Osteoporosis

Definition of Osteoporosis

Osteoporosis (“porous bones”, from Greek: οστούν/ostoun meaning “bone” and πόρος/poros meaning “pore”) is a progressive bone disease that is characterized by a decrease in bone mass and density which can lead to an increased risk of fracture.

In ayurveda this is known as ASTHI (Bone)-SUSHIRTA (Porous-ness) and occurs due to bone wasting (Kshaya) due to any means.

In osteoporosis, the bone mineral density (BMD) is reduced, bone microarchitecture deteriorates, and the amount and variety of proteins in bone are altered. 

If you look at healthy bone under a microscope, you will see that parts of it look like a honeycomb. If you have osteoporosis, the holes and spaces in the honeycomb are much bigger than they are in healthy bone. This means your bones have lost density or mass and that the structure of your bone tissue has become abnormal. As your bones become less dense, they also become weaker and more likely to break.

Types of Osteoporosis

The disease may be classified as

  • Primary type :-  It further contains two types . 
    • primary type 1:- The form of osteoporosis most common in women after menopause or postmenopausal osteoporosis.
    • Primary type 2 osteoporosis or senile osteoporosis occurs after age 75 and is seen in both females and males at a ratio of 2:1.
  • Secondary type :- Secondary osteoporosis may arise at any age and affect men and women equally. This form results from chronic predisposing medical problems or disease, or prolonged use of medications   causes

Sign and Symptoms

There typically are no symptoms in the early stages of bone loss. But once bones have been weakened by osteoporosis, you may have signs and symptoms that include:

  • Back pain, caused by a fractured or collapsed vertebra
  • Loss of height over time
  • A stooped posture
  • A bone fracture that occurs much more easily than expected

Risks factors

Some risk factors for osteoporosis are out of your control, including:

  • Sex. Women are much more likely to develop osteoporosis than are men.
  • Age. The older you get, the greater your risk of osteoporosis.
  • Race. You’re at greatest risk of osteoporosis if you’re white or of Asian descent.
  • Family history. Having a parent or sibling with osteoporosis puts you at greater risk, especially if you also have a family history of hip fractures.
  • Frame size. Men and women who have small body frames tend to have a higher risk because they may have less bone mass to draw from as they age.
  • Sex hormones. The reduction of estrogen levels at menopause is one of the strongest risk factors for developing osteoporosis. Women may also experience a drop in estrogen during certain cancer treatments. Men experience a gradual reduction in testosterone levels as they age. And some treatments for prostate cancer reduce testosterone levels in men. Lowered sex hormone levels tend to weaken bone.
  • Thyroid problems. Too much thyroid hormone can cause bone loss. This can occur if your thyroid is overactive or if you take too much thyroid hormone medication to treat an underactive thyroid.
  • Other glands. Osteoporosis has also been associated with overactive parathyroid and adrenal glands.
  • Low calcium intake. A lifelong lack of calcium plays a major role in the development of osteoporosis. Low calcium intake contributes to diminished bone density, early bone loss and an increased risk of fractures.
  • Eating disorders. People who have anorexia are at higher risk of osteoporosis. Low food intake can reduce the amount of calcium ingested. In women, anorexia can stop menstruation, which also weakens bone.
  • Gastrointestinal surgery. A reduction in the size of your stomach or a bypass or removal of part of the intestine limits the amount of surface area available to absorb nutrients, including calcium.
  • Steroids and other medications. Long-term use of corticosteroid medications, such as prednisone and cortisone, interferes with the bone-rebuilding process.
  • Sedentary lifestyle. People who spend a lot of time sitting have a higher risk of osteoporosis than do their more-active counterparts. Any weight-bearing exercise is beneficial for your bones, but walking, running, jumping, dancing and weightlifting seem particularly helpful for creating healthy bones.
  • Excessive alcohol consumption. Regular consumption of more than two alcoholic drinks a day increases your risk of osteoporosis, possibly because alcohol can interfere with the body’s ability to absorb calcium.
  • Tobacco use. The exact role tobacco plays in osteoporosis isn’t clearly understood, but researchers do know that tobacco use contributes to weak bones.

According to Ayurveda

In ayurveda this is known as ASTHI (Bone)-SUSHIRTA (Porous-ness) and occurs due to bone wasting (Kshaya) due to any means. It is also known as ASTHI KSHAYA.

Pathology in Ayurveda

The General cause of Asthi Kshaya is explained by the accumulation of the air and space (vayu and aakash) in the bones ie. the vata dosha. This can be better explained by the KRIYA KAAl

Sanchaya (accumulation) 

Accumulation of the dosha – VAYU And AAKASH

Prakopa (aggravation) 

The doshas get excited by continuous wrong aahar (diet) , vihar (life style) and seasonal changes of weather. The dosha imbalance overflows and the first signs of illness appear Purvarupa – abdominal distention, constipation, fatigue, insomnia, and all over dryness etc.

Prasara(dissemination) 

the excited and accumulated doshas over flows and spread to other parts, organs, and systems of the body, leaving their original sites, causing dry skin, pain or stiffness of joints, lower back ain, spasm, head ache, abdominal pain with constipation etc.

Sthana Sansraya (relocation)

doshas accumulate at one specific point, the weak dhatus, causing pre-manifestation symptoms leading to malfunction and structural damage.

 Vyakti (manifestation)

symptoms are fully present and the disease is recognizable. Manifested symptoms are now being used by modem medicine also for classification & diagnosis of disease

 Bheda(disruption)

It may become chronic, incurable, or even cause complications and the development of secondary or tertiary illnesses. The disease having taken taken months, years or even decades to reach this final stage, becomes chronic.

Management in Ayurveda

Treatment of asthi kshaya falls into four stages

1. Hetu viparita chikitsa: removal of the causes eg.-prajana-paradh, diet, lifestyle, genetic, inflammatory, iatrogenic etc

2. Agni deepan: Treat the affected agnis – several agnis may be involved eg.-  jatharagni,  bhutagnis, and  asthi dhatu agni.

3. Vata shamak: Pacify vata – there is the inverse relationship between vata and asthi, so vata shaman include use of vata pratyanika herbs, vata Shamak diet, daily self-abhyanga and lifestyle modifications. Basti treatments with also be extremely helpful.

4. Dahtu rasayana: Build bone by counter-measures that are the foods and substances that cause their increase. To do the Pranayamas in sunlight at morning and one hour before the sunset is praiseworthy.

 

 

 

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