Osteopathy

Originating in the 19th century in the USA, osteopathy is a natural therapy in which a practitioner manipulates the musculo-skeletal system in order to treat imbalance in the body and disease.

A common misconception about osteopathy is that it treats diseases that are bone-relegated. Despite its name (osteo meaning “bones”), osteopathy is a system of whole-person well-being.

According to the principles of osteopathy, any misalignment of your spine and skeleton can impair the circulation of blood and lymph around your body and cause your organs to function less efficiently. If a practitioner can correct these misalignments, blood can flow smoothly to your organs, your nervous system can send messages effectively, your lymphatic system can keep your immune system functioning properly (allowing toxins to be eliminated safely and efficiently), digestion and respiration can improve, pain and discomfort can abate, and a state of balance (homeostasis) can return throughout your entire body. Tense muscles are thought to be particularly damaging to the health of your body because when muscles contract they impede the flow of blood and lymph.

Visiting an osteopath

When you visit an osteopath, he or she will be trained to “feel” problems or disruptions in your muscles, bones, and ligaments. As with many other natural therapies, you’ll be asked for your medical history and will need to talk about your lifestyle habits. This is so the osteopath can gain a full sense of your well-being. He or she may ask you to move in certain ways in order to gain a sense of where problems in your musculo-skeletal system might lie. The osteopath then uses a range of techniques, including manipulation, massage, and stretching, to improve the flexibility and range of movement in your joints. He or she will apply greater pressure to joints that are misaligned. This will set blood and lymph flowing freely, and so restore harmony throughout your nervous and musculo-skeletal systems, as well as through all your body’s organs.

As well as stress-related disorders, asthma, ear infections, and swelling, pain and inflammation in the joints, osteopaths successfully treat “female” conditions, such as hormonal imbalances, period pain, menstrual irregularities, some types of infertility, and a number of pregnancy and birth-related health conditions. Osteopathy is suitable for all ages and stages of life, and it’s not usually necessary to consult your doctor before embarking on a course of osteopathic treatment.

There’s also a subtle form of osteopathic treatment called cranial osteopathy. This is suitable for all ages but has been found to be particularly helpful for babies, children, and pregnant women. Cranial osteopathy aims to release tensions and stresses in the body by picking up very slight muscular disruptions and movement s- these are known as the Cranial Rhythm. By using gentle techniques to restore the normal Cranial Rhythm, the practitioner can help your body get back into balance and good health.

Healthy Approaches to Managing Osteoporosis

Although many factors can influence bone health, we focuses on the impact of diet and physical activity. These two lifestyle factors are under your control and can have a major impact on the strength of your bones.

Focusing on Nutrition

The quality of your diet can influence the health of your bones. A healthy, well-balanced diet should provide the necessary building blocks for healthy bones. Even with the best efforts, however, your diet may fall short of meeting recommended levels. In this case, dietary supplements may help you meet the recommended dietary intake. In particular, calcium and vitamin D are two nutrients of importance for healthy bones.

Calcium

Calcium is a critical nutrient for bone health, and the body ardently defends its blood levels of calcium. If you do not replace daily losses through your diet, then your body keeps blood levels steady by taking calcium from your bones. In addition to inadequate dietary consumption of calcium, humans are not very good at moving calcium from the food eaten into the bloodstream. This poor absorption can also cause your skeleton to forfeit some of its stores to keep blood levels normal.

Why is calcium so important in your body? Calcium is the most essential building block for bones and combines with other minerals to form the hard crystals that give your bones their strength. Because humans cannot form calcium in the body, calcium must come from your diet. People who have greater milk and dairy consumption have fewer fractures. Because of the poor absorption of calcium, you will have to ingest a lot of calcium just to offset the small bodily calcium loss each day. With age, the ability to absorb calcium tends to decrease, so over time dietary calcium requirements increase.

One way to help ensure that the supplement you are taking is safe and effective is to look for products that have a USP symbol on the label, which stands for United States Pharmacopeia. USP is a nongovernmental, official public standards – setting authority. Unfortunately, testing of supplements is voluntary so not all suitable products will have this notation.

Vitamin D

Vitamin D is another nutrient important to bone health because it helps the body absorb and store calcium. Low vitamin D levels related to low bone density and increased risk of fractures. The recommended daily intake of vitamin D is between 400 and 800 international units (IU) for adults, which can be obtained from food and sunlight. Vitamin D-rich foods include eggs, fatty fish, and cereal and milk fortified with vitamin D. Based on recent research studies liking vitamin D supplementation to reduced risk of fractures and some chronic diseases, the Institute of Medicine is considering increasing the recommended intakes. Studies suggest that intakes in the range of 800 to 1,000 IU per day of vitamin D are associated with better health outcomes and are well below the 2,000 IU daily limit to avoid any harmful effects of excess vitamin D.

Vitamin D is sometimes referred to as the sunshine vitamin because when UV rays from the sun make contact with the skin, vitamin D is formed. Minimal sun exposure (to feet, hands, and face) of about 15 to 20 minutes per day is usually enough to get most of the needed daily vitamin D, although this ability does decline with age. Sunscreen can reduce vitamin D synthesis by the skin, and deficiencies may also occur in those who are housebond, reside in extreme northern latitudes, do not consume vitamin D – fortified foods, or have kidney or liver disorders that interfere with normal vitamin D metabolism.



Focusing on Physical Activity

Exercise can improve bone health by increasing bone mass or by slowing or preventing age-related bone loss. Researchers and scientists continue to examine what type and how much exercise is necessary to maintain or boost bone health. Though leisurely levels of physical activity are good starting points for beginning and exercise program, more moderate to vigorous levels of activity are necessary to challenge the bones to become healthier. Exercise is also important for fall prevention, and certain types of exercise have been shown to lower fall risk. To realize the potential benefits of exercise, some precautions should be considered.

Researchers continue to work to answer questions about the best type and amount of exercise to both increase bone mass and slow bone loss with aging in order to reduce the risk of fracture. Currently, available information along with standard safety precautions will allow you to set proper exercise limits.

Traditional types of exercise have been studied for their bone benefits including weight-bearing aerobic exercise (e.g., walking, jogging, bench or stair stepping, aerobic dance), resistance (strengthening) exercises, and impact exercise (e.g., jumping). The good news is that most types of exercise can benefit your bones. However, some types are better than others, and the level of effort is also a factor.

The best program may be one that incorporates multiple types of activity and applies the principles of training with bone health in mind. With respect to bone, exercise is site specific. In other words, a particular bone must be directly stressed to receive benefits. A multimodal program can provide multiple benefits for musculoskeletal, cardiorespiratory, and metabolic health plus reduce the risk of injury.

Osteoporosis and Bone Health

Imagine the internal structure of bone as being like the wood foundation of a house. The process of osteoporosis is similar to what happens during a termite infestation of a home’s foundation, whereby termites slowly eat away at the wood supporting the structure. At some point, so much wood is consumed that the strength of the foundation is compromised and it begins to fail. This is not unlike the progressive nature of osteoporosis; over time, the internal architecture of bone is eroded as a result of a number of factors that eventually increase your risk for fracture (bone collapse). The term osteopenia, or low bone mass, refers to a condition of reduced bone density that has not yet progressed to osteoporosis. Those diagnosed with this condition should still be monitored to ensure that the condition does not get worse.

Osteoporosis is the most common disease affecting the skeleton and is one of the most important public health issues facing Americans. Consider the number of people affected by bone fracture: over 50% of women and 20% of men over the age of 50 will suffer an osteoporotic fracture at some time in their lives. Sadly, one in six women will experience a hip fracture, the most devastating type of osteoporotic fracture. Although an osteoporotic fracture can be devastating, the good news is that because this disease progresses slowly, you can take a number of steps throughout your lifespan to reduce your risk of developing it.

Causes of Osteoporosis

During growth and young adulthood, the skeleton is busy changing in size, shape, and density to ultimately support the physical needs of an adult. In adulthood, the skeleton remains relatively stable but is still constantly undergoing a process called bone remodeling, in which bone repairs and renews itself. During bone remodeling, old bone cells replaced with new bone cells in roughly the same amount. Many processes, however, can “uncouple” bone balance. With normal aging, bone breakdown outpaces buildup causing up to 1% of bone to be lost per year after around age 30. Certain conditions, such as estrogen loss from menopause or an overactive thyroid gland, may increase bone breakdown and slow down bone buildup, causing further overall loss of bone. On the other hand, pharmaceutical agents that stop the breakdown of bone, and physical activity, which causes bone to be built, can each cause a net bone gain.

Because bone is a dynamic tissue throughout life, however, strategies to slow down the breakdown of bone and to build new, stronger bone are useful at any life stage. Keep in mind, though, that many factors influence the state of your bones at any given time. The development of osteoporosis is complex, and no single factor can take the sole blame for the disease. Some of the factors you can control, and others you cannot.

Risk Factors for Osteoporosis

Your risk of osteoporosis is influenced by many factors, some of which you can control or modify, and others that are outside of your control.

Risk Factors You Cannot Control

• Being female
• Having a thin or small frame
• Being of advanced age
• Having a family history of osteoporosis
• Being postmenopausal, including early or surgically induced menopause
• Being male, with low testosterone levels
• Being Caucasian or Asian (although African Americans and Hispanic Americans are at significant risk as well)

Risk Factors You Can Control

• Having a diet low in calcium and vitamin D
• Being inactive
• Smoking, including exposure to secondhand smoke
• Excessive use of alcohol (more than three drinks per day)

Risk Factors You May Be Able to Control

• Abnormal absence of menstrual periods (amenorrhea)
• Anorexia nervosa (eating disorder characterized by low body weight)
• Prolonged use of certain medications, such as corticosteroids and anticonvulsants

Rib Repair – Doctor Interview

First of all, how do doctors generally treat rib fractures?

Dr. Mayberry: Most physicians and the public, in general, believe rib fractures heal on their own within six to eight weeks. But, when I look back to see if that has actually been documented, there was very little, if anything, in medical literature to support that.

What do most doctors tell their patients about rib fractures?

Dr. Mayberry: That there is nothing they can do for them. “Just wait and see what happens.” They hand out a lot of pain medication. Of course, everybody knows rib fractures are very painful. The problem is, for some patients, the pain never stops. Those are the patients we hope to help with surgical repair.

So how do you make that decision? I assume you make the repair if the rib is puncturing a lung or internal organ?

Dr. Mayberry: That is right. We do an X-ray or CT scan to see the number of rib fractures and how bad they are. For example, one patient had very severe fractures. There was a deformity on his chest wall. His rib fractures were very displaced. Not only that, but every time he moved or took a deep breath, he could feel those rib fractures moving. It just makes common sense that they needed to be fixed.

So, what are the guidelines to develop in the study? Exactly when do you operate?

Dr. Mayberry: Guidelines now are very simple. For example, with a patient like [that], a number of days passed and the patient was not getting better. If the ribs are still moving, that means they are not healing rapidly. We could intervene and help them.

How do you come up with criteria for treatment?

Dr. Mayberry: We look at the number of ribs, how badly they are fractured, the level of displacement, and the patient’s other interests. These things will probably go into the equation and we will be able to predict which patients are not going to get better. See, I want to know which patients are not going to get better.

What are some of the things you are looking at?

Dr. Mayberry: We want to know how many ribs are fractured, how badly displaced they are. We look at the location of the fracture and whether there are other injuries. For example, if the patient has a fractured leg or if they have a head injury. We want to know if there are other medical problems. Do they have diabetes? What is their age? Even gender makes a difference. We could put all of those factors into the equation to help us predict which patients will not get better rapidly.

Is the U-plate the best option for all patients who need rib repair?

Dr. Mayberry: No, the U-plate is new. It is approved by the FDA. It can be placed through smaller incisions, and therefore, we want to see if it’s efficacious. We want to do it in a number of patients and then follow those patients for six months and document exactly what happens to them over the six months.

I understand the plate you were using before was not made specifically for ribs?

Dr. Mayberry: Correct, it was made to fix the jaw.

What was the difference between the U-plate and what you were doing before?

Dr. Mayberry: It’s a shorter plate. The standard they have been using is a plate that is about nine centimeters long. The U-plate is only 4.5 centimeters long, so it’s literally half the length. The previous plate that we have been using went just along the anterior surface of the rib. It was secured with six screws that went through the anterior surface of the rib. If they were any shorter than that, we found the plate would come off over time because the rib is flimsy and it moves a lot. Every time you breathe, it moves.

The U-plate is shaped like a U, so it cuts the rib. The screws go through the plate, through the rib and back through the plate again, so the plate is cupping the rib and holding it in place. We did some biomechanical studies in the orthopedics lab, and even though it was half the length, it actually was more durable in a test on cadaver ribs. It was more durable. It did not loosen over time like the previous technique.

What is the U-plate made of?

Dr. Mayberry: Titanium. Most orthopedic plates are made of titanium. The U-plate does not need to be removed because titanium is compatible with the body.

Now, are you are the only surgeon using this plate?

Dr. Mayberry: Yes. Currently.

How many other surgeons use this other hardware to repair a rib?

Dr. Mayberry: I am not 100 percent sure, but there are only about four or five surgeons in the entire country that fix rib fractures on a regular basis.

Will insurance not pay for a rib repair?

Dr. Mayberry: No, they will pay for it. It’s just a lack of knowledge, lack of expertise, and lack of awareness that repair is an option.

So what you are saying is that they are probably healed, they have probably gone back together but they are still having pain?

Dr. Mayberry: It’s called chronic pain. Chronic pain is not helped by surgery. It often gets worse with surgery.

Is there ever so much damage that you have to remove part of the lung?

Dr. Mayberry: In rare cases, yes, the lung is so damaged we have to remove it.

About how many patients are treated?

Dr. Mayberry: Nearly 300,000 people go to the ER with rib fractures each year in the United States.

What percentage could benefit from this the U-plate?

Dr. Mayberry: About 5 percent could potentially benefit from the U-plate.

How long does it take for patients to know they can benefit from the U-plate?

Dr. Mayberry: After two weeks, if the ribs are still moving and the patient is having pain associated with that movement, then it should be fixed.

How many U-plate procedures have you done?

Dr. Mayberry: Two patients have received the U-plate.

How many patients are enrolled in the study?

Dr. Mayberry: We would like to enroll 10 in the next year at least.

What have you used in the past to repair ribs?

Dr. Mayberry: I have used every possible combination of things over the past 10 years to fix rib fractures. Each one of them has its own problems. That is why I’m excited about the U-plate. It has potential to be a plate that really works. It’s small. I can put it in small incisions, and I’m not anticipating problems.

Is it FDA-approved?

Dr. Mayberry: Yes, it’s approved by the FDA for marketing and commercial use.

This article was reported by Ivanhoe, which offers Medical Alerts every day.

Conventional Treatments for Osteoporosis

In the past, the usual recommendation for preventing and treating osteoporosis has been hormone replacement therapy (HRT). In the USA, pre-menopausal women can still use HRT (or HT, hormone therapy) to prevent osteoporosis. However, the country’s Food and Drug Administration (FDA) recommend that, because of the side effects of HRT, women should, where possible, use other medications to prevent osteoporosis. It also states that doctors should not prescribe estrogen as a preventative, unless the patient can’t take osteoporotic drugs. In the UK, the Committee on the Safety of Medicines has stated that women who are undergoing a normal, natural menopause should use HRT for a maximum of only five years, and only for the relief of symptoms such as hot flashes and night sweats. They don’t advocate it to prevent osteoporosis, unless you can’t tolerate osteoporotic medication.

Although HRT is effective in most cases against osteoporosis, as soon as you stop taking the medication, your bones break down as before. This means that you would have to be on HRT for the rest of your life to permanently prevent bone loss. Prolonged use of HRT poses considerable health risks, and so now there are several other medications for osteoporosis.

Selective estrogen receptor modulators (SERMS) These drugs aim to stimulate the estrogen receptors in your bones and brain – but not your breasts and uterus because doing so may increase your risk of cancer in these areas. In other words, the drugs make certain parts of your body more sensitive to estrogen; and other parts less sensitive.

Bone-saving medications You may be offered one of two drugs that help preserve your bones. Biphosphonates work by stopping bone breakdown: you won’t lose “old” bone, so your bone density will increase. However, there are concerns about the usefulness of keeping old bone. Strontium ranelate is a newer drug that has a dual action, stopping the breakdown of old bone and helping to build new bone, too. Both drugs carry side-effects: The bisphosphonates cause digestive problems and strontium ranelate can cause nausea, skin irritation, and blood clots.

Your diet

A healthy, balanced diet helps ensure strong, healthy bones. Reduce those foods and drinks that are known to increase your risk of osteoporosis but also watch the amount of dairy products you eat. Although cheese is a good source of calcium, it also encourages the excretion of calcium (cheese is more acidic than milk). And remember that tea contains caffeine – and tannin, which can hamper calcium absorption. Increase your intake boron-rich foods, too, by eating soy beans, apples, pears, raisins, broccoli, hazelnuts, and almonds.

Avoid bran Avoid adding bran to your food or having it as a breakfast cereal. Bran is a refined food, which means that the best part of the grain has been stripped away. It also contains phytates, which have a binding effect on crucial minerals, including calcium, and can stop your body absorbing them.

Sweeten naturally Try using a natural sweetener called xylitol in place of sugar. Found in fruits and berries, especially raspberries and strawberries, plums, and cauliflower, xylitol has a low glycemic index and does not cause blood sugar swings. It may also directly benefit osteoporosis. Incredibly, studies on animals show that xylitol can increase bone calcium and bone density and prevent bone loss. Xylitol should be available in health-food stores and you use it in exactly the same way that you would sugar.

See the light Try to boost your intake of vitamin D, which is essential for your body’s absorption of calcium. Eat plenty of oily fish and eggs, which contain this vital nutrient, and spend time outdoors. Sunlight encourages your body to manufacture vitamin D.

Vitamins and Supplements

B-complex and Folic Acid Vitamins B6 and B12 help reduce levels of homocysteine, a hormone that may increase the risk of osteoporosis.
Vitamin C with bioflavonoid This vitamin is essential for the formation of healthy collagen, the cement that holds your obne structure together. Take it in the form of ascorbate (such as magnesium ascorbate) rather than ascorbic acid, which is too acidic for bone health.
Boron (daily intake in multi-vitamins and minerals) This mineral is concentrated in bone and improves calcium absorption. It’s also found in a number of different foods.
Calcium and Magnesium (combine supplement containing calcium citrate and magnesium citrate) The most difficult form of calcium for your body to absorb is calcium carbonate, so it is advised that to supplement with calcium in the form of citrate, which is 30 percent more absorbable. For the best effects combine it with magnesium, which is just as important for your bone health: Magnesium deficiencies can make your bones more fragile.
Zinc This vital nutrient is often found to be deficient in women with osteoporosis, and we know that it’s important for healthy bone metabolism. Take a supplement to make sure you keep your levels up.

Herbs

Use herbs that provide you with valuable bone strengthening minerals or those that help improve your absorption of these nutrients. Blend equal parts of the dried herbs to make an herbal tea infusion and drink it up to three times a day.

Alfalfa Herb (Medicago sativa) and OAT STRAW (Avena sativa) Both these herbs are thought to help with osteoporosis because of their high calcium content.
Horsetail (Equisetum arvense) This help contains the highest amount of silica of any herb. Silica is important for healthy skin, ligaments, and bones. It helps with the formation of collagen, which is part of your bone structure, and it’s thought that it can help keep bones flexible.
Nettles (Urica spp) Nettle contains good amounts of the minerals calcium and boron, but it can also help improve the general absorption of nutrients form your food.

Other Natural Treatments

Homeopathy Constitutional homeopathic treatments are best, but if you can’t visit a homeopath, Calccarb and Calc phos can help your body to absorb calcium. Take both in a 30c potency, twice daily.

Self-Help

Increase the demand on your bones Do some weight-bearing exercise; for example, walking, jogging, dancing, aerobics, and racket sports. Aim for 30 minuts to an hour of activity, five times a week.

Watch your stress levels When stress levels are high, your adrenal glands have to work overtime, exhausting them so they can’t produce the replacement estrogen your body needs at menopause. Also, when you’re stressed, your digestion suffers, which will affect your nutrient intake.

Balance your weight Make sure you’re not underweight, which can reduce estrogen levels in your body, contributing to bone loss.

Bone-Strengthening Yoga Pose

The Camel pose works on strengthening the bones in your spine and pelvis. It’s a deep stretch that may take time to perfect –only go as far as is comfortable. Practice daily.


1. Kneel, legs hip-width apart, toes pointing behind you. Keep your back straight, your tailbone lifted, and your head erect. Imagine a cord is pulling you up from the top of your head, gently lengthening your spine. Place your hands at the tops of your buttocks, fingers pointing downward. Keep your thighs at right angles to the floor. Move your shoulder blades towards each other, feeling a stretch across your chest.
2. Breathe in through your nose. As you breathe out through your mouth, bend backward. Keep your thighs upright, arch your lower back, and slide your hands down your legs until they reach your ankles, heels, or soles of your feet. (Turn your toes under if it helps). Drop your head backward; keep your throat soft. Lift your pelvis to relieve pressure from your lower spine. Hold the pose for 30 seconds; release and repeat.

Diagnosing Osteoporosis

As always, the more information you have, the easier it is to make informed choices about what you need to do to keep yourself healthy and well. Checking for the risk of osteoporosis is no different. If your bone density is good, you need only work on prevention; but if you already have a problem with your bone density, you have to look at taking action to strengthen your bones now. Osteoporosis is a silent condition, so you can’t tell you have it by symptoms, unless it has gone so far that you suffer a fracture. However, it is now relatively easy to assess whether or not a woman is at risk of the condition, by using a number of tests. These tests include:

Dural Energy X-Ray, Absorptiometry (DEXA)

This X-ray machine is able to pick up changes in bone density far sooner than ordinary X-ray equipment, and it is the most reliable and widely used machine for diagnosing osteoporosis. It makes an image of your bones using two X-ray beams set at different frequencies. The machine can calculate the bone-mineral density by the rate your bones absorb each beam. The World Health Organization defines osteoporosis by what is called a “T score”, which is a measurement compared to a young adult. So a T score of more than minute 1 (-1) is considered normal; between minus 1 and minus 2.5 is classed as osteopenia (low bone density); and a score lower than minus 3.5 is categorized a osteoporosis.

Ultrasound Bone Scanner

An ultrasound is passed through the bone in the heel of your foot to give a reading of bone density. Research shows that ultrasound is as good as DEXA scans at predicting who will go on to have a fracture. It’s the technique most doctors use in the clinics. You’ll be given a “T score” according to the same system as the DEXA machine.

Bone Turnover Analysis

This test does not measure the density for your bone or its quality, but its turnover – how quickly your bone is breaking down. It’s a useful test for monitoring how well you’re doing with exercise, diet, supplements, or even drug treatment for osteoporosis. You’ll be asked to provide a urine sample, which is sent to a lab. Here, technicians use the sample to assess the speed with which you lose bone. You can usually have the test repeated every three months to make sure your bone turnover is not too rapid.