A Critical Review On Mechanism Of Herbal Drugs Cissus Quadrangularis, Mimosa Pudia And Boswellia Serrata In Bone Healing For Osteoporosis (Asthikshaya) And Bone Fracture And Pain

Abstract

- Osteoporosis, a silent epidemic has become a major health hazard in recent years. Osteoporosis which increases bone
fragility and thereby the risk of fractures is associated with high mortality, morbidity and high medical expenses
throughout the world. “It is a progressive systemic skeletal disorder characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture.”(1)
Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses such as bending over
or coughing can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine.World
Health Organization (WHO) defines osteoporosis as bone density (BD) that is 2.5 Standard Deviation (SD ) or more
below the young adult mean value (T score < - 2.5). Bone density decreases with age as the fracture risk rises rapidly.
Every 1 SD decrease in BMD increases fracture risk two to three fold.(2) Osteoporosis is second only to cardiovascular
disease as a leading health care problem, according to the World Health Organization.(3) It is now considered as major
health care problem in India with an estimated 50 % of healthy women and 36% men over 50 years of age having low
bone mass. Occurrence of osteoporosis is 10 years earlier in Indian people than in the West.(4) It currently affects
approximately one in three women and one in five men over age 50. Because of related morbidity and disability,
diminished quality of life and mortality, osteoporosis and fractures associated with it are major public health concern.
India seems to have the highest prevalence of osteoporosis and osteopenia.
- The most important supportive framework of the body among these is Asthi (Bone tissue). The branch of surgery that
deals with deformities of the bones is known as Orthopedics. Asthikshaya (Osteoporosis) is degenerative changes where
depletion of Asthidhatu is seen. Defining feature of Osteoporosis (Asthikshaya) is reduced bone density which causes
micro architectural deterioration of bone tissue and leads to an increased risk of fracture. By Ashrayashrayibhaava- Vata
dosha and Asthi Dhatu is inversely proportional to each other. Vata vruddhi causes Asthikshaya. Trauma management
has been in practice since Vedic periods. Also, the use of plants for medical purposes for their therapeutic properties has
been in vogue since pre-historic times. In India and worldwide, use of herbal ingredients has a long tradition. The
indigenous medicinal systems such as Ayurveda, Siddha and Unani are followed even today as a part of curing many
ailments without any side effect (Smet et al., 1992a).The Ayurvedic medicinal plants have been a source of so many
potential drug candidates for several disease conditions and most importantly for chronic disorders. In Ayurveda many
of drugs and formulations were described for management of osteoporosis, fracture and pain; among them for the
fracture the Asthishrunkhala is one of the drugs widely used as single or in various compound formulations. Also there
are many drugs which are mentioned as Asthiposhak. But we selected Asthishrinkhala, lajjalu and shallaki as it is
Asthiposhak, Balya and Analgesics.
- The purpose of this article is to concentrate in herbal medicines for bone healing in osteoporosis and fractures.