Saturday, 28 November 2015

Most Common Diseases of elder: The Clinical Trials and Studies of Musculo-Skeletal disorders: Osteoporosis - The Symptoms

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. According to a community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home, musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia


Osteoporosis is defined as a condition of thinning of bone and bone tissues as a result of the loss of bone density over a long period of time. It is a widespread degenerative disease of skeletal joints and often associated with senescence in vertebrates due to excessive or abnormal mechanical loading of weight-bearing joints, arising from heavy long-term use or specific injuries(6).

                                                  The symptoms 

1. Lower back pain, as a result of fractured or collapsed vertebra
People with Osteoporosis are susceptible to lower back pain in patient with osteoporosis than those without, according to a cross-sectional study, conducted from October 2002 to March 2003 to gather data from 24,435 adults aged 20 years and older selected randomly from Taiwan’s general population(34). Vertebral fractures(35) and collapsed vertebra(36) in many cases is found to be associated to lower back pain as well as loss of height(35) The Osteoporosis rate of frequent low back pain is higher in women in comparison to those of male(37).

2. Loss of height over time(38)
Vertebral fracture cause of spinal core damage is associated to significant height loss in patients with osteoporosis(35), according to a study of 231 men and women over the age of 65 underwent DXA scan of their spine and hip (38). Osteoporosis patients with chronic obstructive pulmonary disease (COPD) are found to associate to excessive height loss(39).

3. A stooped posture
Postural deformity of patients with osteoporosis is associated to contributed risk factor for postural instability and falls(40)(41). Spinal curvature on postural instability in patients with osteoporosis may influence lumbar kyphosis (lower back curvature) in spinal inclination and a risk of fall(42).

4. Easy bone fracture
Easy bone fracture may be results of a gradual loss of bone density(43)(44). Intravenous infusion of zoledronic acid (5 mg) at 12 months, found that Zoledronic acid treatment was associated with a significantly reduced risk of vertebral fracture(fractures in the spine, hip and wrist), among men with osteoporosis(45). The treatment was also found to be effective in prevention of osteoporotic bone fractures in postmenopausal women(46)(47).

5. Neck and low back pain
Neck and low back pain, frequent in female are prevalent and highly associated in patients with headache and osteoporosis(48)(49), according to 1-year prevalence of neck pain and low back pain in the Spanish population(48).

6.  Depression
Spine bone mineral density(BMD) was negative correlations between anxiety, stress, but depression was found to have a unique significant contribution to the explained variance in right and left hip BMD, according to Bar Ilan University(50). In a population-based retrospective cohort study, researchers at the China Medical University Hospital showed that risk of osteoporosis increase in patients with depression:(51).

7.  Other symptoms
Women with osteoporosis re more likely to experience certain psychosomatic(52)(53), gastrointestinal(52) and swelling(52) and vasomotor symptoms(52), especially depressive symptom if compared to women in generally good health(52)(53).
According to the joint study by University of Porto Medical School and Universidade Nova de Lisboa, knee and hip in patient with osteoarthritis features: differences on pain, function can totally effect the quality of life(54).

8. Etc.

(1) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed
(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) Osteoporosis(Life extension)
(4) Hormone and bone by Francisco Bandeira1, Marise Lazaretti-Castro2, John P. Bilezikian3
(5) Growth hormone and bone by Ohlsson C1, Bengtsson BA, Isaksson OG, Andreassen TT, Slootweg MC.(PubMed)
(6) GH and bone--experimental and clinical studies by Isaksson OG1, Ohlsson C, Bengtsson BA, Johannsson G.(PubMed)
(33) Chronic hyperglycemia modulates osteoblast gene expression through osmotic and non-osmotic pathways by Botolin S1, McCabe LR.(PubMed)
(34) Low back pain associated with sociodemographic factors, lifestyle and osteoporosis: a population-based study by Chou YC1, Shih CC, Lin JG, Chen TL, Liao CC.(PubMed)
(35) Opportunistic Identification of Vertebral Fractures by Adams JE1.(PubMed)
(36) Collapsed L4 vertebral body caused by brucellosis by Ekici MA1, Ozbek Z2, Kazancı B1, Güçlü B1.(PubMed)
(37) Burden of major musculoskeletal conditions Anthony D. Woolf1 & Bruce Pfleger2
(38) Height loss, vertebral fractures, and the misclassification of osteoporosis by Xu W1, Perera S, Medich D, Fiorito G, Wagner J, Berger LK, Greenspan SL.(PubMed)
(39) Precision in Diagnosing and Classifying COPD: Comparison of Historical Height with Current Height and Arm Span to Predict FEV(1) by Ansari K1, Keaney N, Price M, Munby J, Kay A, Taylor I, King K.(PubMed)
(40) Age-Related Hyperkyphosis: Its Causes, Consequences, and Management by Wendy B. Katzman, PT, DPTSc, Assistant Clinical Professor,1 Linda Wanek, PT, PhD, Professor,2 John A. Shepherd, PhD, Assistant Professor in Residence,3 and Deborah E. Sellmeyer, MD, Associate Professor4(PubMed)
(41) Rehabilitation of Patients with Osteoporosis-related Fractures by Patricia Graham MD, PC, Owner, Physical Medicine and Rehabilitation/Integrative Medicine, Princeton, NJ and Kelly A. Trippe, MA, Managing Editor, Osteoporosis: Clinical Updates.(Osteoporosis clinical update)
(42) Spinal curvature and postural balance in patients with osteoporosis by Ishikawa Y1, Miyakoshi N, Kasukawa Y, Hongo M, Shimada Y.(PubMed)
(43) The Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You(NIH)
(44) Improving bone mineral density reporting to patients with an illustration of personal fracture risk by Edmonds SW1,2, Cram P3,4, Lu X5, Roblin DW6,7, Wright NC8, Saag KG9, Solimeo SL10; PAADRN Investigators.(PubMed)
(45) Fracture risk and zoledronic acid therapy in men with osteoporosis by Boonen S1, Reginster JY, Kaufman JM, Lippuner K, Zanchetta J, Langdahl B, Rizzoli R, Lipschitz S, Dimai HP, Witvrouw R, Eriksen E, Brixen K, Russo L,Claessens F, Papanastasiou P, Antunez O, Su G, Bucci-Rechtweg C, Hruska J, Incera E, Vanderschueren D, Orwoll E.(PubMed)
(46) Once-yearly zoledronic acid in the prevention of osteoporotic bone fractures in postmenopausal wome by Irene Lambrinoudaki, Sophia Vlachou, Fotini Galapi, Dimitra Papadimitriou, and K Papadias(PubMed)
(47) Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. by Black DM1, Delmas PD, Eastell R, Reid IR, Boonen S, Cauley JA, Cosman F, Lakatos P, Leung PC, Man Z, Mautalen C, Mesenbrink P, Hu H, Caminis J, Tong K, Rosario-Jansen T, Krasnow J, Hue TF, Sellmeyer D, Eriksen EF, Cummings SR; HORIZON Pivotal Fracture Trial.(PubMed)
(48) Prevalence of neck and low back pain in community-dwelling adults in Spain: a population-based national study by Fernández-de-las-Peñas C1, Hernández-Barrera V, Alonso-Blanco C, Palacios-Ceña D, Carrasco-Garrido P, Jiménez-Sánchez S, Jiménez-García R.(PubMed)
(49) Interventional Spine: An Algorithmic Approach By Curtis W. Slipman
(50) The relationship of depression, anxiety and stress with low bone mineral density in post-menopausal women by Erez HB1, Weller A, Vaisman N, Kreitler S.(PubMed)
(51) Increased risk of osteoporosis in patients with depression: a population-based retrospective cohort study by Lee CW1, Liao CH2, Lin CL3, Liang JA4, Sung FC5, Kao CH6.(PubMed)
(52) Unique symptoms at midlife of women with osteoporosis and cardiovascular disease in Taiwan. by Wang HL1, Tai MK, Hung HM, Chen CH.(PubMed)
(53) Depressive symptoms in Taiwanese women during the peri- and post-menopause years: associations with demographic, health, and psychosocial characteristics by Wang HL1, Booth-LaForce C, Tang SM, Wu WR, Chen CH.(PubMed)
(54) Knee and hip radiographic osteoarthritis features: differences on pain, function and quality of life by Pereira D1,2, Severo M3,4, Santos RA5, Barros H6,7, Branco J8, Lucas R9,10, Costa L11, Ramos E12,13.(PubMed))

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