Thursday, 3 December 2015

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

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 Complications 

Pain, Fractures, Vertebral, Wrist, Rib fractures are associated with Osteoporosis, according to the study of New advances in imaging osteoporosis and its complications(205).

1. Bone fracture
Bone fracture is considered as one of most serious complication of osteoporosis, due to loss of bone mineral density. Even minimum mechanical stress can easily head for fracture(206)(207). According to the Department of Diagnostic Imaging - AOUC, most common fracture sites, other than spine and hip are distal radius, forearm, proximal humerus, other femoral sites, ribs, pelvis, tibia and fibula, metatarsal bone and calcaneum(207). Dr. Parkinson IH and Dr. Fazzalari NL in the differentiation of 
Whole bone geometry and bone quality in distal forearm fracture said" Fracture of the distal radius is a sentinel for future increased risk of other "osteoporotic" fractures"(208). Certain nutritional supplements have shown effectively in reduced risk of fracture, such as vitamin K2(209)(210), vitamin D, calcium(212)
In deed, over weight and high body mass index (BMI) are associated to risk of lumbar spine and hip fracture in menopausal women and men as a result of poor balance and frequent falls(211).
The Health Quality Ontario said".....long-term exercise programs in mobile seniors and environmental modifications in the homes of frail elderly persons will effectively reduce falls and possibly fall-related injuries in Ontario's elderly population.A combination of vitamin D and calcium supplementation in elderly women will help reduce the risk of falls by more than 40%,..."(213).

2. Pain
Chronic pain is often induced poor quality of life in patient with osteoporosis, affecting daily living and functional status(215) and in some cases, causing mental health, such as anxiety and depression  to certain patients(214).
Exercise training program in osteoporotic patients improved balance and level of daily function, quality of life and decreased experience of pain and use of analgesics(215). Analgetic agent in most is used for elder patient with osteoporotic lower back pain(216).
In a Randomized placebo controlled trial, on self reported pain and quality of life in an elderly population, conducted by the International College of Osteopathic Medicine, Cinisello Balsamo, treatment other than mainstream medicine, showed to improvement of psychological and quality of life factors probably due to the effect on pain relief(217).

3. Bone Deformity 
Deformity, dysmorphism, or dysmorphic feature is a major abnormality in the shape(214).
According to the Japanese Population-Based Osteoporosis (JPOS) cohort study by Kinki University Faculty of Medicine, lower trabecular bone score (TBS) in bone density was associated with higher risk of vertebral fracture over 10 years in associated to the prevalence of vertebral deformity(218).
Elderly patients with osteoporotic neck pain, is associated marked thoracic kyphotic deformity(219).  

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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)
(205) New advances in imaging osteoporosis and its complications by Griffith JF1, Genant HK.(PubMed)
(206) Stress fractures by Dr Yuranga Weerakkody and Dr Frank Gaillard
(207) Severe osteoporosis: diagnosis of non-hip non-vertebral (NHNV) fractures by Giovanni D’Elia,1 Giuliana Roselli,1 Loredana Cavalli,2 Paolo Innocenti,1 and Maria Luisa Brandi2(PubMed)
(208) Whole bone geometry and bone quality in distal forearm fracture by Parkinson IH1, Fazzalari NL.(PubMed)
(209) Vitamin K2 (menatetrenone) effectively prevents fractures and sustains lumbar bone mineral density inosteoporosis by Shiraki M1, Shiraki Y, Aoki C, Miura M.(PubMed)
(210) Short-term menatetrenone therapy increases gamma-carboxylation of osteocalcin with a moderate increase ofbone turnover in postmenopausal osteoporosis: a randomized prospective study by Shiraki M1, Itabashi A.(PubMed)
(211) Association of Body Weight and Body Mass Index with Bone Mineral Density in Women and Men from Kosovo by Rexhepi S1, Bahtiri E2, Rexhepi M1, Sahatciu-Meka V3, Rexhepi B1.(PubMed)
(212) Should we prescribe calcium or vitamin D supplements to treat or prevent osteoporosis? by Bolland MJ1, Grey A1, Reid IR1.(PubMed)
(213) Prevention of falls and fall-related injuries in community-dwelling seniors: an evidence-based analysis by Health Quality Ontario(PubMed)
(214) Bone Health and Osteoporosis: A Report of the Surgeon General by Rockville (MD): Office of the Surgeon General (US); 2004.
(215) Positive effects of physiotherapy on chronic pain and performance in osteoporosis by Malmros B1, Mortensen L, Jensen MB, Charles P.(PubMed)
(216) [Therapeutic agents for osteoporotic pain].[Article in Japanese] by Nakao S, Miyamoto E, Kawakami M.(PubMed)
(217) A randomized control trial on the effectiveness of osteopathic manipulative treatment in reducing pain and improving the quality of life in elderly patients affected by osteoporosis by Papa L1, Mandara A, Bottali M, Gulisano V, Orfei S.(PubMed)
(218) Trabecular bone score (TBS) predicts vertebral fractures in Japanese women over 10 years independently ofbone density and prevalent vertebral deformity: the Japanese Population-Based Osteoporosis (JPOS) cohort study by Iki M1, Tamaki J, Kadowaki E, Sato Y, Dongmei N, Winzenrieth R, Kagamimori S, Kagawa Y, Yoneshima H.(PubMed)
(219) Atraumatic Occult Odontoid Fracture in Patients with Osteoporosis-Associated Thoracic Kyphotic Deformity: Report of a Case and Review of the Literature by Mori K1, Nishizawa K1, Nakamura A1, Imai S1(PubMed)

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