Diffuse idiopathic skeletal hyperostosis (DISH)

Diabetes and Bone Problems Another skeletal disease associated with type 2 diabetes is Diffuse idiopathic skeletal hyperostosis (DISH). In this condition, so the ligaments and tendons harden. This occurs mostly in the spine region. In this condition, insulin or insulin-like growth factors promotes new Bone Growth.

What are the symptoms of Bone Problems?

Because DISH mostly affects the spine. In this case, you may experience stiffness in the neck or back. In general, in this condition, you may experience decreased range of motion, stiffness, or pain in the affected part of the body.

How is DISH treated?

Treatment involves managing symptoms, usually with pain relievers such as ibuprofen and acetaminophen, and corticosteroid injections.

Dupuytren’s contracture

Scarring and thickening of connective tissue in the palm of the hand cause Dupuytren’s contracture. But one or more fingers bent towards the palm due to deformity. People with diabetes have this condition if they have had uncontrolled diabetes for a long time. The condition may be due to metabolic changes related to diabetes.

What are the symptoms of Diabetes related bone Problems?

Diabetes and Bone Problems Skin on the palm of the hand thickens leading to stiffness of the palm and fingers of the hand. It is difficult to fully straighten one or more fingers.

How is it treated for Diabetes Problems?

This condition, in severe cases, makes it difficult for you to perform daily activities – such as grasping objects. Therefore, doctors perform a minimally invasive procedure called aponeurotomy to break apart the thick skin tissue. Collagenase enzyme injection and surgery are the other treatment options. Doctors give steroid injections to help reduce pain and inflammation.

Frozen shoulder

This condition commonly affects one shoulder. o The most common risk factor for this condition is diabetes although a well-established cause is often unknown.

People often approach an orthopedic doctor if they experience mild to moderate pain, stiffness and restricted movement in the shoulder joint. The doctor may give glucocorticoid injections to ease symptoms if they are severe. However, physical therapy is beneficial. It helps in easing movement and preserves a wide range of motion in the shoulder joint.

Osteoarthritis

In this degenerative joint disorder, joint cartilage breaks down. Osteoarthritis can affect any joint in the body. People with uncontrolled and long-time diabetes have an increased risk of developing osteoarthritis. Excess body weight (obesity) is the major risk factor for type 2 diabetes.

Symptoms of Osteoarthritis

Swelling and stiffness, joint pain, and also loss of joint flexibility or movement are some of the common symptoms of osteoarthritis.

Treatment for Diabetes and Bone Problems

Maintaining healthy body weight, involvement in regular exercise, resting and taking care of the affected joint, medication for relieving pain and physical therapy may help ease symptoms. To manage pain, massage therapy and acupuncture may be helpful. In severe cases of hip and knee osteoarthritis, hip and knee replacements may be recommended.

Diabetes and bone problems By Dr. Praharsha

Diabetes is a silently damaging disease as it can lead to many serious health issues such as heart disease, kidney disease and nerve disease. These conditions can go hand in hand with diabetes. You may not be aware of the fact that diabetes can also lead to increased risk of bone and joint conditions. The risk increases manifolds in people who have arterial disease, obesity and diabetic neuropathy. Let us try to understand different types of joint and bone conditions along with their symptoms. Diabetes and bone problems.

What is neuropathic arthropathy?

Nerve damage is the common complication of diabetes. A joint deteriorates due to this problem. This is one of the commonest complications of diabetes. The condition is best known as neuropathic arthropathy or Charcot joint. It primarily affects the feet.

What are the symptoms?

If you have this condition, you may experience loss of sensation or tingling sensation in the affected joints. You may also have numbness and the affected area might feel like red and swollen, warm and also become deformed or unstable. Though the joint appears to be bad in appearance, you may not feel severe pain.

How is it treated?

When this condition comes to your notice early, once your Orthopedic doctor diagnoses it, it is possible to slow it down. You can slow the progression of this condition by using orthotic supports and by limiting weight-bearing activities. Protecting the affected joints and surrounding structures can help.

What is Diabetic hand syndrome?

Diabetic cheiroarthropathy or diabetic hand syndrome is a condition that restricts or limits joint mobility. It mostly affects the small joints of the hands. It causes stiffness of the joints.

Initially hands joints come into its fold – and then, slowly shoulder, feet and ankles’ joints get effected. Hands skin can become thick and waxy with the restricted finger movement. The cause of limited joint mobility is not known. However, people with diabetes are more prone to this condition – especially those who have had diabetes for a long time.

What are the symptoms?

You may have restricted fingers movement. Therefore, you may not be able to extend your fingers fully. Even pressing your palms together flat becomes difficult.

What is the treatment for this condition?

Management of diabetes is very important to control this condition. In addition, physical therapy helps in slowing down the progression of this condition. Many people may not able to regain complete movement of their fingers.

What is Osteoporosis?

In osteoporosis bones become weak and lose strength. The causes of weak and brittle or fragile bones can be many including vitamin D deficiency, calcium deficiency, kidney and liver problems. Diabetes is also one of the risk factors for osteoporosis. People with type 1 diabetes are at increased risk of osteoporosis.

What are the symptoms?

Many people who develop this bone condition don’t have any symptoms in the beginning. The only way by which the condition comes to limelight is after bones get fractured. However, in some advanced stages of the disease some people experience loss of height, broken bone and stooped posture.

How is it treated?

Knowing the underlying cause is important for prompt and effective treatment of osteoporosis. For instance, hormonal imbalances in women and men and kidney disease can also cause osteoporosis. However, low calcium levels and vitamin D deficiency are the main causes. Therefore, the best way to manage osteoporosis is taking supplements, making dietary changes, doing weight-baring exercises, walking and eating diet rich in calcium and vitamin D. In more chronic and severe cases, doctors prescribe supplements and medications, injections to prevent further bone loss and increase bone mass. Diabetes and bone problems go hand in hand – therefore, even in the absence of symptoms, you should always get your bone health checked.

To be continued in the next post…

Osteomalacia Causes

Osteomalacia is a condition in which bones become soft and weak. This condition has become very common nowadays both in men and women. Compared to men, women are at increased risk.

Osteomalacia causes: The most common cause of osteomalacia is vitamin D deficiency – which leads to low blood calcium levels. Inadequate levels of calcium in the blood can lead to soft and weak bones.

Symptoms and Risks

Those who develop this condition have weak muscles, weaker bones, bone pain, bowed legs, and brittle bones. They are at increased risk of BONE FRACTURES.

In children – The inability to utilize vitamin D or deficiency of vitamin D can lead to a condition called osteomalacia which leads to rickets.

Osteomalacia Causes

Vitamin D Deficiency

A major source of vitamin D is the one that is produced by the skin on exposure to sunlight. The other source of vitamin D is food – such as milk, fish, eggs, poultry, and meat. Low vitamin D levels or inadequate vitamin D or deficiency of vitamin D occurs in the following cases:

• People who work indoors during the daylight hours
• Women who use a very strong sunscreen
• Individuals with dark skin pigmentation
• Women who wear complete body-covering clothes
• Women and men who avoid daylight
• People who work most of the time indoors
• Women who remained confined to their homes
• People who live in climatic conditions where there is the least exposure to sunlight.

Some people may not get enough vitamin D from their diet if they:

• Have undergone stomach surgery – such as bariatric surgery or intestinal surgery
• Follow a strict vegetarian diet
• Don’t drink milk and milk products (commonly seen in adults)
• Have trouble digesting milk products (lactose intolerance)

What are the other causes of osteomalacia?

The other osteomalacia causes include the following:

• Excessive use of medicines especially the ones that are used to treat seizures
• Acidosis and kidney failure
• Rare types of kidney cancers that lead to low levels of phosphates
• Chronic and end-stage kidney disease
• Lack of enough phosphates in the diet
• Digestive system disorder
• The inability of the liver to convert vitamin D to its active form is due to liver disease.

How is osteomalacia diagnosed?

Doctors order the most common and basic tests to check the levels of vitamin D, calcium, and phosphates. Low levels of vitamin D, calcium, and phosphates indicate osteomalacia. X-rays and bone density scans are helpful in evaluating the amount of calcium and other minerals in bone. Low bone density scans indicate osteomalacia.

How is osteomalacia treated?

Doctors suggest proper sunlight exposure and dietary intake if the cause is vitamin D and calcium deficiency. People who have developed the condition due to malabsorption of nutrients through the intestines should take larger quantities of calcium and vitamin D supplements. It depends on the individual case.

A nerve that travels from the neck to the arm and then to the fingers is known as the ulnar nerve. It is located near the ulna bone. It provides sensation to the ring and little fingers and to the forearm. The ulnar nerve extends the entire length of the elbow, forearm, and fingers. There is a small passage called the cubital tunnel through which muscles, ligaments, and ulnar nerve pass inside the elbow. This is the most common area where irritation may occur. The condition is known as cubital tunnel syndrome.

What causes cubital tunnel syndrome?

The cause of cubital tunnel syndrome is mostly idiopathic or unknown. However, many experts believe that excessive pressure, force, or tension created on this nerve due to repetitive movements may cause this condition.

The anatomical structure and positioning of the ulnar nerve with little soft tissue and a narrow space covering it make it susceptible to direct pressure. Therefore, any pressure or compression of this nerve causes numbness in the fingers.

Stretching – The nerve is vulnerable to stretching – especially during sleep.

Cubital tunnel syndrome has different names – such as handlebar palsy, bicycler’s neuropathy, tardy ulnar palsy, ulnar nerve entrapment, or Guyon’s canal syndrome.

The following activities and any previous injury may put some people at a higher risk of developing cubital tunnel syndrome:

• Previous dislocation or fracture
• Swollen elbow joint
• Prolonged or repetitive movements
• Excessive flexing or bending of the elbow joint
• Arthritis or bone spurs of the elbow joint

What are the symptoms of cubital tunnels syndrome?

The ulnar nerve is a funny bone nerve. As this nerve is sparsely protected and close to the surface of the skin, it is more sensitive. If something hits in the inner elbow region, the sensation resembles an electric shock.

The signs and symptoms associated with cubital tunnels syndrome include:

• Stiffness in the fingers
• Problems manipulating things with hands or fingers
• Straightening and bending fingers are difficult
• Reduced grip or weakened grip strength
• Muscle loss at the base of the first finger and thumb
• Weakness in the arm, forearm, and fingers
• Pain in the arm, forearm, or fingers

How is cubital tunnel syndrome diagnosed?

Your orthopedic doctor may take note of the symptoms and perform a physical examination. The doctor will also take into account your complete medical history, and recommend the following tests:

X-ray: This test takes images of the bones and surrounding structures to see whether you have bone spurs or arthritis in your elbow.

Nerve conduction test: This test helps in determining the speed of signals that travel down a nerve. The test may be recommended to know whether any constriction or compression of the nerve is delaying the signals.

Electromyogram (EMG): This test helps in testing the forearm muscles controlled by the ulnar nerve. Both nerve and muscle functions are tested. When the muscles don’t work properly in their usual manner, it is an indication of a problem with the ulnar nerve.

Treatment

When you see your orthopedic doctor regarding the problem you may have, your doctor will instruct you to avoid certain actions that aggravate your symptoms, such as – leaning on the elbow, driving for a long time, resting your arms on the armrest of a chair for long; holding a book for a long time; typing extensively on a keyboard for long; holding a phone for a long time; and sleeping on the arm by bending the affected elbow.

In addition, your doctor will recommend the following home-based relieving methods:

• Using Pain relieving NSAIDs and anti-inflammatory medications and other OTC drugs
• Ensuring proper workstation ergonomics – the chair should not be kept lower than the tabletop
• Using an elbow pad that provides protection during the day
• Doing a thorough warm-up before exercise
• Resting the elbow and the arm whenever possible
• Avoiding sports equipment or clothing that compresses the elbow
• Wearing an elbow pad during the day provides protection
• wearing an elbow splint at night to prevent the elbow from bending
• Wrapping the impacted arm loosely with paddings, such as cloth, towel, or pillow

Surgery

If you don’t get any relief from the nagging symptoms and the symptoms last longer than six weeks, your doctor may recommend surgery. Orthopedic doctors recommend surgery if your symptoms become extreme and chronic and if you experience weakness or muscle loss in your hand due to cubital tunnel syndrome.

Paget disease of bone is a degenerative disease of bone. It is a chronic bone disorder wherein bones deform and break down excessively. Though bones become enlarged, they become dense, fragile, and deform. Though it is a common disorder in older adults after age 50 or more, many people silently suffer from it. However, over the past several years Paget disease has become less common and less severe when it develops.

What are the signs and symptoms of Paget Disease of the bone?

• Bone and joint pain
• Bone Deformity
• Arthritis
• Risk for bone fractures
• In very rare cases, Paget disease may lead to bone cancer

If the disease affects the pelvis bone, it can cause hip pain. Paget disease of the spine can cause back pain, weakness, numbness, and tingling sensation in the arms or legs.

Enlarged or misshapen bones in the joints can cause extra pressure, force, and stress on hip and knee joints – leading to hip and knee arthritis.

Paget disease symptoms mimic the signs and symptoms of other orthopedic conditions. Talk to your orthopedic doctor for an accurate diagnosis of the condition.

What causes Paget disease of the bone?

Paget disease is mostly idiopathic. Experts are still unsure about the exact cause of Paget disease. However, genetics and environmental factors could play a role.

Diagnosis of Paget Disease of the Bone

Your orthopedic doctor evaluates your medical history and performs a physical examination based on your signs and symptoms – and may recommend the following tests:

X-ray

Bone Scanning – It is a nuclear scanning wherein a tracer material (radioactive) is injected into the blood. Next, scanning is done to detect the tracer material within the bones. Bone scanning test helps in detecting blood flow to the bone and cell activity.

Bone Biopsy – Doctors perform this procedure using a needle and sedation. Doctors also do bone biopsies by making small incisions. Bone biopsies help in determining the cause of bone disease.

Blood tests – Doctors check the levels of alkaline phosphatase in the bone. Increased activity of bone cells or bone growth increases its levels. The enzyme levels increase in Paget disease.

Treatment for Paget Disease of the Bone

Your orthopedic doctor comes out with the best treatment plan based on the medical history, overall health, sickness levels, the duration of your illness; your ability to bear specific procedures, medicines and therapies, and other such factors.

The treatment is aimed at strengthening your bones and muscles and slowing down the abnormal bone resorption. Your orthopedic doctor would recommend physiotherapy and prescribe medicines to manage pain and inflammation. The doctor may also prescribe bisphosphonates to slow down abnormal bone resorption. This is, in fact, the mainstay of treatment. To get relief from the symptoms due to abnormal growth of bones, your orthopedic doctor may recommend surgery to realign, cut or replace affected bone.