Osteoporosis is the condition of atrophy of bone characterized by reduction of amount of bone mass in relation to normal volume of bone.

The density of bone decline from the age of 20 years.

The process is accelerated during the middle age through there are three variation

1. The cortices of long bones are thinner
2. The cancelleus bones are less than normal.
3. The bone density falls below the mean T score of 2.5

Aetiology

Local osteoporosis

Local inflammation

Immobilisation of parts by splinting

Restriction of parts by splinting

Generalized  osteoporosis

Wide spread in skeleton

Idiopathic, primary and senile osteoporosis

       Normal feature of aging of skeleton

Common in female

Late in life (appear)

Appear shortly after menopause (post menopausal osteoporosis)

InRarely< 65 years of age 

In male < 85% years

Due to androgen and oestrogen deficiency

Juvenile osteoporosis

Rare

Spontaneous remission takes place after puberty.

Endocrinal

Cushing syndrom

Hyperthyroidism

Hyperparathyroidism

Acromegaly

Loss of calcium in urine

Hypogonadism

Calcium deficiency

Chronic GI disease

IBD

Scurvy

Protein malnutrition

Chronic liver disease

Miscellaneous cause

RA

Vit c deficiency

Ankylosing spondolytis

Diabetes

Excess of vit D and A

Clinical Features

 Pain

Pain is felt in various part of body

Particularly over skeleton 

Hip joint

Worse in jerking + flexing the spine

Multiple fracture

Limb fracture after fall

Vertebral fractures after lifting heavy weight.

Pain aggravated by body movement.

Kyphosis

Thoracic cage is shrunken

Investigation

Bone biopsy

X ray - loss of density and thinning of cortex

Bone densitometry

Serum ca, phosphate, PTH- normal

Differential diagnosis

Osteomalacia

Treatment

Early mobilization of patient

• Stilboestrol 1-3 mg daily
• Selective osteogen receptor modulators (SERM) (SERM) used in post menopausal women inplace of oestrogen
• Methyl testosterone 25-50 mg 
• Calcitonin injection 100 iu per day
• Anabolic steroid
• Calcitonin nasal spray 2200 IU/cc
• High protein Diet
• Calcium 1-1.5gm/day
• Vitamin D 400-800IU/cc
• Regular exercise

Homoeopathic Remedies For osteoporosis

1. Silicea
2. Calc carb
3. Calc phos 
4. Ruta
5. Symphytum

Silicea

Silicea is useful remedy for disease of bone. 

Imperfect assimilation and consequent defective nutrition.

Ill effects of vaccination.

Pain through hip, legs and feet.

Cramps. 

Loss of power in legs.

Paralytic affection.

The parts lain on go to sleep.

Pain in knee, as if tightly bound.

Worse - new moon, in morning, lying down, damp, lying on left side, cold.

Better - warmth, wrapping up the head, summer, wet or humid weather.

Calc carb

Pain in legs after exposure to water.

Sharp stitching pain as if parts were wrenched or sprained.

Cold, damp, feet, feels as if damp stockings were worn.

Cold knees, cramps in calves.

Burning in soles.

Sweat of hands.

Arthritis nodosities.

Feet feels cold and dead at night.

Tearing in muscle.

A jaded state, mental and physical, due to overwork.

Calc carb patient is fatty, flabby, fair perspiring, cold, damp or sore.

Calc phos

Calc phos is best suited to bone disease

It has a special affinity where bones form sutures or symphysis and all its symptoms are worse from any change of weather.

Numbness and crawling are characteristic sensations.

Stiffness and pain with a cold, numb feeling, worse change of weather.

Buttocks, back and limbs asleep.

Pains in joints and bones.

Weary when going upstairs.

Worse exposure to damp, cold weather, melting snow. 

Better in summer, warm dry atmosphere.

Ruta

All parts of body are painful, as if bruised.

Sprains.

Lameness after sprains.

Feeling of intense lassitude, weakness and despair.

Spine and limbs feels bruised.

Lumbosacral region and loins painful.

Legs give out on rising from a chair, hips and thighs, weak.

Pain and stiffness in wrist and hand.

Sciatica worse lying down at night, pain from the back extending down to hip and thighs.

Tendons sore.

Thighs pain on stretching the limbs.

Pain in bones of feet and ankles.

Symphytum

Acts on joints generally.

Pricking pain and soreness in periosteum.

Severe pain in joints.

The selection of homoeopathic remedies based on symptom similarities and doses according to the Susceptibility of patient.

Don't take homoeopathic medicine without any prescription / without any advise of physician