OSTEOPOROSIS AND BONE/ JOINT/ MUSCLE DISORDER

OSTEOPOROSIS AND BONE/ JOINT/ MUSCLE DISORDER

Then We made the sperm-drop into a clinging clot, and We made the clot into a lump [of flesh], and We made [from] the lump, bones, and We covered the bones with flesh; then We developed him into another creation. So blessed is Allah, the best of creators. 23:14

The embryo is a boneless lump. Its cartilage tissue is transformed into bones in due time, as stated in the Quran, followed by their being clothed in muscular flesh. The Arabic word “lahm” means the muscular flesh. This process was unknown 1400 years ago. It was believed that the bones and muscles developed simultaneously. Advanced microscopes and micro cameras introduced into the uterus corroborated once again the truth expressed in the Quran. 

Or [consider such an example] as the one who passed by a township which had fallen into ruin. He said, "How will Allah bring this to life after its death?" So Allah caused him to die for a hundred years; then He revived him. He said, "How long have you remained?" The man said, "I have remained a day or part of a day." He said, "Rather, you have remained one hundred years. Look at your food and your drink; it has not changed with time. And look at your donkey; and We will make you a sign for the people. And look at the bones [of this donkey] - how We raise them and then We cover them with flesh." And when it became clear to him, he said, "I know that Allah is over all things competent."

The verse quoted from the sura The Cow draws our attention to the skeleton and invites us to examine it closely. While reading this verse, we will try to meditate upon the miraculous formations within our bodies. Our skeletons, marvels of engineering, are formed of 206 bones of varying sizes. They are towers made of bones connected with each other by joints and ligaments, enabling us to jump, run, bend, sit, etc. To turn the page of a book necessitates the concurrent action of our shoulder, elbow, wrist and fingers, without our being aware of the fact that it is the skeleton that performs this act. 

The skeletal system is made up of structures composed of bones or cartilage or a combination of the two, which provide a framework for the vertebrate body and serve as attachment for muscles. Every part of this system independently performs the duty with which it has been charged. Where the movement is deemed to involve danger, the joints are fixed, like in the skull and pelvis, while in the hips or shoulders they are mobile. Cervical vertebrae permit the head to revolve around its axis up to 180 degrees. Thus, one does not have to turn his body to look around. The lungs and heart are protected by ribs to ensure their proper and safe functioning without being exposed to any hazard. The skeletal system supports the body like the columns and beams of a building. However, it is to be wondered at that while in modern buildings the frame forms 60-70% of the building’s weight, the human skeleton forms but 15% of the body weight. The structural frame is highly resistant. For instance the thighbone (the femur) in vertical position can carry a weight of one ton. Solidity and elasticity coexist.

The structure of bone is a framework of a protein called collagen, which is hardened and given strength by the addition of calcium salts ( hydroxyapatite) which adhere to the protein , a process called mineralization. Once bone has become mineralized, it becomes very strong and will normally resist bending and breaking.

 The bone is covered by an outer membrane 

( periosteum) which carries nerves and blood vessels to the bone. Within bone, blood vessels deliver nutrients and oxygen to bone cells and take away the waste products of metabolism. In the larger bones, pelvis, sternum and spine, their internal cavity contains bone marrow where blood cells are made. 

Osteoporosis is a chronic condition which affects all the bones in the body. In this condition bone mineral density is lower then what is normally expected and a micro-structure of the bone is disorder, meaning that the bone structure is weaker than normal.

Bones which have lost their mineral density are at much higher risk for fracture. And, although bone fractures are usually not life threatening, individuals who suffer a bone fracture as a result of osteoporosis have a 20% chance of mortality in the first year following the break.

The World Health Organization has defined osteoporosis as a bone mineral density 2.5 standard deviations below peak bone mass in a 20 year old of the same sex measured by DXA (a radiological procedure). The DXA is the gold standard in diagnosis of osteoporosis.

More important than treatment for osteoporosis is prevention because it is the best way to reduce the risk of fracture. Bone mass density peaks between the ages of 25 and 35. Physical activity has the greatest impact for lalane down strong bone during the teen years. Adults can help maintain and increase bone mass density by one or 2% by using physical activity as well. If the value of your peak bone mass is high at age 25 then the bone loss you suffer as you age will be lower.

The underlying mechanism in the formation of osteoporosis is the difference between bone reabsorption (which normally occurs) and bone formation. During osteoporosis the bone is a reabsorbed more quickly or is formed more slowly than is normal. Most cases of osteoporosis do not result from in adequate calcium but instead from other factors such as a lack of vitamins, cigarette smoking, sedentary lifestyle, family history and and age.

Once an individual has been diagnosed with osteoporosis restoration of a microstructure of the bone is difficult to repair. Although there are medications which have been shown to increase bone mass density they do not make an impact on the micro-structure and therefore the stability of the bone itself. Bone loss can be reduced but it can not be replaced. 

There are two types of bone: trabecular and cortical. The trabecular bone appears spongelike in is the core of the long bones which helps to provide the stability and is where bone formation occurs. Cortical bone is a hard exterior shell which provides the majority of the stability.

When osteoporosis is diagnosed doctors find that the trabecular bone is the section that suffers the greatest amount of bone loss. The hip bone, spine and wrists are the area of the body which have the most trabecular bone and are at the greatest risk for bone fractures.

An individual who suffers of fracture related to osteoporosis places them at a higher risk for developing another one. An individual who has a hip fracture will often result in decreased mobility and an additional risk of animalism that can travel to the lungs or heart. In the year following a hip fracture 20% of these sufferers will die. Individuals who suffer from Vert steamrolled fractures or spinal degeneration will experience dowagers humps making it more difficult for them to breath.

Although individuals who suffer from or have been diagnosed with osteoporosis have an increased mortality rate (death rate) due to complications of fracture more people actually die with the disease rather than of the disease.

Vertebral fractures, a serious consequence of osteoporosis, lead to acute and chronic back pain, spinal deformity, and a reduction in survival equivalent to that caused by hip fractures. The health care burden in financial terms is substantial. Vertebral deformities predict further vertebral fracture, even within one year, and also predict nonvertebral fractures. 

The bone fragility that characterizes osteoporosis after menopause results both from an imbalance in bone remodeling at the cellular level, which causes bone resorption to exceed bone formation, and from an increase in the rate of remodeling at the tissue level. Antiresorptive therapies reduce the rate of bone remodeling and lower the fracture rate by 30 to 50 percent. Antiresorptive agents, however, do not increase bone tissue mass. Instead, the increase in bone mineral density observed in clinical trials of antiresorptive drugs is the result of a more complete secondary mineralization of the existing (but reduced) bone tissue mass. Restoration of bone tissue mass and bone structure is not achieved with antiresorptive drugs and requires the use of anabolic agents. 

Strontium ranelate is a new orally active agent consisting of two atoms of stable strontium and an organic moiety (ranelic acid). It stimulates the formation of new bone tissue and decreases bone resorption, as has been shown in vitro and in experiments in animals.Strontium ranelate prevents bone loss in ovariectomized rats, increases bone mass in osteopenic animals, and increases bone strength in normal animals. To date, no deleterious effects on the primary or secondary mineralization of bone in laboratory animals or humans have been reported. Results from a two-year placebo-controlled, phase 2, dose–response study involving 353 postmenopausal women with osteoporosis suggested that ingestion of 2 g a day of oral strontium ranelate reduced the incidence of vertebral fractures during the second year of treatment and simultaneously increased bone mineral density. In order to confirm these results, we designed the Spinal Osteoporosis Therapeutic Intervention study to test the safety of strontium ranelate and its efficacy against vertebral fracture when given orally at a dose of 2 g per day for three years in postmenopausal women with osteoporosis and a history of vertebral fracture. 

The prevention of osteoporotic fractures with the use of antiresorptive drugs represents an established therapeutic approach for patients with osteoporosis. The results of double-blind, randomized, placebo-controlled trials have indicated that nitrogen-containing bisphosphonates such as alendronate and risedronate, which work principally by suppressing bone resorption, reduce the risk of fracture and increase bone mineral density. 

Unlike bisphosphonates, parathyroid hormone is anabolic when it is administered intermittently for osteoporosis. Both parathyroid hormone and parathyroid hormone increase bone density by stimulating bone formation rather than by reducing bone resorption. Recently, the 34-amino-acid fragment, parathyroid hormone, was shown to reduce the risk of fracture and is now available for the treatment of persons with established osteoporosis and a high risk of fracture.

Whether the use of a bisphosphonate and parathyroid hormone together would provide a therapeutic advantage by combining different mechanisms for the reduction of the risk of fracture is unknown. Parathyroid hormone has been studied as an addition to ongoing therapy with estrogen (an antiresorptive agent), but no similar trials have been conducted using bisphosphonates. Furthermore, no antiresorptive agent (including estrogen or a bisphosphonate) has been studied together with parathyroid hormone from the start of therapy in previously untreated patients. We conducted a multicenter, randomized, double-blind trial comparing monotherapy with parathyroid hormone or alendronate with combination therapy consisting of both agents in postmenopausal women with osteoporosis. Here we report the results at 12 months.

While there are risk factors that can be controlled or preventative measures that can be taken there are some that cannot be changed such as a family history of osteoporosis, a history of bone breakage as an adult, advanced age or European or Asian ancestry. Risk factors that can be controlled are the use of steroids, cigarettes, locally, low calcium and vitamin D intake,alcoholism and poor health.

Osteoporosis will cross genders, age and socio-economic their ears. All individuals are at risk, some more than others. By making a change in your overall health and taking preventative measures many individuals are able to offset the diagnosis, delay the progression or prevent the disease altogether.

The Quran contains many verses of advice about healthy eating that relate to the interconnectedness of physical and spiritual health.  Encouragement to eat only good and pure food is often combined with warnings to remember God and avoid Satan.  Healthy eating not only satisfies hunger but also has an effect on how well we worship.  

“O mankind, eat from whatever is on earth [that is] lawful and good and do not follow the footsteps of Satan. Indeed, he is to you a clear enemy.”  (Quran 2:168)

REFERENCES

1. http://www.islamreligion.com/

2. http://www.natural-holistic-health.com/

3. Stefan Cembrowicz, Theresa Allain,2007,Osteoporosis, Class Publishing Ltd, Page 2.

4. Clifford J. Rosen, Frcp Juliet E Compston M D, Jane B Lian Ph D, 2009,Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, John Wiley and Sons.

5. http://theislamshow.weebly.com/bone-formation-and-clothing-of-bones-with-flesh.html