the bones and muscle (disease of the bones)
What exactly is osteoporosis , and how common a problem is it?
It is a serious and very common condition in which skeletal bones may lose strength to such a degree that they break with little or no trauma. Hip, wrist and spinal bones are those most likely to fracture. Weakened vertebrate, in particular, may collapse under the pressure of body weight, decreasing height and producing the condition know as a widow`s hump. All people suffer some degree of osteoporosis as part of the ageing process, but women are affected by it more than men and at an earlier age. It is estimated that in the first few years following menopause, the rate of bone loss in women may be as high as 4 per cent year, compared with only 0.5 per cent in men.
What causes osteoporosis?
Although the intricacies of osteoporosis are not fully understood, it apperats that a combination of factors contributes to the gradual erosion of bone strength that is characteristic of the disease.The density and strength of bones increase until the age of 35 or so; after that bone strength decreases naturally at the rate of about one per cent each year. People who, because of hereditary factors, have relatively low bone strength at 35 years old - this is especially true of women who are fair haired, fair skinned and slender-may begin experiencing problems with fractured bones and loss of stature in their early sixties. In many women, the bine weakening process may be accelerated by the onset of menopause and the cessation of oestrogen production by the ovaries-oestrogen plays an important role in sustaining bone strength. Younger women who experience premature menopause because of surgical removal of their ovaries are also more likely to suffer from the disease. Cigarette smoking, excessive alcohol consumption, insufficient excessive alcohol consumption, insufficient exercise and poor dietary calcium intake appear to increase tha tendency to osteoporosis.
How can I tell if I have osteoporosis, and what can I do about it?
Many people don`t discover that they have osteoporosis until it well established. In some, the first indication may be a hip or wrist fracture that occurs either spontaneously or as a result of a fall or a blow. A more typical symptom, however, is pain in the lower back due to the collapse pf a vertebra, or a `crush` fracture. It is the unchecked disintegration of the vertebrae over the years that eventually leads to the condition that is known as widow`s hump, in which height diminishes and the spine takes on a pronounced forward curve in the upper back. Newly developed techniques can measure bone density in th spine, wrist and hip. They include dual photon absorptiometry and quantitative CT scanning. These tests show the extebt of demineralisation that has occured in hight-risk subjects , but have limited pre dictive value in normal subjects. Hence the use of such tests in screening is not cost-effective.Doctors and researchers do not fully agree on how best to treat osteoporosis. Prevention is by far the most effective approach and includes adequate dietary calcium intake, bone-stressing exercises such as jogging and tennis, and the avoidance of other risk factors such as smoking and immoderate drinking, from adolescence onwards. Excessive exercise and weight loss can also predispose to osteoporosis.For women in a high-risk category hormone-replacement therapy after menopause is valuable. Oestrogen therapy is not for everyone, and should probably be avoided if there is a history of blood clots, stroke, liver diseases, or breast or uterine cancer. Also it has been shown to increase slightly the incidence of uterine cancer in women who have not had a hysterectomy. The risks is reduces by giving progestogen as wll but this combination may produce cyclic bleeding similar to periods. The risk and benefits of hormone-replacement theraphy should be dicussed with a doctor.Several approaches to treating women who have lost bone strength and are suffering fractures are being studied and used. These include such medications as sodium fluoride combined with calcium and vitamin D, active vitamin D hormone and injections of a substance called calcitonin.
Can a proper diet help to prevent osteoporosis?
Yes, it can. Adequate comsumption of calcium-risch foods can play a significant role in keeping the bones strong and healthy.What makes this particularly important is that calcium tablets or supplements alone do not prevent osteoporosis in highrisk women, nor are they an effective treatment for women who already have the condition. Unfortunately the average woman doesn`t consume sufficient dietary calcium. All women should cultivate the habit of eating calcium-rich foods, consuming at least 800 milligrams of calcium daily (more during pregnancy), together with adequate vitamin D, either by regular moderate exposure to the sun or as medication, to help in the absorption of calcium. For postmenopausal women, the recommended amount is 1000 milligrams daily according to some authorities, as much as 1500 milligrams according to others.Milk is the best source of dietary calcium, but you would need to drink almost a litre a day to meet your calcium needs.Fortunately, good calcium supplies are available in cheeses and other foods.
I have trouble digesting dairy foods and am also watching my weight. How can I get enough calcium in my diet?
Many people who are sensitive to dairy products (because of an inability to digest milk sugar, or lactose) can usually tolerate yoghurt also break down lactose. Other natural sources of calcium include fish (especially canned unfilleted salmon or sardines), broccoli, broad and kidney beans, fennel, okra and dried figs. Although dark green leafy vegetables are also rich in calcium, some, like spinach and kele, contain oxalic acid, a substance that hinders calcium absorption. It isn`t necessary to gorge yourself on calcium-rich foods; just make regular use of them in your regular diet.A variety of calcium supplements are now avaible in tablet form, the simplest and least expensive of which is calcium carbonate. But before deciding on supplements, you should consider increasing your consumption of natural sources of calcium, and remember too that excess calcium may be counterproductive.
I have heard that children can contract a dangerous bone disease from cuts that become infected. Is this true?
Yes, it is. Osteomyelitis is a rare but serious infection of the bone and its marrow. It is caused by bacteria that spread to the bone from a nearby open wound, such as that produced by a compound fracture, or that travel through the blood from an infection elsewhere in the body. The symptoms of osteomyelitis are hard to overlook: extreme pain and tenderness at the site of infection, high fever, reluctance to use the affected limb, and severe redness and swelling if the infection remains untreated for more than a few days.The principal treatment for osteomyelitis involves the use of antibiotics, but treatment must begin early to be effective. If it is delayed and the infection spreads, more complicated procedures, such as surgical drainage, may be necessary. In severe cases, these measures may be continued on a regular basis for several years, and permanent bone damage is possible.
Is rickets still a problem, and if so, what causes it?
Rickets is a childhood condition in which bone fail to harden because of a shortage of vitamin D. This vitamin helps to regulate the body`s absorption of calcium and phosphorus, needed for bone formation. Although still common in some parts of the world, rickets has become increasingly rare in the West. It is easily avoided by eating a normal diet, taking vitamin D-fortified milk, and by moderate exposure to sunlight, which helps the body to synthesise vitamin D.
Isn`t there also a condition called adult rickets? Is this related to the childhood disease?
Like childhood rickets, adult rickets, or osteomalacia, is also caused by vitamin D defeciency. The main symptom of the disease in adults is increased susceptibility to bone fracture. Pregnant women are at a greater risk because their increased need for calcium (for foetal bone development) also boosts their need for vitamin D. Older people may develop osteomalacia because of poor diet and too little sunlight, or because their ability to utilise the nutrients they eat and the sunlight they receive is impaired. The disease often occurs in people undergoing renal dialysis or who are taking certain drugs. The usual treatment involves increasing the patient`s supply of vitamin D, calcium and phosphorus, either in the diet or by means of vitamin-mineral supplements.
When my uncle broke his leg recently, his doctor told him he had something called called Paget`s disease. What is this, and can it be cured?
In this disease, also called osteitis deformans, the normal process of bone production and replacement speeds up and becomes dangerously disorganised. Poorly formed new bone is produced at a faster rate than that at which old bone tissue is more fragile than normal bone tissue, the result of Pager`s disease is a gradual weakening of all or part of the affected bones, usually of the hip, leg, spine and skull; they are often painful and vulnerable to fracture and deformation, and may become enlarged and press against adjacent nervers, causing intense pain. When the skull is affected, it may press against the auditory nerves and cause hearing loss.The underlying cause of Paget`s disease is not know, although a virus is suspected. It may occur at any age, but seldom appears before the age of 50, more commonly in men than in women. Paget`s tends to progress slowly and may go unnoticed until the symptoms- repeated fractures or bone pain that worsens at night-attract special medical attention. There is as yet no cure for Paget`s disease, but aspirin or prescription drugs may relieve tha pain. In certain cases, aggressive drug theraphy may help to stop abnormal bone growth.
the bones and muscles (disease of the bones)
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