Bone Marrow (Trephine Biopsy) Tips

Bones are similar to a porous framework which is filled with minerals that make it hard and strong. With age, there is gradual degradation and the mineralized portion is lost, thereby leading to thinning of the bone. The word osteoporosisliterally translates to porous bones, which is due to the gradual demineralisation. In addition to the natural ageing process, there are other diseases that can accelerate the demineralization process.

Women are more prone to demineralisation, and after the age of 40, they should take extra precaution to slow down the onset of the condition. The following are some ways to improve bone health and halt osteoporosis in the long run-

1. Diet: Ensure that your diet has sufficient amounts of vitamin D and calcium. Though calcium is the essential mineral for bone formation, vitamin D is required for the absorption of calcium, and therefore both these elements play a vital role in maintaining the quality of the bones in our body. Most people require about 1,000 mg of calcium and about 500 units of vitamin D for optimal bone health. This requirement goes up slightly in postmenopausal women.

2. Sun Exposure: In most people, exposure to the sun allows the body to make vitamin D, but careful sun protection prevents this from happening. Also, with age, the body’s ability to form intrinsic vitamin D also declines. The body, therefore, relies on supplements. Most dairy products are good sources of calcium. In addition, spinach, salmon, turnips, and broccoli are some calcium-rich foods. Supplements of calcium carbonate or calcium citrate can be taken if your diet is lacking in calcium. Vitamin D also should be included in the supplementation. The treatment for osteoporosis is incomplete without these two supplements.

3. Exercise With Weights: The constructive tension that exercise puts on the body helps in bone building, whatever the age may be, which prevents the onset of osteoporosis. Any exercise which improves muscle mass strengthens the bones, and puts stress on the bones is advisable. Since the fractured area due to osteoporosis mainly includes the spine, lower back exercises, yoga, tai chi, and abdominal exercises all work wonders. Pick any of these and do them for 30 minutes three times a week.

4. Quit Smoking: Continuing to smoke while taking osteoporosis medications is completely useless. Nicotine negates all the effects which defeat the purpose of taking the medication and is as good as taking no medication at all. So if you want the bone thinning to stop, stop smoking.

5. Alcohol Consumption: While a drink or two per week is permissible, more than this can harm the bones significantly.

6. Constant Health Watch: Talk to a doctor about how other routine medications (if any) can affect your bone health. Also, identify how frequently you should check your bone mineral density and stick to the schedule.

Bone health and osteoporosis can be managed with some conscious efforts.

Metabolic Bone Disease is a term used for various conditions of the bones that can be caused by a number of different disorders. Most of these disorders are developed due to nutritional deficiencies, defects in the bone metabolism procedure or due to hereditary defects in the skeletal structure. Conditions that fall under the category are osteoporosis, osteomalacia, rickets, Paget's disease, parathyroid conditions, chemotherapy induced bone loss and menopause induced bone loss.

Causes of Metabolic Bone Diseases:

1. Imbalance in the level of calcium : Too much calcium or too little calcium can cause bone diseases. While the overabundance of calcium (hypercalcemia) in the body will lead to calculi formation, which can be harmful for the body, the lack of calcium (hypocalcemia) causes weakness, bone pain and restricted growth. 
2. Deficiency of phosphorus: Low phosphorus in blood (hypophosphatemia) leads to softening of the bone tissue and bone loss. Osteomalacia is commonly caused by phosphorus deficiencies.
3. Deficiency of Vitamin D: Vitamin D is essential for the body to absorb calcium. Cells called osteoblasts need vitamin D in order to absorb calcium and secrete the bone tissue proteins. A deficiency of vitamin D can lead to a number of metabolic bone diseases like rickets and osteoporosis.
4. Over or under secretion of the parathyroid hormone:The parathyroid hormone (PTH) stimulates the secretion of an enzyme, which converts the inactive circulatory form of vitamin D into its active usable form. The hormone can also increase the circulation of free or ionized calcium (Ca2+), which is not attached to proteins. Both underproduction and overproduction of the hormone causes skeletal problems.

Symptoms of Metabolic Bone Diseases:

The symptoms of most of the Metabolic Bone Diseases are similar, such as 

1. A dull, throbbing pain in the bones is the most common symptom. The pain is frequent and lasts for a long amount of time, but unlike muscular pain, the exact region of bone pain cannot be specified.
2. Severe joint pains accompanied by stiffness and swelling of the joints. The patient experience pain during regular physical activities, especially during cold weather conditions.
3. Frequent fractures are caused by most bone diseases because the bone mineral density decreases drastically. Severe bone injury may be caused by mild trauma.
4. Defects in the bones can cause bowed out legs and a bent backbone.
5. A general feeling of exhaustion is often caused by bone diseases.
6. Kidney stones are an associated complication of metabolic bone diseases.

Heel bone spur is a form of calcium deposit that causes a bony protrusion under the heel bone. An X-ray can reveal up to a half inch elongation under the hill. Without image report, this condition is commonly known as heel spur syndrome. Heel spurs are mostly painless but reports of pain in not uncommon. They are often related to plantar fasciitis. The latter is an inflammation of the connective tissue that stretches through the foot bottom connecting the heel bone and the football.

What causes heel spurs?
Heel spurs are a result of prolonged calcium deposit. This condition can result from the heavy strain on the muscle of the foot and ligament, stretching of fascia and wear and tear of the heel bone membrane. These injuries are frequently observed among athletes who are involved with activities such as jumping and running. 

What are the risk factors?
1. Walking abnormalities that involve putting more than normal stress on the bone, nerve and ligament in and around the heel.
2. Running on surfaces that are hard in nature
3. Shoes lacking arch support
4. More than normal body weight 
5. Spending too much time on the feet
6. Too flat or too high arches
7. A person suffering from diabetes
8. In case the protective pad of the heel is fading away due to old age or other bone disorder

Non-Surgical treatment
Unlike common belief, only rest may not be the best way to treat heel bone spurs. On the contrary, a patient might feel sharp pain immediately after sleep. This happens when he tries to walk and the plantar fascia elongates all of a sudden. The pain decreases with more walking. Some treatment methods that work for 90 percent of the sufferers includes wearing the right shoe, stretching exercises, wearing orthotic devices inside the shoes and physical therapy. Over the counter medicine such as Aleve, Tylenol and Advil can be consumed to reduce the pain and for improving the overall condition. Corticosteroid injection also tends to give relief from the inflammation.

Surgical treatment
If heel spurs persist for more than 8-9 months, surgical options should be explored by the patient. There are two angles on which a doctor works, either removing the spur or release the plantar fascia. Pre-surgical exams are necessary to ensure that a person is eligible for surgery and all non-surgical avenues are explored. Post-surgical activities are equally important for the process of healing. Usage of bandages, crutches, splints and surgical shoes is a mandate to avoid complications such as infection, numbness, and scarring. Possible side effects should be discussed with the surgeon well before the surgery. The estimated healing time from this procedure is close to 8-12 weeks.

Heel bone spur is a form of calcium deposit that causes a bony protrusion under the heel bone. An X-ray can reveal up to a half inch elongation under the hill. Without image report, this condition is commonly known as heel spur syndrome. Heel spurs are mostly painless but reports of pain in not uncommon. They are often related to plantar fasciitis. The latter is an inflammation of the connective tissue that stretches through the foot bottom connecting the heel bone and the football.

What causes heel spurs?
Heel spurs are a result of prolonged calcium deposit. This condition can result from the heavy strain on the muscle of the foot and ligament, stretching of fascia and wear and tear of the heel bone membrane. These injuries are frequently observed among athletes who are involved with activities such as jumping and running. 

What are the risk factors?
1. Walking abnormalities that involve putting more than normal stress on the bone, nerve and ligament in and around the heel.
2. Running on surfaces that are hard in nature
3. Shoes lacking arch support
4. More than normal body weight 
5. Spending too much time on the feet
6. Too flat or too high arches
7. A person suffering from diabetes
8. In case the protective pad of the heel is fading away due to old age or other bone disorder

Non-Surgical treatment
Unlike common belief, only rest may not be the best way to treat heel bone spurs. On the contrary, a patient might feel sharp pain immediately after sleep. This happens when he tries to walk and the plantar fascia elongates all of a sudden. The pain decreases with more walking. Some treatment methods that work for 90 percent of the sufferers includes wearing the right shoe, stretching exercises, wearing orthotic devices inside the shoes and physical therapy. Over the counter medicine such as Aleve, Tylenol and Advil can be consumed to reduce the pain and for improving the overall condition. Corticosteroid injection also tends to give relief from the inflammation.

Surgical treatment
If heel spurs persist for more than 8-9 months, surgical options should be explored by the patient. There are two angles on which a doctor works, either removing the spur or release the plantar fascia. Pre-surgical exams are necessary to ensure that a person is eligible for surgery and all non-surgical avenues are explored. Post-surgical activities are equally important for the process of healing. Usage of bandages, crutches, splints, and surgical shoes is a mandate to avoid complications such as infection, numbness, and scarring. Possible side effects should be discussed with the surgeon well before the surgery. The estimated healing time from this procedure is close to 8-12 weeks.

In case you have a concern or query you can always consult the Orthopedic doctor in Kolkata & get answers to your questions!

Sometimes children suffer from conditions where their feet may not be in proper shape or size which can affect their posture. Most of the times the disorders correct themselves as they grow up but certainly, there can be situations where medical attention is required. These conditions can be normal variations in the anatomy as well which don't essentially require treatment. Some of the common orthopedic disorders found in children include:
1. Flatfeet-
While most babies are born with flat feet which develop arches as they grow, in some case the arches remain underdeveloped even after they grow older. Their feet may turn inwards while they walk due to their flat nature. There is no inherent problem in this condition unless it becomes painful. Doctors may recommend special footwear with arches inserted for support to reduce the pain.
2. Toe Walking-
Toe walking is not a disorder while your child is just learning to walk. Toddlers who continue to walk on their toes after the age of 3 may require medical attention. Toe walking on one leg or persistent toe walking can be due to other medical conditions like muscle weakness, cerebral palsy or autism. It is advisable to take your child to a therapist for casting the foot and ankle which can help stretch the muscles.
3. Pigeon Toes-
In-toeing or pigeon toeing is common among babies when they are first learning to walk. Sometimes children above 3 years walk with their toes inwards which can be due to femoral anteversion. This happens when the upper part of the leg bends more than it naturally should causing inward rotation of the feet. Specially designed shoes and braces can help to correct this condition. Usually, the condition corrects on its own with age and does not interfere with sports activities which involve running.
4. Knock-Knees-
It is a common tendency among children aged between 3 and 6 to develop knock-knees (genu valgum) since their bodies go through a natural shift in alignment. Usually, treatment is not required as the legs straighten out eventually. Knock knees on one side or persistent knock knees may require medical attention. Children with this disorder may suffer from pain hence in some cases surgery is recommended after the age of 10.

A bone fracture occurs when a strong external force is applied on the bones causing it to break. It is an extremely painful condition that results in days of immobility and rest.

There are several reasons which can result in bone fracture, some of them being:

1. Injuries caused in sports: Any sport requires and demands extreme physical exertion and participation. Being involved in any sport therefore automatically increases your risk of incurring injuries. Bone ractures therefore are mostly reported during sports.
2. Osteoporosis: Due to the deficiency of calcium, the bones of both men and women tend to get weak and more susceptible to fracture and breakage. It is one of the primary causes that lead to bone fracture.
3. Osteomalacia: This also refers to a condition wherein the bones become weak and brittle. Much like osteoporosis, osteomalacia too significantly contributes to instances of bone fractures.
4. Osteosarcoma: This is a rare form of bone cancer that most often develops either near the femur or near the shinbone. An instance of this form of bone cancer is most often found in children and weakens the bone, consequently leading to fractures.

Though there may be different causes of broken fractures, its symptoms remain similar. Some of them are:

1. Swelling: One of the most common symptoms of bone fracture is perceptible swelling. If any of your bone is fractured, that particular part will be visibly swollen.
2. Deformity: Bones give your body the shape it has, thereby, any fracture anywhere would inevitably manifest itself as a clear deformity of that particular part.
3. Extreme pain: It goes without saying that a bone fracture would entail excruciating and extreme pain. This pain sharply increases with mobility thereby necessitating complete rest.
4. Temporary loss of function: The part of the body where the bone is broken temporarily becomes dysfunctional. For instance, if the bone in your hand is broken, you will find it extremely difficult to move and do any work with it.

In case you have a concern or query you can always consult Orthopedic Doctor in Ludhiana & get answers to your questions!  

Low bone density or osteoporosis is a disease, which is not easily visible. Skeleton system is an important part of human body and deficiency of of calcium is the prime cause of osteoporosis.
During osteoporosis, there is lack of minerals like phosphorus and calcium. The skeleton system get weakened and the bones break under slight pressure also.
During osteoporosis, the bones do not get re-joined easily.
Bone loose their elasticity and weaken due to osteoporosis. This disease is seen more in women compared to man. With age, the ostrogen level in women decreases increasing the probability of osteoporosis in women.
Every third women with menopause has osteoporosis.
Unani medicines​ has been formulated with exotic herb, animals and natural minerals. It is designed to increase the bone density, decrease porosity and diminish the probability of bone fracture.

Common unani medicine for bone care.

01-kushta sadaf (cypraea moneta clax)
02-kushta godanti (gypsum clax)
03-kuchla (staychonos nux vomica)
04-silajeet (asphaltum)
05-aswagandha (withania somnifera) etc.

Side effects. No side effects.
Avoid tabacco and related products. Increase intake of vitamin d rich products like milk and dairy products.
Regular exercise maintains balance in old aged people. Expose yourself to balance sunlight.

Note: To control pain in joints patients should try unani hijamah (cupping therapy).

Breaking a bone can be counted among one of the most painful experiences that one can possibly suffer from. Inflicted usually by external injuries, fractured bones generally require surgeries for recuperation. In the occasion of minor fractures however, plasters often facilitate recovery. Although these are the primary treatments that are meted out, recovering from fractured bones entail much more. For some, the time to restore normalcy takes longer than others. In such cases, one tends to opt for palliatives to ease out the pain.

Homeopathic medicines not only offer respite to the pain but also provide a holistic cure for the emotional anxiety one goes through in such times. Many therefore seek out homeopathic remedies for treating bone fractures. Some of the most effective antidotes in this regard have been enlisted below.

1. Arnica: Arnica is extremely helpful at curbing swelling and as a consequence, reducing pain. Prolonged use of Arnica can potentially minimize the swelling to absolute normalcy.

This women’s day let’s resolve our bone health issues to stay stronger for longer and live happier.

A woman’s health is not only centered around menstrual problems or obstetric conditions; good bone health also plays a significant role in the current fast-paced lifestyle. Being fit is more crucial than ever!  A woman's body goes through many changes affecting her bone health, and she needs to be aware of these changes and their effect on the bone structure, for example, during pregnancy and menopause. However, there are other factors as well that can affect bone health and women should not ignore.

Pregnancy

There is a significant transfer of calcium from mother to the foetus and infants during pregnancy and lactation. As far as the symptoms are concerned, body ache and backache are common. Women should not ignore the pain causing a restriction in the movements and leg and finger cramps. Repetitive cramps indicate that the calcium levels are low and especially when you suffer from pain in the ribs or shin bone, you must visit the doctor. The bone mineral density falls and rises between 3% and 10% through this period. Homeopathic medicines like Calcarea Phos, Calcarea Carb and Calcarea Flour can help reduce these symptoms, and the exact dosage and combination depends on the individual case. Along with medicines, regular walking and consuming calcium-rich foods, for example, milk and milk-products, curry leaves and Amaranth grain (Rajgira) are advised.

A 30-year-old pregnant woman came to my clinic. I set up a diet plan and exercise regime along with other supplements. In the eight, month, she complained of leg cramps. She had discontinued the calcium supplements. I told her about the importance of vitamin D and calcium during pregnancy and prescribed medicines. Her pain was reduced in the follow up three weeks later.

Lactation

Lactating mothers lose more calcium than through the pregnancy, to the tune of 280-400 mg daily. Therefore, mothers must keep track of their diet and exercise regularly. Body ache makes it difficult for women to perform daily activities. Not lactating is not the solution; a mother must continue lactating to provide sufficient amounts of calcium to the baby. Mother’s body recovers within 6 months after she stops lactating. However, if issues persist, homeopathy has some effective medicines.

A 35-year-old mother to an 18-month-old baby complained severe body ache for almost a year along with bilateral wrist pain. She thought of discontinuing to breastfeed the baby. After examining her, I prescribed medicines and a diet plan and advised her to continue breastfeeding the child. After the fourth week follow up her complaints reduced drastically, and after three months she was symptom-free.

Menopause

The two age groups in menopause are peri-menopausal and menopausal. Women in the peri-menopausal age group generally complain of aggravated arm pain, especially during the night, and the slightest touch aggravates the pain. They may also suffer from spondylitis and osteoarthritis. Whereas the 65-years-and-above age group may present with fractures, primarily of the wrist bone, vertebral compression fracture, for example. Even after the surgical treatment of the fracture, the patient must be treated for osteoporosis to address the risk of developing further fractures. Homeopathic medicines like Lachesis, Zincum Met, ZIncum Phos are useful in cases of bone loss or osteoporosis due to lack of oestrogen. Symphytum is also a helpful remedy in case of fractures.

A 62-year-old lady complained of pain in her arms and dorsum of her foot on the slightest of touch. Her Bone density test (BMD) showed a T-score of -2.9 while her foot X-ray showed an old stress fracture. She started suffering from bone pain after her ovaries were removed but ignored it. I prescribed her homeopathic medicines for six weeks, and a follow up showed about 50% relief.

Osteoporosis

Osteoporosis is the condition of reduced bone mass and deterioration of bone tissue with an increased risk of fractures. Low calcium intakes, lack of knowledge regarding bone health, vitamin D deficiency, early menopause contribute to osteoporosis. Other factors include age and genetics. Our body keeps on losing bones and creates new bones. At the age of 30, bone mass is the highest; after which age the loss is more than regeneration. One should be more careful if the weak bone trend runs in the family.

Clinical features:

Here the symptoms do not show up until the disease has progressed. Mostly, the cases are of fragility fractures which can affect any bone; however, the most common sites are distal wrist (Colles fracture), vertebral fracture and femoral neck fracture.

A 42-year-old lady suffered from pain in her arms and shin bone for almost a year. These complaints started after the second child's birth. She started consuming vitamin D and calcium supplements, but her diet lacked the necessary calcium. Her BMD indicated osteoporosis; I prescribed medicines, a diet and a regular exercise regime. Within a year, the test results were better, and the patient was relieved of symptoms.

Osteopenia

Osteopenia is a precursor to osteoporosis and is a less worrisome condition, though it has similar risk factors as those of osteoporosis. Medical intervention may not be necessary, but one should take care. Women suffering from osteopenia must check the probability of turning into osteoporosis.

A 37-year-old lady suffered from body aches and bone pain. Her BMD tests showed osteopenia. Her history of smoking since college days was also one of the causes. After a long-term, regular treatment her BMD reports are better.

One must follow a calcium-rich diet and exercise regularly. Women in the peri-menopausal stage must go for tests to check future osteoporosis and take precautions. Lack of vitamin D can lead to problems like osteomalacia and rickets. Non-smoking and losing excess weight will help maintain good bone health and resolve issues if any. 

Although a vegetable, garlic is primarily classified as a spice and is used in many dishes across cultures. However, apart from the pungent smell which is the most known characteristic of garlic, it also has medicinal properties and thus, was even used by healers for various ailments before the advent of modern medicine.

Some of the reasons garlic is considered healthy: 
Garlic is considered healthy for a multitude of reasons. Let's look at some of the ailments that garlic can prevent as well as help in healing.

1. Great Against Common Cold: Garlic and garlic based homemade treatments are great ways to ward off the common cold. Garlic contains the chemical "allicin" which is known to aid health within the body. Having a few cloves or garlic can help you fight the common cold infection.
2. It is Known to Improve Bone Health: Garlic is known to be very beneficial for bone health, especially in menopausal women. Women may encounter bone loss during menopause as the production of estrogen is lowered. Garlic encourages estrogen production which can stop bone loss and even protect against bone problems such as osteoarthritis.
3. Is an effective agent in Lowering Blood Pressure: Hypertension is a known killer all across the world. Garlic contains polysulfides which are effective in vasodilation or the widening of the blood vessels and also relaxation of the muscles. This helps blood pressure being lowered within the body and is an effective home remedy if consumed in controlled amounts.
4. Reduces Fatigue and is a Performance Enhancer: Garlic is known to reduce fatigue within people as it controls the heart rate by lowering blood pressure. Whether it is an athletic performance or other physical work related performance requirements, this spice tends to give an extra boost.
5. Controls LDL Cholesterol, thereby reducing chances of Heart Disease: LDL cholesterol, also known as bad cholesterol, is controlled by allicin as it improves liver functions. The liver can then break down LDL cholesterol easily and thus also helps in preventing arteriosclerosis. Garlic is also known to prevent blood clots that lead to heart attacks.
6. Garlic has anti-parasitic and anti-bacterial properties: Garlic has been known throughout the ages to be an effective anti-bacterial and anti-parasitic agent. Garlic extracts or small amounts of garlic in your diet can help you build up immunity and also kill infections within your system effectively. It is also known to be very effective against tapeworm infestations within the gut. If you wish to discuss about any specific problem, you can consult an Ayurveda.