What Is A Torn Meniscus?

By  aenriquez  published  October 9, 2019

The meniscus is a C-shaped cartilage around the knee that separates the shinbone from the thighbone. Cartilage is a smooth tissue that helps keeps bone from rubbing against another bone. Bones rubbing neighboring bones leads to arthritis and other painful joint conditions.

 

A torn meniscus is a very common sports injury, as it is caused when someone twists on their knee with so much stress the cartilage is torn. It is commonly recognized by the popping sound it produces and the immediate pain that is the result.

 

Symptoms

 

A torn meniscus is quite painful and restricts movement of the knee anywhere from a bit to a major amount. Often it is difficult or impossible to straighten the knee with a torn meniscus. Other symptoms, while they may be self-explanatory, include:

 

  • Swelling and redness
  • Stabbing pain in the knee, especially during movement
  • Difficulty straightening the knee
  • Having difficulty moving the kneed to the extent it feels locked in place

Treatment of a torn meniscus usually starts with the basic approach of rest, ice and medication

Immediate treatment

 

Immediate treatment includes taking the weight off the afflicted knee, wrapping it to prevent movement and using crutches or a wheelchair if these are available. Seek medical treatment as soon as possible.

 

Diagnosis

 

The diagnosis cannot be confirmed with an X-ray, because cartilage is not dense enough tissue to show up on X-rays. However, X-rays can rule out bone trauma and, therefore, could help narrow down the diagnosis.

 

Magnetic resonance imaging (MRI) can present an image of both hard (bone) tissue and soft (cartilage), which allows it to return images of your meniscus.

 

The third technique for diagnosing a torn meniscus is the use of an arthroscope, which is a small camera with a light that is inserted into your knee. While exploring the knee, doctors could also move ahead with surgical procedures to repair the meniscus or remove damaged tissue.

 

Treatment

 

Treatment of a torn meniscus usually starts with the basic approach of rest, ice and medication. It often means taking a break from physical activities for a while.

 

Rest

 

Rest could entail the use of bandaging or braces to stabilize the knee while it heals. It may be wise to use crutches or a wheelchair to give the knee complete rest.

 

Ice

 

Ice is used to reduce swelling and help with the pain. Ice is best used for 15-30 minutes with the knee in an elevated position.

 

Medication

 

Over-the-counter, non-steroidal anti-inflammatory medication is often used. If the pain is severe, you can discuss with your physician use of more powerful medication.

 

Therapy

 

Physical therapists can work wonders with cartilage damage. This is useful when you heal enough to begin activities again in a manner that does not re-injure the meniscus.

 

Surgery

 

There are two strategies for surgery. Physicians first try to repair the meniscus. If this is not possible, surgeons will remove damaged tissue to allow the functioning cartilage to do its job unimpeded by irreparable tissue.

 

Seeking Help

 

A torn meniscus may require medical intervention to stabilize and repair the damage. In Tempe, call FXRX at 480-449-3979 to make an appointment with a specialist who has extensive experience with this injury.

 

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Can Regenerative Medicine Help my Hip Pain?

By  david@ogrelogic.com  published  September 25, 2019

Are you considering surgery for your persistent hip pain? Have non-surgical treatments failed to provide enough relief? If the answer to any or both of those questions is yes, you should consider Regenerative Medicine.

Regenerative medicine treatments focus on enhancing the body’s natural ability to heal and provides a unique solution for all types of joint pain.

Our body has its own growth factors and stem cells to repair and regenerate damaged tissues. These can be extracted from your own body in the form of PRP or platelet rich plasma or bone marrow concentrate.

PRP or Platelet-rich plasma refers to blood that has been processed to obtain a concentrate of platelets along with the liquid component, plasma. Platelets contain growth factors required for healing.

Bone marrow concentrate is derived from the marrow and is rich in growth factors as well as stem cells.

Regenerative treatments for hip pain

The hip is a ball-and-socket type of joint where the ball-type head of the femur fits into the socket-like cavity called the acetabulum formed by the hip bones. The articulating surfaces of the bones are covered by smooth cartilage that allows the bones to glide over each other during movement. Hip pain is caused due to osteoarthritis or inflammation of the joint due to wear and tear of the articular cartilage and rubbing of the bones against each other. Pain may also be the result of damage or injury to the soft tissues surrounding the joint, such as ligaments, tendon, and bursae.

When PRP injections of PRP are administered into the hip joint, there is evidence of regeneration of cartilage and other injured tissue, resulting in reduced pain and improved function. Hence, regenerative medicine offers a unique opportunity to facilitate healing of deep tissues and can be used to effectively treat hip pain or delay surgery. Discuss with your doctor whether regenerative medicine options are suitable for you.

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How To Use Crutches

By  aenriquez  published  September 20, 2019

A young man on crutches sprang past me at the dog park the other day. He was practically sprinting and it was a sight to see. He really knew how to use those things.

 

But sprinting on crutches is not only a bad idea for most of us, but it’s also a very dangerous idea. It is also rather difficult. This man was confident of his balance and the grip of the crutches and he was, well, in excellent shape – except for the fact that one knee was bandaged. Otherwise, he was iron-man fit. For most of us who aren’t track and field stars, crutches will get us places, but steadily, not at a sprint.

 

Even crutches at a reasonable pace require a bit of patience before you get the proper rhythm to make your way forward. But it all starts with the right fit for the crutches.

Crutches also have adjustable features that change the height and the distance to the grips

Fit the crutches properly

 

With very few exceptions, there is a standard way to fit crutches so that you can walk a modest amount without causing yourself further injury. The fitting standards are these:

 

  • Height of crutches should be two inches below your armpit
  • Height of the grips should be level with your hips.
  • You shoulders should lean forward when you are walking
  • The crutches should be close to your body to provide balance, but not splay out so much they slip as you move forward. Also, it’s more convenient to present a narrow profile while you use the crutches, so you don’t knock into people or things
  • Your elbows should be bent comfortably

 

Check Everything

 

Make sure you check the armpit padding, the grips, the rubber stoppers on the bottom that prevent slipping. All of these get worn out over time, especially the rubber stoppers. These can be easily replaced and they aren’t expensive. In contrast, using crutches that slip can be very dangerous, so check these items at least daily. Sometimes gum gets stuck on the bottom of your crutches and hardens there. The following day, the crutches start sliding on hard surfaces – so check the bottom of your crutches frequently.

 

Crutches also have adjustable features that change the height and the distance to the grips. Make sure all these items are secure. Check daily.

 

Normal use

 

Crutches are designed for you to take small steps. The further out you reach with the crutches, the higher the chance they will slip.

 

Small steps also allow you to put your weight on your hands as you walk. You should not be using your armpits to hold you up. Doing this quickly becomes quite painful from abrasion and from putting that much weight on your armpits. Your arms and hands, not your armpits, should be holding you up while you walk.

 

Rest

 

Crutches can be quite tiring. If crutches were an efficient way to walk, everyone would be using them. But, they are not. They will tire you out pretty quickly. When you get tired, stop and rest. Don’t overdo it, as this leads to another injury.

 

Standing, sitting

 

Getting in and out of a chair can be tricky. It is not recommended that you use the crutches to pull yourself up. That puts too much weight on one small spot, which could lead to a crutch going out from under you. Instead, use the chair or the table to pull yourself up. Then use the crutches to walk.

 

Stairs

 

If the stairs have secure enough handrails, it is highly recommended that you use these to help you climb stairs with the crutches as added support. It is also highly recommended that you have a “spotter” climb stairs with you – someone who can stay close to you and correct your balance if you start to fall.

 

Climbing downstairs is also tricky. Again, use the handrails, rather than your crutches. For going downstairs safely, it is recommended that you hold yourself upright and hop on the healthy leg down one stair at a time while holding the handrail. It is very dangerous to lean forward over a set of crutches while going down a set of stairs. If your balance goes past the tipping point, your crutches will pole-vault you forward in a very dangerous fashion.

 

It is also highly recommended that you use a spotter to get downstairs when you are relying on crutches to keep weight off one of your legs.

 

Environment

 

Finally, you can save yourself many hassles and headaches if you prepare your home for someone using crutches Clear out the center of each room to provide a clear path for someone on crutches. Move items to the walls or put them in storage temporarily.

 

Seek Help

 

Staff at FXRX Orthopaedics and Bracing have lots of expertise in the use of crutches. Call 480-449-3979 to make an appointment.

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Bunions Aren’t Cute If You Have Them

By  aenriquez  published  September 11, 2019

A bunion sounds like something small and quaint – a bit like something extra someone in Victorian times would sneak into a picnic basket. Oh, you brought bunions! How delightful.

 

Bunions, however, are not particularly delightful. In fact, they are painful, bony protrusions that form at the base of the joint of your big toe or your little toe, where they are referred to as “tailor’s bunions,” or “bunionettes.” These also sound quaint, but are, in fact, painful.

 

A bunion is an abnormal growth that is fairly common. About 18 million women in the United States over 21 years of age (about 8 percent) have bunions, while about 4 million men suffer from the same condition. The difference between genders is explained due to the shoes men and women choose to wear. But the condition is the same and it can hurt.

The bunion shows as a swollen, usually red, inflamed looking bump protruding outward

A growth at the base of the outer toes has nowhere to go if not outward. The middle toes block the protrusion from going inward, so the growth goes outward. While doing so, it forms an exposed outer nub that will be the first thing your foot collides with when it bangs up against something. It is, in effect, an exposed, readily accessible growth that is even visible. It forms a bump at the base of the large or the small toe that then turns the toe inward. The affected toes then start to crowd the middle toes, overlapping them or pushing them inward.

 

Symptoms

 

The symptoms of a bunion include pain in the first joint of the largest or smallest toes (the first and fifth metatarsophalangeal joints). The bunion shows as a swollen, usually red, inflamed looking bump protruding outward.

 

The skin around the bunion tends to become calloused over time, so the skin is likely to be thickened around a bunion. In addition, bunions usually present a dull pain and are vulnerable to bumping. The toes may become misaligned and bunions can make it difficult to find proper footwear that is not painful to wear.

 

What causes bunions?

 

There are a variety of causes for bunions. Genetics can be a contributing factor. Poorly fitting shoes or foot injuries can also lead to bunions. Other causes include:

 

  • Flat feet
  • Poorly fitting shoes especially shoes that squeeze toes together
  • Congenital defects
  • Arthritis and other joint diseases that cause inflammation
  • Foot injuries
  • Occupational issues that require specialized footwear. Dancers are specifically prone to bunions.

 

Treatment

 

Bunions and bunionettes will often retreat if the patient begins to wear the correct shoes, although orthopedic padding or shoe insteps could help the symptoms retreat even faster.

 

Padded socks can also be worn to protect the patient’s foot and help turn toes back to their proper alignment. Inflammation can be brought down with non-steroidal anti-inflammatory drugs. Heat is sometimes used to reduce swelling and alleviate pain.

 

In more serious cases, cortisone injections are used to reduce swelling and pain. Surgery is also a possibility for the most severe cases.

 

See a specialist

 

Bunions only sound cute. In reality, medical intervention is frequently required. See a specialist as soon as possible. Progressive conditions like bunions are best treated by starting a course of treatment as early as you can.

 

In Tempe, call FXRX Orthopaedics & Bracing at 480-449-3979 for an appointment.

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What is Tendinitis?

By  david@ogrelogic.com  published  August 22, 2019

Tendons are thick cord-like tissues that join muscles to your bones. When these tissues become irritated or inflamed, it is referred to as tendinitis. Tendinitis causes acute pain, tenderness and difficulty in moving the affected joint.

Your shoulder, knee, elbow, heel, or wrist are more prone to tendinitis, resulting in conditions, such as Swimmer’s shoulder, Jumper’s knee, Pitcher’s shoulder, Golfer’s elbow and Tennis elbow.

Causes of tendinitis

Tendinitis is often caused due to repetitive action. You may develop tendinitis if you frequently make the same motion while playing or working. Tendinitis can also be the result of injury, aging and diseases like diabetes or rheumatoid arthritis.

Players of certain sports, such as tennis, golf, or basketball, are at a higher risk of developing tendinitis. If you job involves frequently engaging in activities, such as overhead lifting, or other repetitive motions, you may be at high risk for tendinitis.

Symptoms of tendinitis

Tendinitis pain usually appears as a dull ache, concentrated around the affected joint. Pain worsens upon movement. The affected area may be tender, and painful to touch. You may experience tightness and swelling in the affected area.

Treatments for tendinitis

Treatment options for tendinitis focus on reducing pain and inflammation in the tendon. These may include one or more of the following –

  • RICE
  • medications, such as the pain relievers and the anti-inflammatory
  • physical therapy and stretching and strengthening exercises to improve mobility
  • supports such as splints, braces, or a cane
  • surgery
  • corticosteroid injections
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How long do effects of a Cortisone Injection last?

By  david@ogrelogic.com  published  July 24, 2019

When arthritis causes inflammation and pain in your joints, your orthopedic doctor may recommend a cortisone injection as part of your treatment plan. The injection delivers medication directly to the inflamed joint and reduces inflammation. However, the cortisone pain relief is short term. Yet it allows the patient to undergo physical therapy which can further prolong relief.

Duration of relief varies

Cortisone shots are used in the treatment of several joint conditions in the body. How long the relief will last will depend upon various factors, such as the patient’s age, the condition treated, the joint affected, and patient’s overall health. Generally, a cortisone shot can suppress pain for anywhere between 6 weeks to 6 months.

Number of shots

While there is no medical limit on how many injections you can receive, the number of shots your doctor recommends will depend upon your body’s response to the shot. If the first injection doesn’t provide sufficient pain relief, your doctor may give a second injection 4-6 weeks later. If there’s still no relief, a third injection may not be recommended.

Cortisone shots are only one of the treatment options

Remember that cortisone injections are only one of the tools in your overall treatment plan. Your orthopedic surgeon can provide you various other options for pain relief in your arthritis treatment.

The combination of a cortisone shot with physical therapy and lifestyle modifications has shown better long-term relief.

If you are considering a cortisone shot, discuss your goals and condition with your orthopedic doctor to determine whether cortisone shots will prove beneficial in your overall treatment.

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Joint Stiffness

By  aenriquez  published  July 11, 2019

Are you suffering from stiff joints? If you are, many people will say “Welcome to the club.” This is because stiff joints is a common symptom for many conditions from a cold or the flu to specific joint diseases.  It is also extremely common for the elderly to complain of stiff joints, which are almost as predictable as needing bifocals when you turn 45. If you see an elderly person having trouble bending over, then having more trouble picking up an object from the floor, give them a hand. Those aches and pains are real.

There are two general observations about growing old that contribute to those aches and pains, including stiff joints. One is simple wear and tear on cartilage, bursa, vertebral discs and other mechanisms that help joints move. These structures allow for easy movement by providing a fluid-like cushion or a smooth surface for bones to move without having them grind together. Bursa, for example, acts like very tiny water balloons that are wedged into joints, allowing for smoother motion. Cartilage, meanwhile, covers the ends of bones where they terminate at joints, providing a smooth, resilient surface for the bones to slide on. When the cartilage wears out, it is extremely slow to heal, partly because cartilage does not have a blood supply.

When cartilage wears out, it is extremely slow to heal, partly because cartilage does not have a blood supply

The second reason behind stiff joints as you age is the lack of fluids. As we age, we become drier. While water content in our bodies is also dependent on age and weight (thinner people have less water than heavier people when we are infants, our average water content is 75 percent to 78 percent. As adults, this drops to 50 percent to 65 percent. This loss of water affects mechanisms like your vertebral discs. These compact spongy cushions become less spongy as we age. Part of the reason: They become drier.

Here are just some of the diagnosable conditions that can result in a stiff joint.

  • Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disorder characterized by pain in the wrists, fingers, hands, and feet. The immune system in this disease attacks the lining of your joints, which often creates painful swelling and stiffness.

  • Osteoarthritis

As opposed to rheumatoid arthritis, which is an autoimmune disorder, osteoarthritis is a wear and tear condition. As we age, the cartilage that protects the ends of our bones begins to wear out, resulting in bone against bone movement.

  • Bursitis

Bursitis is another wear and tear condition. Bursae are tiny sacks that give joints cushioned movement. However, when these become inflamed, the result is a painful condition called bursitis.

  • Lupus

Lupus is an autoimmune disorder that can result in painful joints, especially in the knees, wrists, and fingers. People who suffer from lupus have good days and bad days, as the pain is intermittent.

  • Gout

Gout, which generally starts in the joints of the big toe, is a painful condition that is grouped together with arthritis, which it resembles.

  • Fibromyalgia

This chronic pain condition is usually associated with muscle pain, but many patients experience stiff joints, as well.

  • Polymyalgia Rheumatica

This is a joint disease that is rarely seen in people under 50. It results in stiff joints, mostly in the shoulders, neck, hips, fingers, and wrists.

Make a call

Are you or anyone you know suffering from joint stiffness? Let us help you return to an active lifestyle with minimum pain. Call FXRX Orthopaedics and Bracing in Phoenix, Az., at 480-449-FXRX.

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Decompression Laminectomy

By  aenriquez  published  July 2, 2019

The decompression laminectomy operation is a common back surgery in which the doctor removes vertebral bone that is putting pressure on nerves. The back part of the vertebral bone is the part that is removed and the operation could entail removal of that portion of vertebral bone from more than one vertebra. Other painful conditions, like bone spurs, can also be addressed during decompression laminectomy surgery.

The surgery is considered a major operation that requires the use of general anesthesia delivered through a facial mask. Patients are also given a sedative to help them remain calm and to increase the general anesthesia’s effectiveness. During the operation, the patient lies on his or her stomach to allow access to the back. Patients are frequently intubated, which involves putting a plastic tube through the patient’s mouth, past the vocal cords to the windpipe. This allows doctors to have air pumped in and out of the patient’s lungs during the surgery. This is done with a mechanical ventilator.

Spinal surgery can be done from the front or the back, but a decompression laminectomy is done from the back

The Surgery Itself

Spinal surgery can be done from the front or the back, but a decompression laminectomy is done from the back. It starts with the surgeon making an incision above the area where the pain originates. After the incision is made, the surgeon then moves the muscle and soft tissue in order to have a view of the patient’s spine.

After the correct area of the spine is exposed, surgeons then cut away bone spurs and any ligaments that are pressing on nerves. The surgeon could also cut away substantial portions of vertebrae that have been causing the patient pain or discomfort or limiting flexibility.

Spinal Fusion

Along with the decompression laminectomy, the patient may have to undergo spinal fusion. This entails “welding” two vertebrae together by use of bone grafts – one or several – that allow the adjacent vertebrae to heal together as one bone. Sometimes, the surgeon elects to use metal plates, screws and rods to ensure that the vertebrae are stabilized.

A spinal fusion restricts flexibility the patient had before surgery, but the movement is often the source of the pain. The patient sacrifices some movement while finding relief from the pain presented by a herniated disc or other conditions.

When the surgery is complete, the surgeon sews the wound back together and the patient wakes up as the mask is removed and the intubations tube is taken out.

Recovery Time

Recovering from a decompression laminectomy can take a while, although many patients, with their doctor’s approval, find they can go home the same day the surgery is performed.  You will be instructed on how much activity you can take on until healing is complete.

Others are not so lucky. According to Spine-Health, 70 percent to 80 percent of patients who undergo this operation feel immediate relief, while others find relief is slower to arrive.

Risks

There are also risks with this surgery, just as there is with other major operations. In the case of decompression laminectomy, the risks include:

  • Nerve root damage – the odds are 1 in 1,000 of this occurring
  • Cerebrospinal fluid leak – odds are 1 percent to 3 percent, but recovery from this is usually under 24 hours if the patient remains lying down
  • Infections – 1 percent of cases, although usually this can be dealt with by the use of IV antibiotics.

 

Make A Call

Are you or anyone you know suffering from back pain? Let us help you return to an active lifestyle. Call FXRX Orthopaedics and Bracing in Phoenix, Az., at 480-449-FXRX.

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4 Common Injuries that require Urgent Orthopedic Care

By  david@ogrelogic.com  published  June 21, 2019

Orthopedic injuries that result in open fractures (fractures that break the skin) should rush to the nearest ER or call 911. But there are other orthopedic injuries that require urgent orthopedic care.

Knee Injuries

The knee is may suffer an injury even during walking. Most knee injuries are the result of a –

  • sudden change in direction (such as pivoting, shifting, jumping), or
  • sudden force (stepping down from a high surface, landing during a jump)

Any knee injury should be taken seriously and be seen by an orthopedic doctor. Common knee injuries include cartilage and ligament tears, sprains and strains.

Shoulder Injuries

Since the shoulder is one of the most mobile joints, it bears great force and rotation every day.  If the soft tissues, such as ligaments and muscles, of the shoulder are overused or overstressed, injuries may occur. Common shoulder injuries are rotator cuff tears, shoulder fractures, shoulder dislocations and injuries to the soft tissues.

Ankle Injuries

The most common ankle injury is a sprain. When the ankle is –

  • over inverted, such that the soles of the feet point inward, or
  • over everted, such that the soles of the feet point outward, or

the ligaments of the ankle joint suffer a sprain. Ankle sprains may vary in severity.

Wrist Injuries

Wrist injuries usually occur while landing on an outstretched arm during a fall. The wrist may suffer a strain that causes pain, swelling, bruising, and even numbness. A wrist fracture can also similar symptoms.

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Osteoporosis

By  aenriquez  published  June 18, 2019

Osteoporosis is a naturally occurring condition that becomes a health concern once people reach 50 years of age. It becomes potentially more serious the older they get. In fact, since bone mass peaks in your mid-20s, it can be said that the process of osteoporosis begins at that point. After that, as you age, your bones become less dense and weaker. The less dense your bones become, the higher your risk of a fracture.

Bones Are Living Tissue

Many people don’t realize that bones are living tissues that are undergoing constant change. Older cells reabsorb into the body, while new cells are created. At first, of course, your bones grow from the time you are born until you reach your late teenage years. After density peaks in your late 20s, bone strength is maintained through a process called remodeling. During this phase, your bones are still living tissue with old bone matrix reabsorbed into the body, while new formation is taking place.

Depending on your age, your general health and the severity of the injury, the time it takes to heal from a hip fracture can vary

As we age, bone formation continues, but at a pace, that is too slow to keep up with bone loss. This is the process of osteoporosis, which means “porous bone.” Certainly, porous bone is weaker and more prone to fractures and breaking.

Major Concerns

According to the International Osteoporosis Foundation, one in three women and one in five men over fifty years of age are at significant risk for an osteoporosis-related bone fracture. These commonly occur in the hip, the spine and the wrist with more serious consequences depending on the location. All fractures are serious, but the weight-bearing responsibilities of the hips and the spine make a fracture in those locations potentially life-altering.

Depending on your age, your general health and the severity of the injury, the time it takes to heal from a hip fracture can vary. Meanwhile, osteoporosis of the spine can lead to a compression fracture of vertebrae, which can be extremely painful. Left untreated, a vertebral compression fracture results in a condition called Dowager’s Hump, which is a characteristic posture that includes a rounded upper back and a neck tilted too far forward. In addition, a vertebral fracture often results in a lower height.

Diagnosis

While everyone past a certain age experiences osteoporosis – just as everyone past 40 years of age is a candidate for bifocals – when the condition becomes acute, you can be diagnosed with osteoporosis.

This is usually done with a physical at your doctor’s office. If need be, the doctor will then order a bone mineral density test (BMD). This is done with specialized imaging called a DXA, which stands for dual-energy X-ray absorptiometry. This is a low radiation X-ray that can identify small changes in bone density.

Your doctor will recommend one or more specialized DXA tests that focus on the forearm, finger and heel, the spine, the hip or your whole body.

Osteoporosis – essentially, acute osteoporosis – is diagnosed when someone has a T-score lower than minus 2.5. A score of minus 1 to minus 2.5 is labeled osteopenia, while a score lower than minus 2.5 is considered severe osteoporosis.

 

Treatment

 

While diet, exercise and the avoidance of tobacco and heavy alcohol use are recommended for preventing osteoporosis, there are medications available for people diagnosed with osteoporosis. These are:

 

  • Bisphosphonates
  • Denosumab
  • Selective Estrogen Receptor Modulators
  • Calcitonin
  • Strontium ranelate
  • Teriparatide
  • Hormone replacement therapy (HRT)

 

Procedures

 

For persons with compression fractures of a vertebral segment or segments, the procedure known as kyphoplasty is recommended. This procedure involves forcing the vertebrae back to its original shape with an inflating device, then removing the device and filling the empty space with special bone cement. This keeps the vertebral segment in the correct shape, restoring movement and relieving pain.

 

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