Diseases of the musculoskeletal system appear at any age. In children, this is a congenital pathology associated with heredity. In adults – consequences of injuries, inflammatory diseases. In older people, dystrophic and degenerative processes predominate due to age-related deterioration of blood supply. Their bone tissue is more fragile, so long-term recovery is necessary after fractures. Muscles must be constantly dosed to maintain normal tone.
If you are over 50...
If you are over 50 years old, experience minor back pain, and are concerned about your health, you should be screened for osteoporosis. First, briefly: what is osteoporosis? Osteoporosis is a body condition in which bones lose calcium and become brittle and less dense. As a result, at the slightest injury they are easily deformed or broken. Why is this happening? The most common myth is that osteoporosis develops in people who get little calcium from their diet. In fact, you can eat calcium day and night and achieve nothing except disruption of salt metabolism and the possible formation of kidney stones. Osteoporosis is a disease in which calcium is poorly absorbed by the bones or is “washed out” of them, even if there is an excess of it in food. This could be due to several important reasons.
Myeloma treatment
The fight against myeloma is a complex task that requires the participation of many doctors of various specialties: oncologist, chemotherapy, neurologist, urologist and others. The more information about the state of the body and the course of the disease they receive from each other, the more factors they are able to take into account.
The oncology department provides complete diagnosis and any treatment for myeloma. We consider each case individually - all our patients receive therapy prescribed by the decision of a council of doctors, candidates and doctors of medical sciences with extensive experience. This approach allows us to select the best options for influencing altered cells and causing minimal harm to healthy tissues. We use only the most modern equipment and original drugs that give predictable results. With us you don’t have to waste time - examination and treatment are carried out with us without queues or delays, just on time.
Doctors use several methods to treat myeloma:
Drug therapy
Chemotherapy
is the destruction or prevention of the growth of altered cells using special drugs.
These include: Cyclophosphamide, Etoposide, Doxorubicin, Melphalan and Bendamustine. They enter the bloodstream and reach almost all areas of the case, affecting any foci of the disease. Corticosteroids
, powerful anti-inflammatory drugs such as Dexamethasone and Prednisolone, are an important part of therapy.
They can be used alone or in combination with other medications. Immunomodulators
are substances that affect a person’s own immune system and help it fight the disease: Lenalidomide and Pomalidomide.
Proteasome inhibitors
- prevent the breakdown of proteins necessary for cell division: Bortezomib, Carfilzomib and Ixazomib.
Histone deacetylase inhibitors
, such as Panobinostat, affect the activity of certain genes in cells.
Monoclonal antibodies
:
substances artificially designed to attack a specific target—for example, proteins on the surface of myeloma cells. These include Daratumumab and Elotuzumab. Bisphosphonates
are medications that slow down the weakening of bones and reduce pain in them: Pamidronate. Zoledronic acid and Denosumab.
Stem cell transplantation
– a bone marrow transplant, whose cells can become red blood cells that carry oxygen throughout the body, white blood cells that help fight infections, and platelets that stop bleeding. First, the patient is given high-dose chemotherapy, which destroys the damaged bone marrow, after which new, healthy hematopoietic cells are injected. Transplantation can be autologous - using pre-collected own material, or allogeneic - using cells from another person - a donor.
Radiation therapy
: destruction of foci of disease using radiation is one of the most suitable options for combating single plasmacytomas. Plasmacytoma is a tumor consisting of altered plasmacytes - cells that produce antibodies - proteins that protect the body from bacteria and viruses.. It is used to treat areas of bones damaged by myeloma that have not responded to chemotherapy or other drugs are painful or may break down.
IVIG
maintenance therapy is the intravenous administration of normal antibodies - immunoglobulin proteins necessary to fight infection.
Erythropoietin
is a drug that increases the number of red blood cells that carry oxygen from the lungs to other tissues.
Plasmapheresis
is a procedure that removes myeloma proteins and reduces blood viscosity.
7th course of chemotherapy for a rare disease - myeloma.
The “culprits” of osteoporosis:
- Gender and complexion
Bone density depends on the amount of certain hormones in the body, primarily on sex hormones. In a man’s body, the amount of testosterone is greater than in a woman’s, which is why men’s bones are initially thicker and stronger than women’s. This is why men suffer much less from the effects of osteoporosis. A person’s complexion largely depends on hormonal levels and metabolic levels. Tall and thin, “thin-boned” people are more susceptible to osteoporosis than people with a dense build and short stature. With the onset of menopause in women, the level of sex hormones in the body significantly decreases, as a result of which osteoporosis begins to progress quite quickly. After menopause, approximately half of women lose 1-2% of bone mass per year. The “artificial menopause” caused by bilateral ovarian removal operations also affects bone density in the same way. - Sedentary lifestyle.
If a person is deprived of mobility for a year, during this time the skeleton will lose 50% (!) of its strength. Movement is a factor that determines bone strength. It is precisely because of the lack of physical activity in our age that signs of osteoporosis can be found in an increasing number of people. - Chronic diseases.
Diseases that contribute to the development of osteoporosis can be listed for a long time - these are diabetes mellitus, diseases of the thyroid and parathyroid glands, chronic renal or liver failure, malabsorption syndrome in the intestines... Also, a high risk of developing osteoporosis occurs in patients suffering from bronchial asthma and rheumatoid arthritis ( while taking glucocorticoids), as well as in people taking anticonvulsants, diuretics and anticoagulants for a long time. - Lack of vitamin D.
Vitamin D is synthesized in the human body independently, under the influence of sunlight, or enters the body with foods such as fish oil, butter, eggs, liver and milk. Vitamin D is involved in the regulation of calcium absorption in the intestine and the mechanism of bone tissue formation. Accordingly, a lack of sunlight or a lack of the above foods in the diet increases the risk of developing osteoporosis. - A glass of wine and a cigarette.
Studies conducted in recent years have clearly established a trend towards decreased bone mass in people who regularly drink alcohol compared to non-drinkers, and equally in both women and men. Unlike alcohol, smoking affects women to a greater extent—women who smoke have lower concentrations of sex hormones in the blood and experience menopause earlier. All this leads to faster bone loss.
Summarizing the conversation about the causes of osteoporosis, with some degree of irony, we can draw up a portrait of the “ideal” candidate for the development of the disease: “A tall, thin woman over 50 years old, leading a sedentary lifestyle, living in the northern regions, drinking heavily and smoking two packs cigarettes a day instead of breakfast.”
Diagnostics
To identify such pathologies, radiation diagnostic methods are primarily used: X-ray, CT and MRI. “If there is already suppuration with the formation of liquid pus, it can be detected using ultrasound. Various laboratory research methods are also used, including microbiological studies to determine microorganisms that are the direct causative agents of the disease,” says Evgeniy Peretsmanas.
Article on the topic
Fragile bones of the stronger sex. How a man can avoid osteoporosis People at risk should be especially wary of such problems. Today it includes people with diabetes, various chronic diseases, and HIV infection. “The cause of hematogenous introduction of infection into the osteoarticular system can be dental diseases, including carious processes in teeth, pathology of the ENT organs,” notes the specialist.
Of course, it is preferable not to wait until treatment is needed, but to engage in prevention. It should be understood that there is no specific prevention of infectious pathologies of the skeleton, the doctor notes. To maintain health, it is necessary to promptly and fully treat infectious diseases and sanitize foci of chronic infection. It is important to avoid injuries and receive qualified assistance in a timely manner in case of injuries (cuts, wounds, fractures).
Fractures happen unexpectedly, osteoporosis creeps up unnoticed
Having talked about the causes of osteoporosis, it is necessary to understand the forms of its manifestation. The main mistake of many doctors lies in the fact that they often mistake symptoms of other diseases for manifestations of osteoporosis. In reality, osteoporosis manifests itself with minor symptoms with an almost complete absence of complaints; very often the disease is detected only in the presence of fractures. This feature of the disease has given scientists reason to call osteoporosis a “silent epidemic.” Of course, with osteoporosis, there are back pains, but these are aching pains of “fatigue” that arise only after a relatively long (more than 30 minutes) stay in one static position - standing or sitting. Other indirect signs of the disease include senile stoop (hunchback), night leg cramps, increased fatigue, periodontal disease, brittle nails and premature graying. And although the presence of these symptoms is not a 100% confirmation of the diagnosis, it still allows us to determine the range of studies necessary to clarify it.
How to search?
The most objective result in cases of suspected osteoporosis can be obtained by examining a special device for measuring bone density - a densitometer. Densitometry allows you to determine bone density with an error of only 1-5%. The lower the bone density, the more X-rays pass through the bone and reach the measuring device. Radiation exposure with this research method is minimal - tens of times lower than with conventional radiography. And one more study that will need to be done to select a group of medications is a biochemical blood test, which pays attention to the content of calcium, phosphorus and alkaline phosphatase in the blood.
Gymnastics is the best helper!
Many methods are used to combat osteoporosis; they can be conditionally divided into two completely compatible and complementary groups: medications and a healthy lifestyle, which here means reasonable physical activity (gymnastics), dosed sun exposure and massage treatments. For example, with regular gymnastics 3-4 times a week for 30-40 minutes, you can achieve an increase in bone mass by 3-5% within the first months. In this case, of course, it is advisable that a specialist select a set of gymnastic exercises taking into account your characteristics and capabilities. Massage procedures enhance the effect of gymnastic exercises, allowing you to improve blood circulation and “pumping” of the back muscles: manual and vacuum massage are especially good in this sense. However, care must be taken and the procedures must be done very gently to avoid injury to the bones.
How are diseases of the musculoskeletal system treated?
Treatment of the musculoskeletal system can be:
- surgical;
- conservative;
- restorative.
To treat the musculoskeletal system, orthopedic fixation and traction devices are used. The rest period is provided by specialized knitting needles, plaster splints, bandages, and orthoses. To restore the full range of motion after acute phenomena have subsided or a fracture has healed, massage techniques, physical therapy, physiotherapy, laser exposure, and exercises in water are used.
After complex treatment, the musculoskeletal system becomes more trained, strong muscles protect the skeletal system from injury.
Key word - "calcium"
The strength of bones is affected not so much by the absolute amount of calcium in food, but by the ratio of calcium and phosphorus in the diet: the amount of calcium should be one and a half to two times the amount of phosphorus. In addition, for complete absorption of calcium, the diet must also contain magnesium, boron, copper, manganese, zinc, vitamins B6, C, K and folic acid, as well as certain proteins and fats that promote the absorption of vitamin D. A properly formulated diet containing all necessary components can seriously reduce the threat of osteoporosis.
Stages of multiple myeloma
Stage 1 - characterized by mild anemia, calcium remains within normal values, M-protein is low, the number of bone lesions is no more than 5.
Stage 2. Moderate anemia (hemoglobin within 85-100 g/l), there is an increase in calcium (up to 3 mmol/l) and M-protein. There is also an increase in the number of osteolysis foci. For the second stage, their number should not exceed 20.
Stage 3 multiple myeloma is diagnosed when at least 1 of the following symptoms is detected:
- Hemoglobin is below 85 g/l, which corresponds to severe anemia.
- Exceeding the calcium value by more than 3 mmol/l.
- M-protein level is more than 70 g/l.
- The number of bone lesions is more than 30.
What should be on the table
The menu of a person predisposed to osteoporosis should include the following products: Milk and dairy products (preferably low-fat). They have an optimal ratio of calcium and phosphorus. In addition, fat makes it difficult to absorb calcium, so low-fat dairy products are preferable. Fresh vegetables and fruits, especially all types of cabbage (white cabbage, broccoli, cauliflower), carrots, turnips. In addition to calcium, they contain the entire “support group” of microelements necessary for the full absorption of calcium. Legumes, walnuts, pumpkin and sunflower seeds, and vegetable oils contain proteins and fats necessary to strengthen bone tissue and absorb vitamin D.
Calcium stealers
Products that impair the absorption of calcium or contribute to its “leaching” from the body: Sugar, honey, wheat flour products (pasta, white bread), coffee, tea. All refined foods and caffeine interfere with the absorption of calcium in the intestines. Factory-made meat products (natural meat does not affect the absorption of calcium). Excess salt. Displaces calcium from the body, which is lost along with urine. Just one extra teaspoon of salt per day can cause bone mass to decrease by 1.5 percent per year.
Sunshine on the menu
In winter and spring, the rate of development of osteoporosis accelerates, because calcium alone is not enough for the process of building bone tissue (although this is a very important “building material”), vitamin D is also needed, but it is formed in the body only under the influence of sunlight. And the spring sun of the middle zone is still timid and does not appear for long, and precisely during those hours that we spend at work, indoors. Even if you manage to spend time in the fresh air during the day, only your face is exposed to the sun’s rays, and even then it is often covered with a protective cream to avoid the appearance of freckles. And during the “dark” months of winter, the calcium reserves in the body were depleted: after all, it was poorly absorbed without the sun, and was used up with the same intensity. At this time, a solarium can help out, as it will stimulate the formation of vitamin D in the body. To prevent osteoporosis, two visits per month are sufficient.
Osteoporosis. Don't give him a single chance!
Drug therapy for osteoporosis has reached a fairly high level in recent years thanks to the efforts of pharmacological companies conducting active research in this area. The choice of drugs is so large that the length of the article does not allow us to talk about all the drugs, but one of them, nevertheless, is worth mentioning - Miacalcic nasal aerosol. Systematic use of this drug prevents bone destruction, increases bone density and reduces the risk of fractures. As mentioned above, calcium supplements for osteoporosis do not always need to be taken. First of all, it is necessary to take medications that help this calcium to be absorbed or suppress the process of removing calcium from the bones. The development of new drugs to combat osteoporosis is ongoing, new drugs regularly appear on the pharmacological market, but, nevertheless, nothing can replace a healthy, active lifestyle, proper nutrition and exercise. So, if you are over 50, have minor back pain and are predisposed to developing osteoporosis, do not delay visiting your doctor, take care of your health in advance. By contacting our Center, you can always count on a consultation with a highly qualified orthopedic traumatologist, the necessary research and competent treatment for osteoporosis. Say no to osteoporosis!
Cause of myeloma
Doctors and scientists do not know the exact reasons for its occurrence - they only know factors that increase the likelihood of this event:
- The older the person, the higher his risks - in most cases, the disease is detected in people at least 65 years of age. It can also develop in young people, but it is quite rare - in less than 1% of all cases it is detected before the age of 35. The average age
of patients is 66-70 years. - Genetics
. Having blood relatives with myeloma - parents, children, brothers or sisters - increases the chances of similar tumors developing in their family members. - Similar factors include gender
- the chances of this type of cancer occurring in men are slightly higher than in women. To date, the reasons for this difference are not known to doctors. - Obesity
. People who are overweight are at increased risk of developing certain types of dangerous tumors, including myeloma, pancreatic, prostate, kidney, gallbladder, colon, endometrial, esophageal, ovarian, cervical and breast cancer. The higher a person's body mass index is, body mass index is equal to weight in kilograms divided by the square of height in meters. BMI = kg/m2., the more likely he is to develop a dangerous neoplasm. Obesity leads to increased inflammation in the body, causes blood vessels to grow, and also changes the levels of various hormones that can promote the proliferation of altered cells. - Race
: Black people are twice as likely to have myeloma than other races. - In fairly rare cases, the likelihood of developing cancer increases due to exposure to X-rays or other types of radiation
.
Having other plasma cell diseases also increases your risks. These include:
- Monoclonal gammopathy of unknown origin is the presence of abnormal plasma cells in the bone marrow that produce an abnormal protein. It disrupts the functioning of various tissues and systems, such as the kidneys. People with this condition often have no symptoms, but in some cases it can develop into myeloma.
- Solitary plasmacytoma is a tumor consisting of altered plasma cells, located either in the bone or in other organs, for example, in the digestive system or respiratory tract. Approximately 65-84% of its cases degenerate into oncology within 10 years.