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It is by far the commonest metabolic bone disease. It is characterized by a diffuse reduction in the bone density due to decrease in the bone mass. It occurs when the rate of bone resorption exceeds the rate of bone formation.The three main mechanisms by which osteoporosis develops are an inadequate peak bone mass (the skeleton develops insufficient mass and strength during growth), excessive bone resorption, and inadequate formation of new bone during remodeling. An interplay of these three mechanisms underlies the development of fragile bone tissue.
Hormonal factors strongly determine the rate of bone resorption; lack of estrogen (e.g. as a result of menopause) increases bone resorption, as well as decreasing the deposition of new bone that normally takes place in weight-bearing bones.
1. PRIMARY OSTEOPOROSIS:
Results from decreased bone density without any underlying disease. · Idiopathic: seen in young & juveniles · Involutional type: seen in post menopausal women
2. SECONDARY OSTEOPOROSIS: ·
Occurs due to underlying pathology i.e immobilisation, anaemia, acromegaly, hyperthyroidism, starvation, effect of medication i.e anticonvulsant, large dose of aspirin
- protein deficiency
- inadequate intake i.e. old age or illness
- excess protein loss i.e. 3rd degree burn
- drug induced i.e. long term steroid therapy
Asymptomatic unless complication occurs i.e. fracture due to fall or some trivial trauma.
About 30% of bone mass must be lost to become apparent on x-ray.
.neutron activation analysis
Generally we find excessive hotness, dryness and coldness. So best option is tonify heat or humidity.
Diet : .high protein diet if deficiency
.vitamin-d intake to increase calcium absorption from gut
Exercises: Weight bearing exercise is a major stimulus to bone formation and increased guarded activity would therefore be of benefit to the patient.