Friday, 18 December 2015

Most Common Diseases of elder: The Clinical Trials and Studies of Musculo-Skeletal disorders: Osteoporosis: The Magnificent Natural treatment, according herbal and TCM medicine specialist

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.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.
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 Treatment

B. In herbal  and traditional Chinese medicine perspective
7. The Magnificent Natural treatment 
Beside suggesting certain herbal medicine for treatment of osteoarthritis, modern herbal and TCM medicine doctors may also combine other natural treatment for alleviating symptoms of the disease
1.  Electrostimulation
Use of electricity for treatment of pain, muscle dysfunction and sarcopenia can be dated back to Ancient Egyptians and later the Greeks and Romans(421,462).
In a variectomized rat study, application of pulsed electric field exposure reduced the effect of osteoporosis and restore the bone loss(463). Dr. Manjhi J. and the research team at the Jawaharlal Nehru University, said" In in CCPEF bones, there was an attenuation of decrement in the noted parameters(significant decrease in BMC, BMD, calcium, and phosphorus contents) except phosphorus" probably through stimulation of osteogenesis(465) of that may attenuate the effects of the ovariectomy-induced bone mineral loss in rats(464) and enhance higher global bone mineral content(465).

2. Use Ice or Heat Therapies therapy
Ice therapy such as repeated, rather than continuous, ice applications may be considered as an effective treatment for some patient with pain in osteoporosis due to fracture, a series of compression fractures, muscle spasm and chronic back pain, according to the recommendation by the Osteoporosis: Coping With Chronic Pain by National Institutes of Health Osteoporosis and Related Bone Diseases ~ National Resource Center(466).
Dr. Mediati RD and the research team at the Palliative Care and Pain Therapy Unit, said "osteoporotic acute pain may be reduced if ".... in cases of acute pain, improve the functional capacity of patients and helps to prevent neurological alterations that seems to contribute in significant way in causing irreversible pain chronic syndromes"(467).

3. Acupuncture
The most oldest form of medical treatment in traditional Chinese medicine has been known for its function in relief pain(383,468) and functional limitation(384,469) for chronic patient, including patient with moderate or severe chronic knee pain(383,468), peripheral joint osteoarthritis(384,469) and hip osteoarthritis(470).
A twenty-four 8-week-old female Sprague-Dawley rats study conducted by Suzuka University of Medical Science, 16 weeks of treatment of acupuncture not only promoted the bone formation but also suppressed the bone resorption of which may be useful for treatment of menopausal osteoporotic women(471). Dr, Ma J and the research team said " acupuncture can suppress abnormal increase of body weight and decrease of serum E2 level, and significantly downregulate serum of alkaline phosphatase, bone gla protein and tartrate-resistant acid phosphatase levels in OVX rats, which may contribute to its effect in relieving osteoporosis"(472).
Other study also promotes the use of electroacupuncture (EA) for treatment of osteoporosis not only for it effects as mention in (472) but also improve the level of E2 and propeptide of type I procollagen (PICP) significantly(473).

3. Massage Therapy
Massage therapy has been used in traditional Chinese medicine over thousands of year for treatment of chronic and acute pain in osteoporostic patient due to fractures and fracture related conditions(474).
Comprehensive therapy including massage therapy has shoen to improve the bone metabolism, clinical symptoms and the activity function of joints, and elevate serum SPARC levels in patient with osteoporosis, according to the Shanghai East Hospital Affiliated to Tongji University(475).
Unfortunately, the The Third Hospital of Hebei Medical University reported a case of a pedicle fracture after a back massage, therefore, this event may raise awareness of awareness of a complication of alternative medicine(476).
Dr. Uhlemann C and Dr. Lange U. said" Physical therapy applied in osteoporosis includes ......  mechanical (massage, physiotherapy) stimuli, which can be applied regionally, locally or holistically"(477)(for pain relief).

4. Spa therapy
Spa therapy may be one the effective technique for treatment of lower back pain, according to some studies(392, 478). The spa therapy conducted by Santa Maria de is Acquas, suggested that long-term mud-bath therapy (MBT) showed a reduced frequency of osteopenia and osteoporosis and benefit for the BMD of menopausal women(479).
In pain relief, spa therapy showed to relief symptoms of pain, stiffness and mobility(395,480), improve physical function and quality of life(397, 481) in patient with OA.

5. Hydro exercise therapy
Hydrotherapy, using water for the treatment of disease has shown some beneficiary for treating pain in patient with lower back pain(399,482), joint hemorrhages(400,483) and multiple sclerosis(401,484). The study of 35 postmenopausal women trained for seven months for three one-hour sessions per week suggested that water exercise exhibit a positive effects in maintenance and improvement of bone status(485).
In a randomized Clinical Trial of Aquatic versus Land Exercise, conducted by the University of Saskatchewan, researchers showed that aquatic exercise Significant improvements in balance and may be considered as a viable alternative for older women with OP who have difficulty exercising on land(486).
In deed, the 152 older persons with chronic symptomatic hip or knee OA study by the University of Sydney, hydrotherapy or Tai Chi classes expressed the enhancement of large and sustained improvements in physical function for many older, sedentary individuals with chronic hip or knee OA(403,487) for pain relief.
6. Tai Chi
Tai chi, an ancient form of mind-body exercise or technique used in Chinese with meditative movements that promote balance and healing of the mind and body induced mental concentration, physical balance, muscle relaxation, and relaxed breathing(406,488) and beneficial effects with respect to balance, falls and non-vertebral fractures(489).
The Universität Würzburg, in the study of effects of aging on osteoporosis, suggested that Tai Chi, suitable to patient with osteoporosis may be a better form of disease-adapted exercise to reduce fracture risk, improve quality of life, maintain independence and decrease mortality(490).Dr. Kozaki K, in the study of  the Cochrane systematic review article 2009 said " exercise such as Tai-Chi, ............ are shown to prevent falls in community-dwelling elderly"(491).
In fact other study such as combination of Green tea polyphenols (GTP) and Tai Chi(TC) improve osteoporotic degenerative bone health by effectively reduced the levels of oxidative stress in postmenopausal women with osteopenia (492)

7. Yoga
An ancient form of medical technique originated from India, is become a popular multimodal mind-body exercise in the Western world for promoted flexibility, strength, endurance, and balance(412,493).
Practice of yoga, according to Dr.Smith EN, and Dr. Boser A. is found to provide a greatest benefit to individuals with osteoporosis such as prevented or ceased the progression of osteoporosis, strengthened the muscles supporting the spinal column, promoted balance, improved posture, and enhanced quality of life with least risk(494), especially not for spinal flexion exercise (SFE) in patients with spinal osteoporosis(495).
Further more, the Istanbul University study insisted that yoga may be an alternative physical activity potentially for a positive effect on pain, physical functions, social functions in the rehabilitation of osteoporotic menopausal women(496).

8. Chiropractic
 Chiropractic is one the alternative therapy for diagnosis and treatment of Musculoskeletal disorders (MSDs), including lower back pain with osteoporotic patient(497).
According to the joint study by the Dartmouth Institute for Health Policy and Clinical Practice and Southern California University of Health Sciences,chiropractic spinal manipulation may lower 76% risk of injury to the head, neck, or trunk within 7 days among subjects with a chiropractic office visit in patient of aged 66 to 99 years(498).
In the treatment of a 74-year-old man presented with low back pain (LBP) and loss of feeling in his lower extremities for 3 months, Dr. Roberts JA and Dr. Wolfe TM. said" Chiropractic management...activator-assisted spinal manipulative therapy, had positive subjective and objective results for LBP and ambulation in a geriatric veteran with degenerative disk disease and diffuse idiopathic skeletal hyperostosis"(499).

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By addressing the Underlying Causes through Clinical Trials and Studies

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(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)
(463) Changes in bone histology due to capacitive electric field stimulation of ovariectomized rat by Behari J1, Behari J.(PubMed)
(464) Changes in bone histology due to capacitive electric field stimulation of ovariectomized rat by Behari J1, Behari J.(PubMed)
(465) Electrical field stimulation improves bone mineral density in ovariectomized rats by Lirani-Galvão AP1, Bergamaschi CT, Silva OL, Lazaretti-Castro M.(PubMed)
(466) the Osteoporosis: Coping With Chronic Pain by National Institutes of Health Osteoporosis and Related Bone Diseases ~ National Resource Center
(467) Pathogenesis and clinical aspects of pain in patients with osteoporosis by Mediati RD1, Vellucci R1, Dodaro L1.(PubMed)
(471) Acupuncture increases bone strength by improving mass and structure in established osteoporosis after ovariectomy in rats by Zhang W1, Kanehara M, Zhang Y, Yu Z, Zhang G, Yang Y, Tachi S, Ishida T.(PubMed)
(472) [Effects of acupuncture on bone metabolism and serum estradiol level in ovariectomy-induced osteoporosisrats].[Article in Chinese] by Ma J1, Yun-guang H, Zhang DH.(PubMed)
(473) [Effect of electroacupuncture on the biochemical indices of bone and bone collagen metabolism and TNF-alpha in osteoporosis model rats without ovaries].[Article in Chinese] by Bao SY1, Zhang SJ, Lin WJ, Chen JF.(PubMed)
(474) Massage Therapy for Osteoporosis(ME)
(475) [Effects of comprehensive therapy on serum SPARC levels in ankylosing spondylitis patients accompanied withosteoporosis].[Article in Chinese] by Xu JR1, Lin Y, Zhang CY, Li WM, Guo CJ, Ye L.(PubMed)
(476) Isolated unilateral vertebral pedicle fracture caused by a back massage in an elderly patient: a case report and literature review by Guo Z1, Chen W, Su Y, Yuan J, Zhang Y.(PubMed)
(477) [Physiotherapy strategies in osteoporosis--recommendations for daily practice].[Article in German] by Uhlemann C1, Lange U.(PubMed)
(479) Bone mineral density in women on long-term mud-bath therapy in a Salus per Aquam (SPA) environment by Loi A1, Lisci S, Denotti A, Cauli A.(PubMed)
(485) The effect of a water exercise program on bone density of postmenopausal women by Rotstein A1, Harush M, Vaisman N.(PubMed)
(486) A Randomized Clinical Trial of Aquatic versus Land Exercise to Improve Balance, Function, and Quality of Life in Older Women with Osteoporosis by Arnold CM1, Busch AJ, Schachter CL, Harrison EL, Olszynski WP.(PubMed)
(489) Tai chi for osteoporosis: a systematic review by Lee MS1, Pittler MH, Shin BC, Ernst E.(PubMed)
(490) [Age and osteoporosis. Effects of aging on osteoporosis, the diagnostics and therapy].[Article in German] by Jakob F1, Seefried L, Schwab M(PubMed)
(491) [Fall risk and fracture. Aging and fall/fracture].[Article in Japanese] by Kozaki K1.(PubMed)
(492) Mitigation of oxidative damage by green tea polyphenols and Tai Chi exercise in postmenopausal women with osteopenia by Qian G1, Xue K, Tang L, Wang F, Song X, Chyu MC, Pence BC, Shen CL, Wang JS.(PubMed)
(494) Yoga, vertebral fractures, and osteoporosis: research and recommendations by Smith EN, Boser A.(PubMed)
(495) Yoga spinal flexion positions and vertebral compression fracture in osteopenia or osteoporosis of spine: case series by Sinaki M1(PubMed)
(496) Yoga might be an alternative training for the quality of life and balance in postmenopausal osteoporosis by Tüzün S1, Aktas I, Akarirmak U, Sipahi S, Tüzün F.(PubMed)
(497) Chiropractic spinal manipulative therapy for a geriatric patient with low back pain and comorbidities of cancer, compression fractures, and osteoporosis by Roberts JA1, Wolfe TM.(PubMed)
(498) Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66 to 99 years by Whedon JM1, Mackenzie TA, Phillips RB, Lurie JD.(PubMed)
(499) Chiropractic management of a veteran with lower back pain associated with diffuse idiopathic skeletal hypertrophy and degenerative disk disease by Roberts JA1, Wolfe TM.(PubMed)

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