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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for osteoporosis

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Dr. Mahaveer Patil

Orthopaedic Surgeon

Practicing since :2002

Answered : 1209 Questions

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Posted on Fri, 3 Mar 2017 in Bones, Muscles and Joints
Question: my arm shoulder joints point at back or neck get stiffed often, I am diagnosed with osteoporosis, with T score -3, Z Score - 2.7.

Today again I have pain, from arm shoulder back to chest and at left arm, not able to move much and raise hand above head. Pls suggest.
doctor
Answered by Dr. Mahaveer Patil 24 minutes later
Brief Answer:
cervical slipped disc / neuroradiculopathy

Detailed Answer:
Hi Mr XXXXXXX

Thank you for posting the question.
I have gone through your medical history in detail.

From the history and symptoms that you have mentioned,it seems that you are suffering from a cervical slipped disc.

As the T score is very low,your vertebral bones are very weak.
This is causing increased pressure over the cervical discs.

Any minor jerk or trauma can cause the disc to prolapse backwards causing the spinal nerve to get compressed.This in turn causes pain in neck,shoulders arm and chest.

I would suggest you to get a Cervical spine MRI to confirm the diagnosis.

Once the diagnosis is confirmed, you need to start on physiotherapy,cervical traction,infra red / LASER therapy .

Soft cervical collar,application of local analgesic gel with hot fomentation will help.
Do not use pillow while sleeping.

Take analgesic muscle relaxants like aceclofenac / thiocolchicoside along with pregabalin and gabapentin.

I hope the answer was useful.

Feel free to ask me any follow up queries that you may have.

Thank you.
Kind regards.

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Mahaveer Patil 50 minutes later
Thanks Doctor for reply.
can u pls advise preventive action -
1. do's and don't and we can make this condition better?
2. can I do yoga back exercise or it can be fatel?
3. which exercise or tablets on daily basis can be good for long term?
Action as suggested by you, I am rewriting again with Query on short term
Long Term -
I would suggest you to get a Cervical spine MRI to confirm the diagnosis.
Once the diagnosis is confirmed, you need to start on physiotherapy,cervical traction,infra red / LASER therapy .
Short Term
Soft cervical collar,application of local analgesic gel with hot fomentation will help.
Do not use pillow while sleeping.
Take analgesic muscle relaxants like aceclofenac / thiocolchicoside along with pregabalin and gabapentin.
Query for short term plan
1. are these medicines like are these aceclofenac / thiocolchicoside along with pregabalin and gabapentin -
and how much and for how much period I would need to have these?

doctor
Answered by Dr. Mahaveer Patil 7 minutes later
Brief Answer:
Query answered

Detailed Answer:

Do's-Use cervical soft collar.
Do neck strengthening exercises that are done in yoga (rotations,flexion extension)

Dont's-Do not lift anything heavy.
Do not use pillow below the head while sleeping.

You can do yoga for back only if you do not get pain while doing it.
Its better if you do yoga after getting MRI done.

Aceclofenac/thiocolchicoside needs to be taken twice daily for 5-10 days,depending upon the pain factor. Stop these once the pain reduces significantly.

Pregabalin/gabapentin and calcium/vitamin D tablets should be taken once a day for 2-3 months
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Mahaveer Patil 22 minutes later
Thanks Doctor for quick and great advise.

Would request you if, u can prescribe some tablets/brands to purchase for Aceclofenac/thiocolchicoside and Pregabalin/gabapentin and calcium/vitamin D

Rgds
doctor
Answered by Dr. Mahaveer Patil 1 hour later
Brief Answer:
Query answered

Detailed Answer:
Some brand names- Aceclofenac/thiocolchicoside- Aceclo-MR,Acifact-MR

Pregabalin/gabapentin - Nervigen-P, Juven plus,Nervemax-OD

Calcium/vitamin D- Shelcal-CT,Calcimax

No need for drotin. Aceclofenac/thiocolchicoside will be enough.

Do let me know the results after completing 5 days of above medicines.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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