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Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed(1).
Types of Musculo-Skeletal disorders in elder(2)
1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia
The Treatment
B. In herbal and traditional Chinese medicine perspective
B.3. The Preventive Minerals and Vitamins
1. Minerals for osteoarthritis
Certain minerals such as calcium(316)(317), magnesium, selenium, zinc, and iron; may be a good sources of pain reliever for patient with osteoarthritis, according to the studies(325). According to the randomized to four double-blinded treatments for 12 weeks by Minnesota Applied Research Center, Glucosamine sulfate (1500 mg/d), Aquamin (2400 mg/d) and Combined treatment composed of Glucosamine sulfate (1500 mg/d) have shown effectively in improvements in symptoms of pain and stiffness of osteoarthritis(315).
1.1. Calcium
The osteoporosis association of Canada recommended at 3 serving of milk and alternative serving of yogurt, cheese, calcium-fortified beverages, puddings, custards, etc for 50 plus elder(318). In deed, as we get older the function of replacement of osteoclasts in any areas of damaged or weakened bone are slower due to reduced process of bone remodelling(319) of which may involve the utilization of body in calcium aborption(319).
1.2. Magnesium
According to the study by Central South University,dietary magnesium (Mg) of elder patients is associated to reduce risk of radiographic knee osteoarthritis (OA), joint space narrowing (JSN)(320), especially in white population(321).
According to joint study lead by Dr. Zeng C, Serum Magnesium Concentration is found to be deficient in patient with osteoarthritis(322). In deed, patient with osteoarthritis is found to have a decreased bone levels of Mg, in comparison of radiographic bone density and bone mineral density (BMD) in patient with Musculoskeletal disorders (MSDs)(323),
1.3. Selenium
In male STR/1N mice model, dietary selenium and other vitamins not only is found to have an decreased risk of osteoartritis, OA, but also play an important role in prevention or therapy of mechanically induced OA(324). In deed, according to the joint study by College of Medicine of Xi'an Jiaotong University, alterations in selenium metabolism and apoptosis due to inability of MYC mediated metabolism and apoptosis signaling pathway may contribute to the pathogenesis of KBD, a special type of endemic osteoarthritis(326). Patient with osteoarthritis is found to have a low level of selenium in comparison to osteopororsis(323).
1.4. Zinc
Zinc may plays an important role for the development of osteoarthritis, according to Randers Regional Hospital, patient with osteoarthritis are found to have significantly higher serum zinc concentrations and lower urine zinc concentrations in comparison to patient with osteoporosis(327).
High level of zinc in patient with osteoarthritis may be a influence of bone turnover and femoral head bone density and biomechanical properties(328).
In the inflammatory effects, according to the Harran University, plasma trace element concentrations do not exhibit change in immunoregulatory cytokines in OA patient(329).
1.5. Copper
Used topical Copper-salicylate gel has shown to relief pain for patients with the hip or knee osteoarthritis with side effects of more skin rashes(330). Other topical Cu-Indo gel has shown effectively against joint inflammation in the MIA-treated rat model of osteoarthritis(332).
In a comparison of caeruloplasmin-bound copper in serum copper levels in 49 patients with active rheumatoid arthritis, in 33 patients with osteoarthritis, research found that caeruloplasmin-bound and non-caeruloplasmin bound are both elevate in serum copper levels in the rheumatoid group, as compared to patient with osteoarthritis(331).
1.5. Iron
Reduced intake of rich iron dietary foods and supplements may be necessary for patient with with osteoarthritis and rheumatoid arthritis, according to studies, synovial iron deposition is found to associate to patient with osteoarthritis and rheumatoid arthritis(334). Hereditary hemochromatosis (HH), a hereditary disease cause of excessive intestinal absorption of dietary iron, may have a contribution to the synovial iron overload in induction of the progression of HH-related OA(333).
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(317) Calcium and vitamin D nutrition and bone disease of the elderly by Gennari C1.(PubMed)
(318) Calcium: An Important Nutrient that Builds Stronger Bones(Osteoarthritis Canada)
(319) Bone Health and Osteoporosis: A Report of the Surgeon General(NCBI)
(320) Association between Dietary Magnesium Intake and Radiographic Knee Osteoarthritis. by Zeng C1, Li H1, Wei J2, Yang T1, Deng ZH1, Yang Y1, Zhang Y1, Yang TB2, Lei GH1(PubMed)
(321) Association of dietary magnesium intake with radiographic knee osteoarthritis: results from a population-based study by Qin B1, Shi X, Samai PS, Renner JB, Jordan JM, He K.(PubMed)
(322) Relationship between Serum Magnesium Concentration and Radiographic Knee Osteoarthritis. by Zeng C1, Wei J1, Li H1, Yang T1, Zhang FJ1, Pan D1, Xiao YB1, Yang TB1, Lei GH2.(PubMed)
(323) Comparison of bone tissue trace-element concentrations and mineral density in osteoporotic femoral neck fractures and osteoarthritis by Karaaslan F1, Mutlu M2, Mermerkaya MU1, Karaoğlu S3, Saçmaci Ş4, Kartal Ş4.(PubMed)
(324) Dietary vitamins and selenium diminish the development of mechanically induced osteoarthritis and increase the expression of antioxidative enzymes in the knee joint of STR/1N mice by Kurz B1, Jost B, Schünke M.(PubMed)
(325) Synovial fluid and plasma selenium, copper, zinc, and iron concentrations in patients with rheumatoid arthritis and osteoarthritis by Yazar M1, Sarban S, Kocyigit A, Isikan UE.(PubMed)
(326) Expression profiles of genes involved in apoptosis and selenium metabolism in articular cartilage of patients with Kashin-Beck osteoarthritis by Wu SX1, Wang WZ2, Zhang F3, Wu CY3, Dennis BS3, Qu CJ4, Bai YD5, Guo X6.(PubMed)
(327) Differences in zinc status between patients with osteoarthritis and osteoporosis by Ovesen J1, Møller-Madsen B, Nielsen PT, Christensen PH, Simonsen O, Hoeck HC, Laursen MB, Thomsen JS.(PubMed)
(328) Differences in zinc status, bone turnover and femoral head bone density and biomechanical properties between patients with osteoarthritis and osteoporosis by Thomsen JS1, Nielsen PT, Christensen PH, Simonsen O, Hoeck HC, Laursen MB, Møller-Madsen B, Ovesen J.(PubMed)
(329) Synovial fluid and plasma selenium, copper, zinc, and iron concentrations in patients with rheumatoid arthritis and osteoarthritis by Yazar M1, Sarban S, Kocyigit A, Isikan UE.
(330) Copper-salicylate gel for pain relief in osteoarthritis: a randomised controlled trial.
Shackel NA1, Day RO, Kellett B, Brooks PM.(PubMed)
(331) Serum copper and zinc in rheumatoid arthritis and osteoarthritis by Grennan DM, Knudson JM, Dunckley J, MacKinnon MJ, Myers DB, Palmer DG.(PubMed)
(332) Effect of a topical copper indomethacin gel on inflammatory parameters in a rat model of osteoarthritis by Yassin NZ1, El-Shenawy SM1, Abdel-Rahman RF1, Yakoot M2, Hassan M3, Helmy S4.(PubMed)
(333) Iron overload in a murine model of hereditary hemochromatosis is associated with accelerated progression ofosteoarthritis under mechanical stress by Camacho A1, Simão M2, Ea HK3, Cohen-Solal M3, Richette P3, Branco J4, Cancela ML5.(PubMed)
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