2. • Definition
• Fragile bones (porous bones ): low density
bones
• Progress to painful fractures (hip; spine; wrist)
• Permanent or temporarily disability or death.
• Affects women 4x men
• Less Ca; PO4 and minerals.
3.
4. • Signs and symptoms
• In the early stages : no pain or symptoms.
• symptoms include:
• Sudden onset of pain, typically in the front of
the thigh, the side of the hip, the buttocks or
the groin (No previous accident or injury to the joint
that would trigger pain )
• Limited motion; pain intensifies with turning
movements.
5. • Pain intensifies with weight bearing and
may lessen with rest.
• Pain gradually increases over a period of
weeks or month and may be so intense that
it is disabling.
• A change in gait as the patient tries to
protect the joint and ease the pain.
• Back pain, : a fractured or collapsed
vertebra
• Loss of height over time, with an
accompanying stooped posture
• Fracture of the vertebrae, wrists, hips or
other bones
6. Bone Remolding
• Bone is continuously changing — new bone is
made and old bone is broken down : a process
called remodeling, or bone turnover.
• cycle of bone remodeling: two - three months.
When you're young, your body makes new
bone faster than it breaks down old bone, and
your bone mass increases. You reach your
peak bone mass in your mid-30s. After that,
bone remodeling continues, but you lose
slightly more than you gain.
• how much bone mass you attained between
ages 25 and 35 (peak bone mass)
7. • Presentation
• Usually silent →fracture.
• Vertebral fracture:
• 2/3 no attention clinically
• Sudden pain:
• unrelated to exertion.
• Bed rest
• Not generalized skeleton pain
• Peripheral fractures.
8. Risk factors
• sex
• Age
• Race
• Family history
• Frame size
• Tobacco use
• Lifetime exposure to estrogen
• Eating disorders
• Thyroid hormone
9. • Some diuretics
• Other medications
• Breast cancer
• Low calcium intake
• Medical conditions and procedures that
decrease calcium absorption
• Sedentary lifestyle
• Excess soda consumption
• Chronic alcoholism.
• Depression
10. • pregnancy appears to help protect a woman’s
calcium reserves in several ways:
• Pregnant women absorb calcium better from
food and supplements than women who are
not pregnant. This is especially true during the
last half of pregnancy, when the baby is
growing quickly and has the greatest need for
calcium.
• During pregnancy, women produce more
estrogen, a hormone that protects bones.
• Any bone mass lost during pregnancy is
typically restored within several months after
Osteoporosis and Pregnancy
11. • the baby’s delivery (or several months after
breastfeeding is stoppe.
• Some studies suggest that pregnancy may be
good for bone health overall. There is some
evidence that the more times a woman has
been pregnant (for at least 28 weeks), the
greater her bone density and the lower her risk
of fracture.
• In some cases, women develop osteoporosis
during pregnancy and/or breastfeeding,
although this is rare. Osteoporosis is bone loss
that is serious enough to result in fragile bones
and increased risk of fracture.
12. Screening and diagnosis
1-X-Ray
Detect bone loss after 30 percent of the skeleton
depleted.
2- Bone Mineral Density Tests
• Dual Energy X-R Absorptiometry
(DEXA): T-score
• Hip and spine.
• Identify osteoporosis
• Determine your risk for fractures (broken
bones:
14. • 4-Laboratroy Tests
• Blood
• A-blood calcium levels
• B- Blood vitamin D levels
• C-thyroid function
• D- Parathyroid hormone levels
• E- Estradiol levels to measure estrogen (in
women)
15. • F- Follicle stimulating hormone (FSH) test to
establish menopause status
• G- Testosterone levels (in men)
• H- Osteocalcin levels to measure bone
formation
• Endomyseal AB (coeliac Dis).
17. • Urine
• 24-hour urine collection to measure calcium
metabolism
• tests to measure the rate at which a person is
breaking down or resorbing bone.
18. • Prevention
• Avoid risk factors: adequate calcium and
vitamin D (helps Ca absorption, strengthen
muscel and against cancer).
• Treatment
Coping with pain
• Heat and ice
• Transcutaneous Electrical Nerve Stimulation
(TENS)
• Braces and supports
• Exercise and physical therapy
• Acupuncture and acupressure
• Massage therapy
19. Physical Methods of Pain
Management
• Relaxation training
• Biofeedback
• Visual imagery and distraction
• Hypnosis
• Individual, group, or family therapy
22. • Emerging therapies : spinal weighted kypho-
orthosis (WKO) combined with a light weight
attached — and specific back extension
exercises :
• Daily for 30 minutes in the morning and 30
minutes in the afternoon and while performing
10 repetitions of back extension exercises.
