Dr. Muhammad Mahtab Hossain Mazed

World Osteoporosis Day 2024 Every year on 20 October, the day is celebrated worldwide through various awareness programs. The theme of this day is 'Say No to Fragile Bones'. At the government level in the country, not much importance is given to celebrating this day. Osteoporosis is a bone loss disease, every year more than 9 million people in the world break their bones due to osteoporosis. Osteopenia itself weakens the bones and increases the risk of fractures. Without any symptoms, this disease starts nesting in the body silently.

Before the bone breaks, there are no symptoms of this disease, and in Bangladesh, as many as 6 million people are suffering from osteoporosis. Women over fifty have a 5.1 percent risk of the disease, compared to 3.1 percent for men. In women, post-menopausal hormonal imbalances (estrogen, progesterone) increase the risk of bone loss.

And osteoporosis refers to a decrease in bone density in the body. Severe osteoporosis can be broken even by sneezing or coughing. Bone loss or its symptoms begin to appear in the body after the age of fifty. But it started a long time ago. Although this bone loss gradually increases, no symptoms are revealedIncidentally, osteoporosis is a disease in which the bone density decreases to a certain level, causing the bones to become weak and brittle.

Between 20 and 35 years, bone reaches its fullness, then after age 40, bone begins to lose its calcium and phosphate, causing the bone to change, becoming weak and brittle. 15% at the age of 50 and 30% at the age of 70-80 will break the hip bone or hip bone. In women, the rate of bone loss is very fast in the post-menstrual period. Apart from this, various factors or risks can increase the risk of bone loss. People who have had one fracture have a significantly increased risk of future fractures. Once a rib fracture occurs, the risk of hip fracture increases 2-3 times and the risk of femur fracture increases 1-4 times.

> Spondylosis

We often have neck and back pain. One of the causes of neck and back pain is spondylosis. There are two types of spondylosis – cervical spondylosis and lumbar spondylosis.

If there is any natural change in the spine of our body, especially the vertebrae of the neck and waist, it is called spondylosis. Many call it bone loss or bone growth disease.

> Symptoms of neck pain

The pain radiates from the neck to the arms, back, or chest. Arms feel numb or paralyzed. Many also report headaches or dizziness. If the pain is severe, the patient cannot sleep and even lies down.

> Symptoms of back pain

The pain radiates from the waist to the legs. Can't stand or sit for long in one way. Legs are shaking. Leaning forward increases the pain.

Many also experience pain on the side of the toilet or urinary tract. This pain usually worsens gradually. Sometimes severe pain starts suddenly.

> Those at risk of osteoporosis
As mentioned earlier, this disease is more common in people in their fifties and post-menopausal womenIn addition, those with a history of bone fractures, long-term use of steroid-like drugs or anticonvulsant drugs, excessive smoking or alcohol consumption, low-calcium diet, underweight, and physical inactivity are at increased risk. Apart from that, some rheumatic diseases, thyroid and reproductive gland diseases, problems in absorption of nutrients and vitamins from the esophagus can also cause osteoporosis.

> Unmodifiable risk : Age, female sex, genetic defects, absence of ovaries due to operation, hypogonadism (male and female), hypertrophy.

> Modifiable Risks : Vitamin D deficiency, smoking, malnutrition (calcium, zinc, vitamin A, K etc.), underweight, non-vegetarian diet, excessive tea/coffee/chocolate intake at older age, heavy metals in food or air, soft Drinks and alcohol.

> Medical risks: long-term immobility and use of steroid-like drugs (very common among patients in Bangladesh; especially prescribed by uncertified doctors who take drugs for other hormonal disorders such as hyperthyroidism, hyperparathyroidism, Cussing syndrome, diabetes, acromegaly, Addison's diseaseRheumatoid arthritis, SLE, kidney failure etc.> Symptoms : Initially, there may be no physical symptoms. But pain in the waist or back or elsewhere, especially of a character unrelieved by painkillers. Some have short stature, stooping, or stooping forward.

> Identification: A variety of tests may be needed—some to measure concentrations, some to identify hazards. BMD test is best for this purpose.

> Treatment: The main and first step in this disease will be to identify the risk, if possible to eliminate it. Then any of the drugs available may be applicable to a particular patient. Consult an experienced homeopath if required. Since, once osteoporosis has occurred, it is unlikely to be reversed, national and institutional programs to prevent it early must be put in place. As part of this, it is important to determine who is at risk or who is already suffering from osteoporosis, and to select and implement appropriate treatments.

> Domestic Advice:-
When lifting something from below-
* Do not bend or bend the waist. * Bend the knees* When carrying anything * Don't lift anything on the neck.
* Keep heavy objects close to the body.
* Lean forward when carrying something heavy on your back.
> Bed time:-
* Do not sleep on your back. Do not sleep on broken mattresses, foam or spring mattresses.* Use an even mattress. * The bed should be firm, wide and even* A firm bed refers to a thin mattress on a flat surface.
> While standing:-
* Do not stand for more than 10 minutes.
* Don't lean forward without breaking your knees.
* Do not wear high heels if you want to walk or stand for a long time. * If you want to stand for a long time, shift your body weight from one leg to the other after a while* Use small foot rests for prolonged standing.
> While sitting:-
* Do not take your chair too far from the table. * Do not lean forward.
* Give support behind the waist.
* Sit so that the thighs are parallel to the ground.* Do not sit on a sofa or chair with a soft mattress or springs*Do not sit away from the steering wheel while driving while riding in a vehicle. * Sit up straight.
* Use lumbar corset during travel pain. * If the back pain is more, the rules of lying down and getting up from bed lie down and bend one knee. * Now bend the other knee. Keep both hands on the bed* Now slowly bend to one side.* Hang both legs from the bed, now sit up slowly by leaning on the elbow of the bent side and the palm of the other hand.* Sit on both hands and place the feet on the floor. Lean forward with both hands.
Rules for girls to follow: Wear low-heeled shoes or sandals, the heel height of different shoes should not be different.
* While cutting curry, grinding spices, washing clothes and cleaning the house, keep the spine in a normal position and the waist straight. * Do not hold the baby with the waist bent. * Keep the waist straight while sweeping, pressing the tubewell.
* Standing for hours in marketing or shopping
If you have to, sit for 10 to 15 minutes of standing or walking to rest.
* Knees should be bent while making the bed instead of bending the waist.

> Homeo Remedy:- The patient is treated not the disease, for this reason if the patient can be treated with the complete symptoms then it is possible to treat the osteoporosis (bone loss) patient by the grace of God, again recently some homeo doctors have come out, they treat the patients with patents, tonics, mixed diseases, Osteoporosis (bonedecay) is given to patients by what Dr. Samuel Hahnemann calls the Sankar type homeopath.Medicines that can be used to treat symptoms of osteoporosis include Aconite, Lidampal, Rastox, Rhododendron, Colophyllum, Lac caninum, Bryonia, Artica urens, Medorinum, Ferramphos, Arnica mont, Mag phos, Costicum and many other medicines. Consult an experienced physician before self-medication.

Finally, the role of everyone involved in medical management including the general public as well as the medical community is important in the area of osteoporosis awareness.

The writer is a, physician, columnist and researcher Founder and Chairman, ja Rogi Kallyan Society