.
What is the Treatment of Prolapsed Intervertebral Disc?
----------------------------------------------------------------------------------
Conservative treatment:
-----------------------
Initial phase:
1.Bed rest with a hard board below the mattress- straighten the back
2.Physiotherapy such as traction, shortwave diathermy
Mobilisation phase:
1.Wearing a corset to strengthen the back and help the traction of the spinal bones
2.gradual mobilisation and exercises to strengthen the spinal extensor muscles
Maintenance phase:
1.Exercises to strengthen the back muscles.
2.Wear a corset
3.Avoidance of postural strain on the back
Drug Therapy:
-----------------------
1.Pain killers such as NSAID(non-steroidal anti-inflammatory drugs) for pain
2.Muscle relaxant to relax muscles
3.Extradural injection of local anesthetic and long acting steroid may help to relieve the pain
Surgery:
--------------
Surgery is required if there are:
1.persistent pain and neurological symptoms remain after conservative treatment
2.progressive neurological symptoms
3.Disc has protruded more than 75% out of its intervertebral space as seen on MRI
Surgery consists of:
1.laminectomy - removal of the disc and prolapsed material.
2.microdiscectomy- insertion of a titanium disc to replace the removed prolapsed disc
Finally treatment of the underlying cause(eg.space occupying spinal tumors) is important.
What is the prognosis of Prolapsed Intervertebral Disc?
-------------------------------------------------------------------------
Prognosis depends on the underlying cause.
Preventative measures are important in preventing recurrences of the prolapse of the intervertebral disc.
What is the Prevention of Prolapsed Intervertebral Disc?
----------------------------------------------------------------
Avoidance of postural strain on the back
Wear a corset
Exercises to strengthen the back muscles.
Showing posts with label osteoporosis. Show all posts
Showing posts with label osteoporosis. Show all posts
Thursday, July 17, 2008
Monday, December 3, 2007
A Simple Guide to Menopause
A Simple Guide to Menopause (Part 2)
----------------------------------------------
How to Treat the symptoms of Menopause?
----------------------------------------------------
In most cases of menopause, no treatment is necessary as it is a normal physiological event.
It is important that there is reassurance and psychological support from family and friends.
Menopause may mean the end of fertility but it also means the freedom from all the discomfort and inconvenience of monthly menstruation and fear of pregnancy.
Hormone replacement therapy used to be the best solution for all the symptoms and problems of menopause at one time.
They help to prevent heart disease and osteoporosis as well as to reduce the symptoms of menopause such as hot flushes, skin , breast and vaginal changes.
Oestrogen and progesterone are the two types of female hormones prescribed for and after menopause.
A combination of the two hormones is taken, as progesterone helps to protect the uterus from endometrial cancer.
If the woman have had removal of the womb, she will normally be given only oestrogen.
HRT can be taken as pills as a single oestogen tablet or as combination of oestrogen and progesterone.
Besides tablets, female hormonal patches, implants or vaginal creams can be used to help replace the level of hormones in the menopausal women.
There are benefits to the use of HRT:
1.Relieves hot flushes
2.reduce vaginal dryness.
3.Prevents osteoporosis and protects against fractures.
4.Indirectly improves mood symptoms by relieving the physical discomfort of menopause.
5.Safe for short term use.
There are also risks in using HRT:
1.increase risk for breast cancer for long term users (>5 years).
2.side effects such as vaginal bleeding, nausea, hair loss and headaches.
3.cause PMS (Pre-Menstrual Syndrome) symptoms such as bloating or irritability.
4.cause venous thrombosis due to increased coagulation of blood.
Hormone replacement therapy has recently fell out of favour due to new study which indicate higher incidence of breast and womb cancer taking HRT over a 5 year period.
It is still prescribed more as a single oestrogen tablet rather than a combination pill of oestrogen and progesterone.
Selective estrogen receptor modulators(SERM) like Evista has been used to replace HRT with good effect.
Plant based female hormones has also being used to reduce the symptoms of menopause. Alternative medicines like evening primrose oil has also been used.
For premature menopause where symptoms of menopause are more obvious due to their age, hormone replacement therapy is still given at intervals of 6 to 12 months.
Besides hormonal therapy, medicines such as:
1200mg of calcium daily
800 to 1000 IU of vitamin D daily
may be able to help prevent osteoporosis.
The current treatment for the symptoms of menopuse in the older women are:
1. A healthy life style.
Exercise
Regular exercise strengthen the muscles and bone.
Exercise also burns up calories to reduce obesity and hence prevent diabetes, hypertension and heart disease.
Walking is one of the best weight-bearing exercises to prevent osteoporosis.
Swimming and dancing are also good exercises.
Eat a balanced diet
A good balanced diet helps to prevent obesity, diabetes, osteoporosis, heart disease and colorectal cancer.
More fruit and vegetables will help reduce calories and prevent colorectal cancer.
Foods rich in calcium and Vitamin D such as fish, low fat high calcium milk can prevent osteoporosis.
Alcohol, coffee, tea, canned drinks should be avoided.
Less sugar, salt and saturated fats will reduce the risk of diabetes,hypertension and heart disease.
Control Stress
Medititation, yoga, deep breathing exercises and sufficient sleep reduces stress and heart disease.
Community service work, hobbies, time with family take the mind off work and stress.
Stay smoke-free
The risk of heart disease, lung and cervical cancer can be reduced by not smoking.
2.hot flushes:
Cool showers and cool tempreatures may help to reduce hot flushes.
Hot beverages and spicy foods should be avoided.
Thin cotton clothes are more comfortable.
Drinking a glass of cold water, loosening any tight clothing and using a small fan to cool down can stop the beginning of a hot flush.
Soy products like tofu and soya bean burns up less calories.
Meditation and mild exercise may also help by reducing stress.
hormone replacement therapy (mainly oestrogen) for a short peroid may be used as a last resort.
3.vaginal changes
Water-soluble vaginal lubricants can reduce dryness.
Oestrogen replacement creams may be prescribed to reduce the vaginal discomfort.
4.incontinence:
Doing simple pelvic floor exercises will strengthen the muscles surrounding the sphincter of the bladder opening.
Wearing a pad in the underwear may reduce the discomfort due to leaks.
Injection of collagen sometimes work to tighten the sphincter of the bladder opening.
Surgery to tighten the muscles of the bladder opening may be used as a last resort.
5.mood changes:
Many women going through menopause may become irritable,anxious or depressed.
Learn how to relax and make time for yourself.
Exercise is good for your health as it keeps your mind off emotional problems!
A hobby or volunteer work that you enjoy may take your mind off your symptoms.
Build up a good support system through talking with friends or a professional counsellor.
6.Osteoporosis:
A balanced diet with adequate calcium and active lifestyle can prevent development of osteoporosis:
Women who are at higher risk are those who
had early menopause or have ovaries removed
have a family history of osteoporosis
have a diet low in calcium and Vitamin D
smoke
are not physically active
are on steroids for long term (E.g. asthmatics)
drink coffee, tea or alcohol regularly
have certain disease such as an overactive thyroid gland
7.Breast Cancer
It is the most common cancer in menpausal women in their 50s.
Early detection by doing monthly breast self examination and a mammography once a year in your 40s and once every two years after age 50 is the best prevention.
8.Cervical Cancer
Cervical cancer is another common cancer among women.
It can be prevented by going for regular Pap smear tests.
Pap smear tests for cervical cancer once every 3 years from age 25 to 65 years if sexually active.
Pap smears can detect precancer so that early treatment can prevent full blown cancer.
9.Regular check-ups
Early detection and checkup can prevent complications such as heart disease and stroke.
A yearly blood pressure with blood sugar and blood cholesterol once every 3 years help to check for danger of heart disease and stroke.
Stay active and be confident about the future.
Take care of your health and personal appearance so that you both look and feel good.
Menopause marks a new Chapter in your life
-----------------------------------------------------
While menopause marks the end of fertility, it is NOT the end of health, or a satisfying and enjoyable life. Menopause means freedom from the inconvenience and discomfort of monthly menses.
Every Woman Goes Through Menopause
Knowledge about menopause is important so that you know what to expect.
Most women welcome the cessation of periods.
Others may feel a sense of loss that their childbearing ability is gone.
By understanding the physical and emotional changes of menopause, more women are able to cope with life in the golden years.
----------------------------------------------
How to Treat the symptoms of Menopause?
----------------------------------------------------
In most cases of menopause, no treatment is necessary as it is a normal physiological event.
It is important that there is reassurance and psychological support from family and friends.
Menopause may mean the end of fertility but it also means the freedom from all the discomfort and inconvenience of monthly menstruation and fear of pregnancy.
Hormone replacement therapy used to be the best solution for all the symptoms and problems of menopause at one time.
They help to prevent heart disease and osteoporosis as well as to reduce the symptoms of menopause such as hot flushes, skin , breast and vaginal changes.
Oestrogen and progesterone are the two types of female hormones prescribed for and after menopause.
A combination of the two hormones is taken, as progesterone helps to protect the uterus from endometrial cancer.
If the woman have had removal of the womb, she will normally be given only oestrogen.
HRT can be taken as pills as a single oestogen tablet or as combination of oestrogen and progesterone.
Besides tablets, female hormonal patches, implants or vaginal creams can be used to help replace the level of hormones in the menopausal women.
There are benefits to the use of HRT:
1.Relieves hot flushes
2.reduce vaginal dryness.
3.Prevents osteoporosis and protects against fractures.
4.Indirectly improves mood symptoms by relieving the physical discomfort of menopause.
5.Safe for short term use.
There are also risks in using HRT:
1.increase risk for breast cancer for long term users (>5 years).
2.side effects such as vaginal bleeding, nausea, hair loss and headaches.
3.cause PMS (Pre-Menstrual Syndrome) symptoms such as bloating or irritability.
4.cause venous thrombosis due to increased coagulation of blood.
Hormone replacement therapy has recently fell out of favour due to new study which indicate higher incidence of breast and womb cancer taking HRT over a 5 year period.
It is still prescribed more as a single oestrogen tablet rather than a combination pill of oestrogen and progesterone.
Selective estrogen receptor modulators(SERM) like Evista has been used to replace HRT with good effect.
Plant based female hormones has also being used to reduce the symptoms of menopause. Alternative medicines like evening primrose oil has also been used.
For premature menopause where symptoms of menopause are more obvious due to their age, hormone replacement therapy is still given at intervals of 6 to 12 months.
Besides hormonal therapy, medicines such as:
1200mg of calcium daily
800 to 1000 IU of vitamin D daily
may be able to help prevent osteoporosis.
The current treatment for the symptoms of menopuse in the older women are:
1. A healthy life style.
Exercise
Regular exercise strengthen the muscles and bone.
Exercise also burns up calories to reduce obesity and hence prevent diabetes, hypertension and heart disease.
Walking is one of the best weight-bearing exercises to prevent osteoporosis.
Swimming and dancing are also good exercises.
Eat a balanced diet
A good balanced diet helps to prevent obesity, diabetes, osteoporosis, heart disease and colorectal cancer.
More fruit and vegetables will help reduce calories and prevent colorectal cancer.
Foods rich in calcium and Vitamin D such as fish, low fat high calcium milk can prevent osteoporosis.
Alcohol, coffee, tea, canned drinks should be avoided.
Less sugar, salt and saturated fats will reduce the risk of diabetes,hypertension and heart disease.
Control Stress
Medititation, yoga, deep breathing exercises and sufficient sleep reduces stress and heart disease.
Community service work, hobbies, time with family take the mind off work and stress.
Stay smoke-free
The risk of heart disease, lung and cervical cancer can be reduced by not smoking.
2.hot flushes:
Cool showers and cool tempreatures may help to reduce hot flushes.
Hot beverages and spicy foods should be avoided.
Thin cotton clothes are more comfortable.
Drinking a glass of cold water, loosening any tight clothing and using a small fan to cool down can stop the beginning of a hot flush.
Soy products like tofu and soya bean burns up less calories.
Meditation and mild exercise may also help by reducing stress.
hormone replacement therapy (mainly oestrogen) for a short peroid may be used as a last resort.
3.vaginal changes
Water-soluble vaginal lubricants can reduce dryness.
Oestrogen replacement creams may be prescribed to reduce the vaginal discomfort.
4.incontinence:
Doing simple pelvic floor exercises will strengthen the muscles surrounding the sphincter of the bladder opening.
Wearing a pad in the underwear may reduce the discomfort due to leaks.
Injection of collagen sometimes work to tighten the sphincter of the bladder opening.
Surgery to tighten the muscles of the bladder opening may be used as a last resort.
5.mood changes:
Many women going through menopause may become irritable,anxious or depressed.
Learn how to relax and make time for yourself.
Exercise is good for your health as it keeps your mind off emotional problems!
A hobby or volunteer work that you enjoy may take your mind off your symptoms.
Build up a good support system through talking with friends or a professional counsellor.
6.Osteoporosis:
A balanced diet with adequate calcium and active lifestyle can prevent development of osteoporosis:
Women who are at higher risk are those who
had early menopause or have ovaries removed
have a family history of osteoporosis
have a diet low in calcium and Vitamin D
smoke
are not physically active
are on steroids for long term (E.g. asthmatics)
drink coffee, tea or alcohol regularly
have certain disease such as an overactive thyroid gland
7.Breast Cancer
It is the most common cancer in menpausal women in their 50s.
Early detection by doing monthly breast self examination and a mammography once a year in your 40s and once every two years after age 50 is the best prevention.
8.Cervical Cancer
Cervical cancer is another common cancer among women.
It can be prevented by going for regular Pap smear tests.
Pap smear tests for cervical cancer once every 3 years from age 25 to 65 years if sexually active.
Pap smears can detect precancer so that early treatment can prevent full blown cancer.
9.Regular check-ups
Early detection and checkup can prevent complications such as heart disease and stroke.
A yearly blood pressure with blood sugar and blood cholesterol once every 3 years help to check for danger of heart disease and stroke.
Stay active and be confident about the future.
Take care of your health and personal appearance so that you both look and feel good.
Menopause marks a new Chapter in your life
-----------------------------------------------------
While menopause marks the end of fertility, it is NOT the end of health, or a satisfying and enjoyable life. Menopause means freedom from the inconvenience and discomfort of monthly menses.
Every Woman Goes Through Menopause
Knowledge about menopause is important so that you know what to expect.
Most women welcome the cessation of periods.
Others may feel a sense of loss that their childbearing ability is gone.
By understanding the physical and emotional changes of menopause, more women are able to cope with life in the golden years.
Thursday, October 4, 2007
A Simple Guide to Backache
A Simple Guide to Backache
----------------
What is Backache?
-----------------
Backache is a symptom, not an illness.
It is one of the most common complaints.
The complaint may be:
1.Constant aching, pain or stiffness that occurs anywhere along your spine, from the base of the neck to the hips.
2.Sharp pain in the neck, upper back, or lower back, especially after lifting heavy objects or other strenuous activity.
3.Chronic ache in the middle or lower back, especially after sitting or standing for long period of time.
Who suffer from Backache?
--------------------------------
About 80 per cent of people will experience back pain at some point in their lives.
More men suffer from it than women.
Backache is most common among people in their middle age.
Backache also occurs among young people aged between 16 - 24
Backache can also be hereditary (example: ankylosing spondylosis)
What causes Backache?
----------------------------
Acute Backache
Acute backache may occur due to
1.back strain from the lifting of a heavy object,
2.from a fall,
3.violent jerk as a car suddenly stops.
4.fracture of the spine or the dislocation of a vertebral disc
Chronic Backache
Chronic backache may be caused by
1.Osteoarthritis with degeneration of the spinal column when one vertebra slips forward on the one immediately below it
2. slipped disc. The discs act as cushions between two vertebral bones but due to degeneration in old age, or in cases when the spine has been injured before, a slipped disc may occur.
3.Bad posture can also lead to chronic backache such as sitting for long hours in an incorrect position. The right position is to stand up or sit up straight instead of slouching in a couch when watching TV. If the bad posture is prolonged, backache may occur.
4.sprains in the muscles of the back and
5.gynaecological problems (such as ovarian tumours,fibroids) and pregnancy.
----------------
What is Backache?
-----------------
Backache is a symptom, not an illness.
It is one of the most common complaints.
The complaint may be:
1.Constant aching, pain or stiffness that occurs anywhere along your spine, from the base of the neck to the hips.
2.Sharp pain in the neck, upper back, or lower back, especially after lifting heavy objects or other strenuous activity.
3.Chronic ache in the middle or lower back, especially after sitting or standing for long period of time.
Who suffer from Backache?
--------------------------------
About 80 per cent of people will experience back pain at some point in their lives.
More men suffer from it than women.
Backache is most common among people in their middle age.
Backache also occurs among young people aged between 16 - 24
Backache can also be hereditary (example: ankylosing spondylosis)
What causes Backache?
----------------------------
Acute Backache
Acute backache may occur due to
1.back strain from the lifting of a heavy object,
2.from a fall,
3.violent jerk as a car suddenly stops.
4.fracture of the spine or the dislocation of a vertebral disc
Chronic Backache
Chronic backache may be caused by
1.Osteoarthritis with degeneration of the spinal column when one vertebra slips forward on the one immediately below it
2. slipped disc. The discs act as cushions between two vertebral bones but due to degeneration in old age, or in cases when the spine has been injured before, a slipped disc may occur.
3.Bad posture can also lead to chronic backache such as sitting for long hours in an incorrect position. The right position is to stand up or sit up straight instead of slouching in a couch when watching TV. If the bad posture is prolonged, backache may occur.
4.sprains in the muscles of the back and
5.gynaecological problems (such as ovarian tumours,fibroids) and pregnancy.
6. Chronic infections of spine such as Tuberculosis
7. Cancer of the organs of pelvic region such as bladder or prostate
8. Cancer of the spine from primary bone marrow or secondary spread.
How can Backache be prevented?
--------------------------------------
1.Maintain the correct posture at all times. When standing or sitting, ensure that your back is kept straight instead of a slouched position.
2.support your back and use a cushion when necessary.
3.Correct furniture can also help to prevent the occurrence of backache.
Use chairs of a proper height in relation to the table or desk.
4.Sleep on a firm mattress
5. Do not wear high heels
6. Keep your back straight when carrying heavy item.Keep the item close to the body.
7.Do not bend the back to carry heavy objects. Bend the knees and keep the back straight
8.Exercise is another good way to prevent backache by strengthening the back muscles. However, if you have had back injuries before such as a slipped disc, do be cautious when you exercise.
What to do when Backache occurs?
-----------------------------------------
1. maintain good posture and rest the back.
2.Ice packs can provide relief for backaches. Ice packs will help to reduce the swelling and inflammation.
3.Heat treatment will help improve circulation and reduce stiffness.
4.Painkiller like paracetamol may relieve pain
If pain persists, do consult a doctor.
When should you see a doctor for Backache?
---------------------------------------------------
You should see a doctor under the following conditions:
1. backache is severe and acute.
2.backache starts suddenly and is severe enough to prevent you from work.
3.backache is accompanied with associated pain in legs or weakness and tingling in the legs or back.
4. painkillers and other therapies do not help to relieve pain and your backache is getting worse.
5.pain increases when you cough or bend forward at the waist. This could be a sign of a herniated disk. Try to lie flat with a pillow under your knees.
6.pain follows an injury and is accompanied by sudden loss of bladder or bowel control. If you have difficulty moving any limb, or if you feel numbness, pain, or tingling in a limb, you may have injured your spinal cord.
7.backache is accompanied by nausea, vomiting, fever, muscle weakness, pain down an arm or leg, or bowel or bladder disturbances
8.pain is still present after two to three days of rest.
9.pain lasts longer than 72 hours.
10.pain radiates into the legs,
11.other symptoms such as unexplained weight loss occur,
12.pain is in one side of the small of your back accompanied by a sick feeling and fever. You may have a kidney infection.
13.the pain in your back extends downward along the back of the leg. You may be suffering from sciatica.
14.dull pain in one area of your spine when trying to lie down or getting out of bed, especially if you are over 50 years of age. You may be suffering from osteoarthritis.
15.pain is felt in both thighs when walking. This can be a symptom of spinal stenosis (the narrowing of the lower spinal canal).
16.persistent backache may also be an indication of an undetected cancer of the colon,ovary,bladder or prostate.
How to investigate the cause of Backache?
--------------------------------------------------
1.Full medical history especially of injuries, type of work, onset of pain,radiation to the arms or legs, changes in bowel or bladder habit, loss of weight
2. Full medical examination especially of movement of the back ,any deformity of the spine, abdominal swelling, straight leg raising test
3. X-ray of the Spine: to exclude fracture, osteoarthritis, dislocation,deformity, bone tumour,
4. X-ray of abdomen to exclude any tumours in the abdomen pressing against the spine
5.MRI of spine for slipped disc,tumours,fracture
6.Bone density test to exclude osteoporosis
7.Blood tests for calcium, protein,kidney function,cancer markers, RA factor
8. Urine and stool tests for blood,
A definite diagnosis can then be made and the cause of the pain treated.
What is the Treatment of Backache?
-------------------------------------------
Symptomatic:
Painkillers and muscle relaxants
Ice packs or heat treatment
Physiotherapy to strengthen muscles
Good posture and firm mattress
Avoid aggravating factors like high heels, overstretching muscles,excessive strenous activities
Curative:
The cause must be found and treated. Examples are fractures due to injury.
Causes like cancer and aged related illness(osteoarthritis) may not be cured but may improved with treatment.
Tuesday, September 4, 2007
A Simple Guide to Osteoporosis
A Simple Guide to Osteoporosis
-------------------------------------
What is Osteoporosis?
---------------------------
Osteoporosis, which literally means porous bones, is a condition in which the bones become weak and brittle, resulting in a greater likelihood of breaking after minor trauma.
Bone is constantly being removed and replaced in our body.
Osteoporosis occurs when bone is lost faster than it can be replaced.
What are the symptoms of Osteoporosis?
------------------------------------------------
Osteoporosis is a silent disease. People with osteoporosis often do not know that they have the condition. Fractures from osteoporosis commonly occur in the wrist, spine and hip.
Persons with hip fractures suffers considerable loss of function and becomes dependent on others.
What are the risk factors of developing Osteoporosis?
---------------------------------------------------------------
Factors that will increase the risk of developing osteoporosis are:
Female gender;
Caucasian or Asian race;
Thin and small body frames;
Family history of osteoporosis ;
Personal history of fracture as an adult;
Cigarette smoking ;
Excessive alcohol consumption;
Lack of exercise;
Diet low in calcium;
Poor nutrition and poor general health;
Malabsorption syndromes(nutrients poorly absorbed from the gastrointestinal system)
Low estrogen levels (such as occur in menopause or early surgical removal of both ovaries); Chemotherapy can cause early menopause due to its toxic effects on the ovaries;
Amenorrhea (loss of menstrual period) in young women causes low estrogen and osteoporosis;
Chronic inflammation, due to diseases (such as rheumatoid arthritis,chronic liver diseases);
Immobility, such as after a stroke, or from any condition that interferes with walking;
Hyperthyroidism, a condition with too much thyroid hormone ;
Hyperparathyroidism, a disease with excessive parathyroid hormone. In untreated hyperparathyroidism, excessive parathyroid hormone causes too much calcium to be removed from the bone, which can lead to osteoporosis;
Vitamin D deficiency. When vitamin D is lacking, the body cannot absorb adequate amounts of calcium to prevent osteoporosis.
Certain medications can cause osteoporosis. These include long-term use of heparin (a blood thinner), anti-seizure medications phenytoin (Dilantin) and phenobarbital, and long term use of oral corticosteroids (such as Prednisone).
How do you Screen for Osteoporosis?
--------------------------------------------
Bone Mineral Density:
Routine X-rays cannot detect osteoporosis until it is quite advanced and there is a lot of bone loss.
The best way to detect osteoporosis is to carry out a Bone Mineral Density (BMD) test to measure density (solidness) at various sites (e.g. hip, spine).
It will help to assess your risk of having a fracture.
BMD is frequently measured by dual energy X-ray absorptiometry (DXA).
It is a painless procedure.
How is osteoporosis diagnosed?
--------------------------------------
A routine x-ray can reveal osteoporosis of the bone, which appears much thinner and lighter than normal bones. Unfortunately, by the time x-rays can detect osteoporosis, at least 30% of the bone has already been lost.
DXA measures bone density in the hip and the spine. The test takes only 5 to 15 minutes to perform, uses very little radiation and is quite precise.
Who should have bone density testing?
----------------------------------------------
All postmenopausal women below age 65 who have risk factors for osteoporosis;
All women aged 65 and older;
What are the consequences of Osteoporosis?
----------------------------------------------------
Osteoporosis bone fractures are responsible for considerable pain, decreased quality of life, lost workdays, and disability.
Elderly patients can further develop pneumonia and blood clots in the leg veins that can travel to the lungs (pulmonary embolism) due to prolonged bed rest after a hip fracture.
Some 20% of women with a hip fracture will die in the subsequent year as an indirect result of the fracture.
How is osteoporosis treated and prevented?
----------------------------------------------------
The purpose of osteoporosis treatment is the prevention of bone fractures by stopping bone loss and by increasing bone density and strength.
Early detection and timely treatment of osteoporosis can substantially decrease the risk of future fracture.
There is no complete cure for osteoporosis .
There is no way to completely rebuild bone that has been weakened by osteoporosis.
Therefore, prevention of osteoporosis is as important as treatment.
Osteoporosis treatment and prevention measures are:
Lifestyle Changes:
1.Exercise has a wide variety of beneficial health effects especially weight-bearing exercise, such as walking.
However, exercise does not bring about substantial increases in bone density.
The benefit of exercise for osteoporosis has mostly to do with decreasing the risk of falls, probably because balance is improved and/or muscle strength is increased.
It is important to avoid exercises that can injure already weakened bones.
In patients over 40 and those with heart disease, obesity, diabetes mellitus, and high blood pressure , exercise should be monitored.
Cessation of Smoking :Smoking cigarettes decreases estrogen levels and can lead to bone loss in women before menopause.
Decrease regular consumption of alcohol and caffeine on osteoporosis is not as clear as with exercise and cigarette.
Medications:
1.Medications that stop bone loss and increase bone strength, such as
alendronate (Fosamax),
risedronate (Actonel),
raloxifene (Evista),
ibandronate (Boniva),
calcitonin (Calcimar);
2.Medications that increase bone formation such as teriparatide (Forteo).
3..Calcium Supplements
Building strong and healthy bones requires an adequate dietary intake of calcium and exercise beginning in childhood and adolescence for both sexes.
800 mg/day for children ages 1 to 10
1000 mg/day for men, premenopausal women, and postmenopausal women also taking estrogen
1200 mg/day for teenagers and young adults ages 11 to 24
1500 mg/day for post menopausal women not taking estrogen 1200mg to 1500 mg/day for pregnant and nursing mothers
The total daily intake of calcium should not exceed 2000 mg
Daily calcium intake can be calculated by the following method:
Excluding dairy products, the average diet contains approximately 250 mg of calcium;
There is approximately 300 mg of calcium in an 8-ounce glass of milk;
There is approximately 450 mg of calcium in 8 ounces of plain yogurt;
There is approximately 1300 mg of calcium in 1 cup of cottage cheese;
There is approximately 200 mg of calcium in 1 ounce of cheddar cheese;
There is approximately 90 mg of calcium in ½ cup of vanilla ice cream;
There is approximately 300 mg of calcium in 8 ounces of calcium-fortified orange juice.
Additional calcium can be obtained by drinking more milk and eating more yogurt or cottage cheese, or by taking calcium supplement tablets as well from calcium-fortified foods.
Calcium supplements are safe and generally well tolerated.
Side effects are indigestion and constipation.
4.Vitamin D:
Vitamin D is important in several respects:
Vitamin D helps the absorption of calcium from the intestines.
A lack of vitamin D causes calcium-depleted bone (osteomalacia), which further weakens the bones and increases the risk of fractures.
Vitamin D, along with adequate calcium (1200 mg of elemental calcium), has been shown in some studies to increase bone density and decrease fractures in older postmenopausal, but not in premenopausal or perimenopausal women.
Vitamin D comes from the diet and the skin. Vitamin D production by the skin is dependent on exposure to sunlight. Daily Vitamin D intake are:
200 IU daily for men and women 19 to 50 years old,
400 IU daily for men and women 51 to 70 years old, and
600 IU daily for men and women 71 years and older.
But if a person already has osteoporosis, it is advisable to ensure 400 IU twice per day as usual daily intake, most commonly as a supplement alongside prescription osteoporosis medication.
5.Hormone therapy (menopausal hormone therapy)
Menopausal hormone therapy (previously referred to as hormone replacement therapy or HRT) has been shown to prevent bone loss, increase bone density, and prevent bone fractures. It is useful in preventing osteoporosis in postmenopausal women.
Medications that prevent bone loss and breakdown
How do you monitor Osteoporosis?
------------------------------------------
Repeat bone density testing (DXA scans) is NOT indicated in monitoring osteoporosis treatment or prevention on a routine basis.
Bone density changes so slowly with treatment that the changes are smaller than the measurement error of the machine.
The real purpose of osteoporosis treatment is to decrease future bone fractures.
There is no good correlation between increases in bone density with decreases in fracture risks with treatment.
In the future, however, if ongoing research brings new technology or new therapies, testing decisions will clearly change.
Added 4th October 2008
------------------------------
Osteoporosis
------------------
One way of determining the risk of Osteoporosis:
substract the weight in kg from the age in years.
If the number is less than 0 the risk is low
If the number is between 0-20 the risk is moderate
If the number is above 20 the risk is high and you should see the doctor.
-------------------------------------
What is Osteoporosis?
---------------------------
Osteoporosis, which literally means porous bones, is a condition in which the bones become weak and brittle, resulting in a greater likelihood of breaking after minor trauma.
Bone is constantly being removed and replaced in our body.
Osteoporosis occurs when bone is lost faster than it can be replaced.
What are the symptoms of Osteoporosis?
------------------------------------------------
Osteoporosis is a silent disease. People with osteoporosis often do not know that they have the condition. Fractures from osteoporosis commonly occur in the wrist, spine and hip.
Persons with hip fractures suffers considerable loss of function and becomes dependent on others.
What are the risk factors of developing Osteoporosis?
---------------------------------------------------------------
Factors that will increase the risk of developing osteoporosis are:
Female gender;
Caucasian or Asian race;
Thin and small body frames;
Family history of osteoporosis ;
Personal history of fracture as an adult;
Cigarette smoking ;
Excessive alcohol consumption;
Lack of exercise;
Diet low in calcium;
Poor nutrition and poor general health;
Malabsorption syndromes(nutrients poorly absorbed from the gastrointestinal system)
Low estrogen levels (such as occur in menopause or early surgical removal of both ovaries); Chemotherapy can cause early menopause due to its toxic effects on the ovaries;
Amenorrhea (loss of menstrual period) in young women causes low estrogen and osteoporosis;
Chronic inflammation, due to diseases (such as rheumatoid arthritis,chronic liver diseases);
Immobility, such as after a stroke, or from any condition that interferes with walking;
Hyperthyroidism, a condition with too much thyroid hormone ;
Hyperparathyroidism, a disease with excessive parathyroid hormone. In untreated hyperparathyroidism, excessive parathyroid hormone causes too much calcium to be removed from the bone, which can lead to osteoporosis;
Vitamin D deficiency. When vitamin D is lacking, the body cannot absorb adequate amounts of calcium to prevent osteoporosis.
Certain medications can cause osteoporosis. These include long-term use of heparin (a blood thinner), anti-seizure medications phenytoin (Dilantin) and phenobarbital, and long term use of oral corticosteroids (such as Prednisone).
How do you Screen for Osteoporosis?
--------------------------------------------
Bone Mineral Density:
Routine X-rays cannot detect osteoporosis until it is quite advanced and there is a lot of bone loss.
The best way to detect osteoporosis is to carry out a Bone Mineral Density (BMD) test to measure density (solidness) at various sites (e.g. hip, spine).
It will help to assess your risk of having a fracture.
BMD is frequently measured by dual energy X-ray absorptiometry (DXA).
It is a painless procedure.
How is osteoporosis diagnosed?
--------------------------------------
A routine x-ray can reveal osteoporosis of the bone, which appears much thinner and lighter than normal bones. Unfortunately, by the time x-rays can detect osteoporosis, at least 30% of the bone has already been lost.
DXA measures bone density in the hip and the spine. The test takes only 5 to 15 minutes to perform, uses very little radiation and is quite precise.
Who should have bone density testing?
----------------------------------------------
All postmenopausal women below age 65 who have risk factors for osteoporosis;
All women aged 65 and older;
What are the consequences of Osteoporosis?
----------------------------------------------------
Osteoporosis bone fractures are responsible for considerable pain, decreased quality of life, lost workdays, and disability.
Elderly patients can further develop pneumonia and blood clots in the leg veins that can travel to the lungs (pulmonary embolism) due to prolonged bed rest after a hip fracture.
Some 20% of women with a hip fracture will die in the subsequent year as an indirect result of the fracture.
How is osteoporosis treated and prevented?
----------------------------------------------------
The purpose of osteoporosis treatment is the prevention of bone fractures by stopping bone loss and by increasing bone density and strength.
Early detection and timely treatment of osteoporosis can substantially decrease the risk of future fracture.
There is no complete cure for osteoporosis .
There is no way to completely rebuild bone that has been weakened by osteoporosis.
Therefore, prevention of osteoporosis is as important as treatment.
Osteoporosis treatment and prevention measures are:
Lifestyle Changes:
1.Exercise has a wide variety of beneficial health effects especially weight-bearing exercise, such as walking.
However, exercise does not bring about substantial increases in bone density.
The benefit of exercise for osteoporosis has mostly to do with decreasing the risk of falls, probably because balance is improved and/or muscle strength is increased.
It is important to avoid exercises that can injure already weakened bones.
In patients over 40 and those with heart disease, obesity, diabetes mellitus, and high blood pressure , exercise should be monitored.
Cessation of Smoking :Smoking cigarettes decreases estrogen levels and can lead to bone loss in women before menopause.
Decrease regular consumption of alcohol and caffeine on osteoporosis is not as clear as with exercise and cigarette.
Medications:
1.Medications that stop bone loss and increase bone strength, such as
alendronate (Fosamax),
risedronate (Actonel),
raloxifene (Evista),
ibandronate (Boniva),
calcitonin (Calcimar);
2.Medications that increase bone formation such as teriparatide (Forteo).
3..Calcium Supplements
Building strong and healthy bones requires an adequate dietary intake of calcium and exercise beginning in childhood and adolescence for both sexes.
800 mg/day for children ages 1 to 10
1000 mg/day for men, premenopausal women, and postmenopausal women also taking estrogen
1200 mg/day for teenagers and young adults ages 11 to 24
1500 mg/day for post menopausal women not taking estrogen 1200mg to 1500 mg/day for pregnant and nursing mothers
The total daily intake of calcium should not exceed 2000 mg
Daily calcium intake can be calculated by the following method:
Excluding dairy products, the average diet contains approximately 250 mg of calcium;
There is approximately 300 mg of calcium in an 8-ounce glass of milk;
There is approximately 450 mg of calcium in 8 ounces of plain yogurt;
There is approximately 1300 mg of calcium in 1 cup of cottage cheese;
There is approximately 200 mg of calcium in 1 ounce of cheddar cheese;
There is approximately 90 mg of calcium in ½ cup of vanilla ice cream;
There is approximately 300 mg of calcium in 8 ounces of calcium-fortified orange juice.
Additional calcium can be obtained by drinking more milk and eating more yogurt or cottage cheese, or by taking calcium supplement tablets as well from calcium-fortified foods.
Calcium supplements are safe and generally well tolerated.
Side effects are indigestion and constipation.
4.Vitamin D:
Vitamin D is important in several respects:
Vitamin D helps the absorption of calcium from the intestines.
A lack of vitamin D causes calcium-depleted bone (osteomalacia), which further weakens the bones and increases the risk of fractures.
Vitamin D, along with adequate calcium (1200 mg of elemental calcium), has been shown in some studies to increase bone density and decrease fractures in older postmenopausal, but not in premenopausal or perimenopausal women.
Vitamin D comes from the diet and the skin. Vitamin D production by the skin is dependent on exposure to sunlight. Daily Vitamin D intake are:
200 IU daily for men and women 19 to 50 years old,
400 IU daily for men and women 51 to 70 years old, and
600 IU daily for men and women 71 years and older.
But if a person already has osteoporosis, it is advisable to ensure 400 IU twice per day as usual daily intake, most commonly as a supplement alongside prescription osteoporosis medication.
5.Hormone therapy (menopausal hormone therapy)
Menopausal hormone therapy (previously referred to as hormone replacement therapy or HRT) has been shown to prevent bone loss, increase bone density, and prevent bone fractures. It is useful in preventing osteoporosis in postmenopausal women.
Medications that prevent bone loss and breakdown
How do you monitor Osteoporosis?
------------------------------------------
Repeat bone density testing (DXA scans) is NOT indicated in monitoring osteoporosis treatment or prevention on a routine basis.
Bone density changes so slowly with treatment that the changes are smaller than the measurement error of the machine.
The real purpose of osteoporosis treatment is to decrease future bone fractures.
There is no good correlation between increases in bone density with decreases in fracture risks with treatment.
In the future, however, if ongoing research brings new technology or new therapies, testing decisions will clearly change.
Added 4th October 2008
------------------------------
Osteoporosis
------------------
One way of determining the risk of Osteoporosis:
substract the weight in kg from the age in years.
If the number is less than 0 the risk is low
If the number is between 0-20 the risk is moderate
If the number is above 20 the risk is high and you should see the doctor.
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