Dr Lokesh Mantri
Postmenopausal women tend to more susceptible to primary osteoporosis due to association with oestrogen deficiency this occurs mostly in senile age & more common in the condition is characterised by a reduction in the amount of bone in the skeleton which radiologically manifested when approximately 40% of the skeleton has been lost at this time cortical of long bone much thinner & cancellous bone less dense where vertebral bone having fish head appearance where histologically bone becoming normal where disease manifested symptomless in which fracture of bone most common as a part of disease concern osteoporosis also clinically difficult to manage whereas homoeopathic medicine play very important role in osteoporosis as well as homoeopathic medicine not only play a curative role but also play preventive role & reduce post complication like fracture, paralysis & disability in postmenopausal women.
Key word- postmenopausal women, osteoporosis, Bone, Homoeopathy, osteopenia, degeneration, pain, fracture, backache, who,
Normally bone is made up off 2/3 part of mineral that is calcium hydroxyapatite. & (1/3) part organic matrix osteoid mainly collagen type 1 “ osteoporosis is a condition where a decrease in both the bone matrix & bone mineral component “.
Other definition decreased bone mass per unit volume normally mineralised bone . due to loss of bone protein.
Incidence of osteoporosis in India is generally 10.4% in men & above 52 years is 18.6 % in men while prevalence in pre -menopausal women is 3.5% while newly developed postmenopausal women is 18.4% while postmenopausal women 37.3% while post- menopausal women above 5 year 37.3 % 
Who definition based on T score the overall prevalence of osteoporosis was 14.5% in men & 18 % in women at the lumbar spine and 5.7% in men & 12.7% in postmenopausal women at the hip overall total osteoporotic patient Osteopenia was noted in 39.4% men & 21.6% women since above two study shows that postmenopausal & important character while studying osteoporosis.  in the maximum cross sectional study shows that Indian men & women above 40 year higher prevalence rate where as post-menopausal above 5 year`s getting higher incidence.
DEXA criteria for osteoporosis as Determined by WHO are BMD of spine & hip of 2-5 SD`s or more below the mean for healthy young women range below 2.5 stated osteoporosis & osteopenia between 1-2.5 SD`s or below that.
Osteoporosis again classified in two types according to their etiopathogenesis
1] primary 2] secondary
Where primary again sub divided in two subtype 1] Type 1 2] Type 2.
Type 1- [postmenopausal osteoporosis] is characterised by bone loss after menopause due to decrease oestrogen level. Mostly seen in trabecular bone approximately 2-3% of total bone /year except cortical bone where vertebral & Radius bone are more common . .
Type 2 – also called senile osteoporosis here bone loss is more gradual 0.5-1 % /year & involve both corticular & Trabecular bone here increase risk of vertebral & Hip fracture mostly men & female are involved above age of 70 year .
Most common clinical features –
As an earliest of disease most commonest site of pain in the middle or low thoracic or high lumbar region especially in a sudden movement like sitting, sneezing cough, lead to osteopenia which relives by rest only . .[1,2]
A most common symptom in back pain decrease in bone mass causes a reduction in strength of bones which lead pathological fracture that is vertebral fracture multiple compression fractures in bone multiple compression fractures with loss of height in bone leading pathological fracture neurological deficient mostly uncommon osteoporotic fracture like colles fracture [distal radius] ,hip fracture & femur fracture specially neck of femur & Trochanteric are most common. backache & progressive loss of height are later feature seen in osteoporosis.[1,2]
Which also present associated feature like Brittle hair, cervical spine compression, loss of vertebral height, skin wrinkles degenerative hip & fracture of long bone. .[1,2]
In type 1 – pain & stress fracture of vertebra distal forearm most common.
In type 2- pain & stress fracture with multiple wedge .hip, tibia, proximal part extracapsular . Dorsal kyphosis.[1,2]
Homoeopathy plays a great role in the management of osteoporosis in nearly some evidence having play role in the management of osteoporosis in which medicine select with individualisation & totality of symptom. Some best homoeopathic drug which play most important this are
1] calcarea phos – mostly adapted to person who anaemic & dark complexioned dark hair & eyes thin spare subject children emaciated unable to stand slow in learning to walk sunken flabby abdomen cranial bones thin & brittle spine week disposed to curvature tendency to bone soften or spine to curve non union of bone rheumatism of cold weather headache of school girl lack of animal heat.  pain along the sutures & symphyses non union of fractured bones swelling of condyle and arms spina bifida tendency of bone bend & curve caries of hip joint & heel with stinking pus & suppuration of bone edges of callous form in bone  best act on especially low potency great remedy for non union fractured bone remedy is use for stimulate callus formation remedy also use in rickeet weakness of bone defective bone growth defective nutrition predispose to glandular disease worse when thinking of symptom rheumatic pain every cold causes pain  bones are slow in forming bone pain are shooting, drawing aching burning & pressing complain better during rest & aggravated by exertion, stiffness & in moving in bed Electric shock like pain so patient could not standing. Women with dysmenorrhoea marked back pain are more marked. 
2] calcarea flu- mostly use for dispersing bony growth, ulceration of bone & fistula . a giant cell sarcoma of upper maxilla causing deformity known as frog face periosteal swelling one on right radius one on left ulna lumbago for strain worse after rest better after moving suppuration of bone complain.  act on periarticular tissue hereditary malfunction of pitututary. Stony hardness of gland especially parathyroid gland and thyroid gland. Exudation from surface of bone which quickly harden a nodular or jagged from osteosarcoma & supparation of bone disease.  help for bone formation useful in case of bony infiltration mostly in periosteum. General stiffness It cured exostosis of bone specially at angle of 8th rib .best remedy for malnutrition of bone caries, necrosis with boring type of pain especially all bone. 
3] Aurum Metalicum– mostly suited to sanguine ruddy people with black hair & eyes lively restless anxious about the future old people weak vision tired of life due to bone pain osteopenia mostly in cold air osteopenia also due to emotion caries of cranial bone & bones of the palate are especially met by this remedy. Violent bone pain at night. There is an offensive order & discharge of small pieces of bone pain in the bone of extremities necrosis of all bone with marked osteoporosis exostosis also present in old aged syphilitic affection all major bone bone feel painful as if broken bone pain aggravated lying down and also from touch caries of mastoid process & of nasal bone exfoliation of portion of frontal bone swelling of periosteum of bone bone pain aggravated at night. Periosteal inflammation marked. The chloride of gold & platinum useful in caries & necrosis. 
4] phosphorus- Adapted to tall slender person with sanguine temperament young people who grow rapidly oversensitive to noise touch odours burning in all part of bone especially spine, between scapula severe restless due to osteopenia great weakness and prostration with nervous dribbling & trembling left sided bone pain are marked rib pain especially marked chest pain coughing aggravation before midnight amelioration on painful side degeneration of all bone in body especially on spine, all long bone, paralysis of body destructive metabolism bone fragility. Burning pain in back weakness along with trembling all over body formication of hands & feet sensation as if joint suddenly give way. patient feeling so emaciated rheumatic stiffness in all joint tearing & drawing pain in all bone with osteopenia bone pain especially in cold weather joint following sprain staggering while walking due to bone pain . bone easily fractured along with large quantity of blood loss.
Rachitic necrosis of lower jaw exostosis especially of the skull tearing pain in all bone
5] Silicea- this is best drug for osteoporosis specially all bone disease caries & necrosis of bone there is organic changes deep & in slow action osteopenia more in cold there is great defective assimilation in all bone intolerance of alcoholic stimulant there is great soreness of all bone specially all lower limb bone tibia, femur all tarsal & metatarsal bone.  curvature of bone defected offensive sweat hip joint disease caries with inflammation of all long bone bone easily fractured due to defective assimilation. Spinal weakness with leg trembling due to defective assimilation of bone pain & uneasiness in bone action of silica is on slow on proving so all complain developed slowly osteoporosis also a slow developed disease dread of failure feeling due to bone complain suppuration of sweat lead to bone complain like osteoporosis. In silecea bone become softer since childhood. All cartilaginous tissue easily brittles including bone also. .  silecea is intolerance of milk so deficiency of calcium lead to osteoporosis.
6] Symphytum- the root contain a crystalline solid that stimulate the growth of epithelium on ulcerated surface mainly administered internally specially ulcer it act on tendon & periosteum act on joint prevent osteoporosis in bone & in non union of fracture pricking pain & soreness of periosteum.  this is best orthopaedic herbal medicine in homoeopathy bones are easily fractured great soreness with osteopenia are marked stitching pain at point of injury. Along with bone fractured there is marked injury to the soft part of body. Any bone injury very nicely healed with symphatum 30 specially complete recovery within 48 hours also done with an evidence in homoeopathy. Seems to a there is act especially in all joint. There is marked inflammation in bone including periostitis. [o8]
7] Fluoric acid – best homoeopathic medicine specially act on chronic disease with syphilitic & mercury history act especially on lower tissue like bone where destructive pathology formed mostly complain of old age or prematurely aged with weak early decayed of bone caries & brittle bone osteopenia are more marked along with degenerative necrosis of all maximum bone. Cause of osteoporosis specially a zinc like wine. There is great numbness of all limbs motion, bending, lead to great osteopenia [o8] osteopenia is summer & in winter also exostoses of bone of face
8] ruta- this remedy is most useful in complain of osteopenia well acted on periosteum & cartilage at all over in body all part of body as if painful as if bruised great homoeopathic remedy for chronic sprain feeling intense lassitude weakness & despair there is marked injurious in bone like fracture & degeneration especially in chronic pathology.  osteopenia specially in sitting, stooping, going up & down stair best homoeopathic drug in any type of fracture with great osteopenia or any type bone pain osteopenia also lifting any object. also useful any mechanical injury of bones & periosteum any single movement lead to great pain mostly best acted type 2 & secondary osteoporosis related disease. Best acted drug where menses are suppressed. 
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Dr Lokesh Mantri
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Gurumishri Homoeopathic Medical College, M.D.Part 1 Practice Of Medicine, Shelgaon
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