Question

Describe to me the etiology, pathogenesis, clinical manifestations, and treatment options for Osteoporosis? Patients of any gender need to complete resistance training to prevent bone loss after age 30. What resistive training program might you suggest to your patients?

Answer 1

Osteoporosis

It is a disease condition that affect bones, especially seen in women following menopause. In osteoporosis the bones become extremely porous and are subject to fracture.

Etiology

There are various risk factors that can contribute to the disease condition Osteoporosis. The major risk factors are:

* Age : After 35 years, breaking down of bone may become faster than the replacement.

* Gender : women are at more risk in developing osteoporosis, especially after Menopause

* Family history

* Race : White or Asian descent

* Dietary factors like Low calcium intake , inadequate vitamin D intake makes the bone week.

* Hormonal imbalance , especially lowered sex hormones, hyperthyroidism etc stimulate bone loss

* Medical conditions like Inflammatory Bowel Disease, liver or kidney disease, Rheumatoid arthritis etc.

* Medication use especially steroids  

* Sedentary lifestyle or physical inactivity

* Alcohol abuse and tobacco use

Pathogenesis

Osteoporosis may occur due to various causes or factors as it may be due to less calcium intake, or due to hormonal changes. The risk factors causes incread bone resorption than bone formation , thus creates an  imbalance in bone remodelling . Here there is a lack of compensatory mechanism of osteoblastic bone formation to balance with osteoblastic bone resorption . It inturn leads to the formation of pores in the bone and the bone density become less . The condition can increase the  risk for fragility fractures.

Clinical manifestations

* Brittle bones

* A stooped posture

* Back pain , due to collapsed or fractured vertebra

* loss of height

Treatment

* Biophosphonates . Example : Risedronae Alendronate

* Hormone related therapy ; Estrogen therapy

* Monoclonal antibody medications

Example: denosumab

* Bone building Medications . Example: Romosozumab , Abaloparatide ( parathyroid hormone medication)

* Life style changes :

- Avoid smoking and alcohol

- prevention of falls

* Prevention:

- adequate protien, Calcium ( 1000mg / day) and Vitamin D intake

- Maintain a proper body weight

- Regular exercise can keep the bones and muscles feet

2. Resistive training programme

Resistive training programme is beneficial for improving the bone density and muscle mass especially in women who gone through the menopause. This training session is indicated 2 to 3 times a week. It should include:

* Strength training or resistance training: push ups , lifting weights , squats

* weight bearing exercises : jogging , walking , dancing.

* balance training : standing on one leg, stand on a rocker board