Recently, a patient with osteoporosis was admitted to the hospital. The patient was 74 years old, female, previously healthy, and had a sudden onset of pain in the thoracolumbar and pelvic girdle muscles six months ago. Recently, she had poor diet, dry stools, frequent nocturnal urination and poor sleep. Pain medication was ineffective. Imaging supported the diagnosis of osteoporosis, and bone metabolic examination suggested low ionized calcium and slightly abnormal renal function. We diagnosed osteoporosis. It was as if all the symptoms were well explained. Wang Dehui, Department of Integrative Chinese Medicine, The First Affiliated Hospital of Xinjiang Medical University, Changji Branch
So calcium supplementation, calcitonin administration, physiotherapy and herbal medicine were given. However, the condition was not controlled as we expected after three days. There was no improvement in muscle twitching, insignificant relief of pain symptoms, more frequent night urination, weakness, poor nausea and drowsiness. We must have made a mistake somewhere, and found that the patient’s muscle twitching was due to the tonic spasm of Parkinson’s disease, and the osteoporosis was a complication of renal insufficiency. Because of our medication, we aggravated the patient’s renal insufficiency. So we gave only benzhexol hydrochloride tablets orally for Parkinson’s disease, saw the patient on a low protein, high energy diet, and gave physical therapy to improve circulation for pain relief, and the patient’s condition improved significantly after twenty days. The pain symptoms were significantly reduced, muscle twitching was relieved, and the poor nausea, nocturia, drowsiness and fatigue were relieved.
We actually made the empirical mistake of thinking of osteoporosis first as soon as we looked at an elderly person, a woman, imaging suggestive of osteoporosis, and extensive pain in the spine and pelvic girdle muscles. But for someone who has previously complained of good health, has not had any recent fractures, and has not used medications associated with osteoporosis that can cause osteoporosis. So why do only a few of the many elderly people suffer from osteoporosis?
I think it must be related to abnormal changes in the function of certain systems of the patient’s body, such as thyroid function and kidney function. For elderly people with chronic pain disorders, many of them have the experience of taking painkillers for a long time, which may be the reason why these painkillers seriously damage the kidney function of the patients and eventually lead to abnormal bone metabolism and nutrition, resulting in the manifestation of osteoporosis. This is also similar to the view of Chinese medicine that “the kidney is the master of bone”. Therefore, for each patient with osteoporosis, we should pay attention to the changes in the kidney function of the patient, and not to blindly use drugs.