Osteoporosis

Don't Ignore

Osteoporosis

Osteoporosis is a condition of weakened bone sometimes called brittle bone disease. The bone that is present is biologically normal, but there is a deficiency on the amount of bone substance. There are other very rare conditions where the bone is not normal, and may or may not be mechanically weaker.

Highlights

Birth Control

10 Tips for Health Living

Skin Care

Nutrition

Pregnancy

These fractures come about from the loss of bone substance, most of which is lost after menopause. Men and other women are more protected, but from time to time can also have osteoporosis.

There is a close relationship between the strength of the bone supporting the joint prosthesis and the long-term success of the implant. We are only now realizing how important the surrounding bone is in protecting the joint implant from loosening and other damage.

Typically bone loss starts after menopause, and progresses over time. All bone loss is bad, but as bone loss progresses complications can arise, such as fractures, curvature of the spine, and back pain. While some risk factors for osteoporosis and not under our control, like our age and gender, our ancestry, and our family health history, other risk factors can be affected by our behavior. These include smoking, excessive alcohol consumption, lack of exercise, and avoidance of calcium rich foods. If you have suffered a bone fracture, especially of the hip, wrist or spine, bones that are most frequently involved with osteoporosis, you probably already have some osteoporosis. In this circumstance, treatment for bone weakness is justified and is very important.

Treatment for osteoporosis

	Synthetic estrogen or progestin therapy or both for postmenopausal women
	Intake of calcium and other nutrients >
	Weight-bearing exercise
	Drugs such as calcitonin and alendronate sodium, a no hormonal treatment for osteoporosis.

Simple measures that are important for good bone health is an adequate dietary intake of calcium, 1200 mg per day is recommended.

An 8 oz. Glass of milk has 300 mg of calcium. Along with calcium, it is important to take at least 400 units of vitamin D, found in all over-the-counter multivitamins.
Another simple measure is to get daily weight-bearing exercise, such as a walking program.

Newer drugs which are not hormones can be used when hormone replacement is too risky, associated with too many side effects or is not working to maintain bone strength. After treatment is started, a bone density test should be repeated every 2 years. If drugs are necessary for bone maintenance, they may be necessary for a lifetime, although this has not yet been decided.

Diet

	Goal: 1200 mg of Calcium Milk, 8 oz 300 mg Cheese 1 oz, 200 mg Calcium pills (Calcium carbonate, calcium citrate, 1200 mg/day)
	Goal: 400 to 800 units per day Vitamin D Yogurt 8 oz 400 mg Calcium fortified orange juice Multivitamins, 400 units/tablet, Fortified milk, 400 units/quart

Lifestyle

	Avoid smoking
	Walking, Nordic Track, treadmill
	Avoid sudden rapid movement, heavy lifting
	Limit alcohol
	Aquatic program
	Low-impact, weight bearing best

Medications

	Hormone (Estrogen) Replacement Therapy, (HRT) Should be considered by all post menopausal women
	Protective for heart disease, bladder problems,
	Dementia
	Side-effects, vaginal bleeding,
	Breast tenderness,
	Venous thrombosis (blood clots),
	Gall bladder problems

Raloxifene (Evista)

If cannot take HRT Side-effects, precipitate hot flashes, same venous Thrombosis risk of estrogen Benefits of estrogen without stimulation of uterine or Breast tissue.

Hot or Cold compression for joints? Do you ever wonder?

Cold reduces blood to the area it is applied to and heat brings more blood to the area it is applied to.

Heat reduces muscle spasm and therefore is useful in situations where muscles are tight such as a stiff neck or back. Muscle ache after exercise. During excessive exercise beyond what one is accustomed to comfortably do, muscles can get sore. If the exercise is very intense, there may not be enough blood flow to eliminate all the chemicals produced as side products, these are needed to be eliminated. It is these accumulated chemicals that cause this type of muscle ache. Over the next few hours these chemicals are gradually eliminated through the blood and the muscles are no longer sore. Since it is blood supply that helps eliminate the chemicals that cause the pain, it makes sense to use heat to help sore muscles after exercise. Add to that the effect heat has in relaxing tight muscles and a hot bath (or any form of heat) makes great sense here. In fact it is from this use of heat that heat became so popular.

When an injury occurs, tissues are damaged and bleeding occurs. Here, heat would increase blood flow and increase the bleeding. Instead cold will reduce blood flow to the area and therefore reduce bleeding which is good. Also as you recall, cold numbs the area it is applied to which in the case of an injury is an added benefit.

Inflammation (tendonitis, bursitis, etc.) means that more blood is going to an area as a reaction to some problem there. That is why an inflamed area of skin is red and painful. Applying heat to an inflamed area will send more blood to the area making it even more inflamed. Cold on the other hand will reduce the blood and numb the pain. In the case of inflammation, cold is the right choice.

People so frequently misuse one or the other that I thought it would be helpful to explain what each does and when it is best to use one or the other and even situations when both may work.

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