Successful treatment of osteomalacia is accomplished by mineralization of the soft bones matrix with light, dietary advice and supplements of vitamin D and calcium.
Sunlight (ultraviolet B light) in the treatment of osteomalacia (soft bones)The sunlight apart from containing visible light composes a broad band of invisible light and ultraviolet (UV) light is one of them.
Ultraviolet light is again divided into three types depending upon the wave length like UV-A, UV-B and UV-C.
The UV-A spectrum causes sun tan and sunburn. Long exposure to UV-C can cause skin cancer. UV-B is involved in the production of vitamin D in the skin and strengthening the soft bones.
The presence of UV-B is relative to the slant of the light. Greater the slant lesser are the UV-B rays present.
Exposure between 10am-2pm gives the maximum benefit of vitamin D synthesis and helps in osteomalacia treatment.
In places like north America, Canada, northern Europe, northern Asia and southern Australia the slant of the sunlight is greater especially in their winter.
People who are confined to homes or have indoor jobs and those with darker skin are very high risk groups in these areas and may become deficient in vitamin D and develop osteomalacia resulting in soft bones.
They should make every possible attempt to go out in the sun to prevent osteomalacia.
The exposure of face, arms and hands to 15-20 minutes of sunlight is sufficient to produce required vitamin D in fair skinned people and will help in prevention of osteomalacia.For people with darker skin require more exposure as the dark pigment melanin in their skin filters the sunlight.
Light-therapy (phototherapy) for osteomalaciaThe light treatment is given using lamps which give light near equal to sunlight for a specific period. Special bulbs and lamps are available in the market.
Alternatively UV-B radiating devices are also available with the sole purpose of vitamin D production in the skin.
Please take medical advice before using them in osteomalacia care due to the side-effects of the over-exposure.
Nutrition in osteomalaciaFood rich in cholecalciferol like fortified milk and cereals, egg, canned tuna and sardines, herring, mackerel and salmon are given during recuberation. Cod and its liver oil and liver are good sources of vitamin D. However it is doubtful whether adequacy levels of the nutrient can be reached through food sources only.
Vitamin D (cholecalciferol) supplements for OsteomalaciaDepending upon the condition, osteomalacia treatment includes oral or intra-muscular supplements of cholecalciferol and calcium. Phosphorus supplements may also be given.
During this period, supplements of cholecalciferol of strength 800-4000 IU/per day are given for 6 - 8 weeks.
Serum levels of calcium rises within 48 hours of the start of the treatment with cholecalciferol.
There will be marked improvement of the condition of the osteomalacia affected within a few days of starting of the treatment for soft bones (osteomalacia).
After 8 weeks the cholecalciferol dose may be reduced to the normal maintenance level of 400 IU/day and the condition of osteomalacia resolves.
If there is any absorption problem in osteomalacia affected, intra-muscular injections are given and excess vitamin D is stored by the body for future utilization. Sufficient calcium should be given during treatment.
During treatment regular blood tests may be done to keep track of the cholecalciferol in serum. Cholecalciferol in excess can cause hypercalcaemia, a condition in which the presence of excess calcium in the blood causing problems.
For the treatment of osteomalacia, efforts must be taken to prevent it by sufficient exposure of the body to sunlight and the inclusion of vitamin D rich food in our daily diet.