What are the primary causes of bone loss. How does aging affect bone density. Which lifestyle factors contribute to weakening bones. Can certain medical conditions lead to osteoporosis. What treatments may increase the risk of bone decay. How can bone loss be prevented or managed effectively.

Understanding Bone Loss and Its Impact on Health

Bone loss, also known as osteoporosis, is a condition characterized by the weakening of bones, making them more susceptible to fractures. This occurs when the body fails to maintain a balance between new bone formation and old bone resorption. As a result, bones become brittle and fragile, increasing the risk of fractures even from minor accidents or everyday activities.

The severity of bone loss is determined by bone density, which refers to the amount of calcified bone tissue present. A diagnosis of osteoporosis indicates a significant reduction in bone density, putting individuals at heightened risk for fractures.

Key Facts About Bone Health

• The human skeleton is completely replaced approximately every 10 years
• Bone remodeling slows down with age
• Healthy bones require a balance between new bone formation and old bone resorption
• Bone loss occurs when old bone is reabsorbed faster than new bone is created

The Role of Aging in Bone Loss

As we age, our bodies undergo various changes that can affect bone health. One significant factor is the tendency for the body to reabsorb calcium and phosphate from bones rather than retaining these essential minerals. This process gradually weakens the bones, potentially leading to osteoporosis if left unchecked.

Do age-related hormonal changes contribute to bone loss? Indeed, they play a crucial role. For women, the drop in estrogen levels during menopause is a major contributor to bone loss. Men experience a similar effect due to declining testosterone levels as they age, albeit typically at a slower rate.

Age-Related Risk Factors for Osteoporosis

• Women over 50 years old
• Men over 70 years old
• Postmenopausal women
• Men with declining testosterone levels

Lifestyle Factors Influencing Bone Health

Our daily habits and lifestyle choices can significantly impact bone health. Nutrition, physical activity, and certain behaviors all play crucial roles in maintaining strong bones throughout life.

Nutritional Factors

Calcium and vitamin D are essential nutrients for bone health. How do they contribute to bone strength? Calcium is a primary building block of bone tissue, while vitamin D aids in calcium absorption and bone formation. Insufficient intake or absorption of these nutrients can lead to weakened bones.

Exercise and Physical Activity

Regular weight-bearing and resistance exercises are vital for maintaining bone mass and strength. These activities stimulate bone formation and help prevent bone loss. Conversely, a sedentary lifestyle can accelerate bone deterioration.

Harmful Habits

Certain lifestyle choices can negatively affect bone health:

• Excessive alcohol consumption: Can damage bones and increase the risk of falls and fractures
• Smoking: Weakens bones in both men and women, with an even higher risk for postmenopausal women
• Low body weight: Associated with reduced bone mass and weaker bones

Medical Conditions Associated with Bone Loss

Various medical conditions can contribute to bone loss, either directly or indirectly. Understanding these connections is crucial for identifying individuals at higher risk and implementing appropriate preventive measures.

Chronic Conditions Affecting Mobility

Long-term medical conditions that limit mobility can lead to bone loss. How does immobility affect bone health? When bones and muscles are not regularly used or bearing weight, it can result in decreased bone density and increased fracture risk. This is particularly true for conditions that confine individuals to bed or a chair for extended periods.

Endocrine and Metabolic Disorders

Several endocrine and metabolic conditions can impact bone health:

• Hyperthyroidism
• Hyperparathyroidism
• Cushing syndrome
• Type 1 diabetes

These conditions can interfere with normal bone metabolism, leading to accelerated bone loss or impaired bone formation.

Gastrointestinal and Nutritional Disorders

Conditions that affect nutrient absorption can indirectly lead to bone loss. Examples include:

• Celiac disease
• Inflammatory bowel disease
• Cystic fibrosis
• Eating disorders (anorexia nervosa, bulimia)

These disorders can impair the absorption of calcium, vitamin D, and other nutrients essential for bone health.

Medications and Treatments That May Contribute to Bone Loss

While many medications are essential for treating various health conditions, some can have unintended effects on bone health. It’s important to be aware of these potential side effects and discuss them with healthcare providers.

Hormone-Related Treatments

Certain hormone-blocking treatments used in cancer therapy can lead to bone loss:

• Treatments for prostate cancer
• Treatments for breast cancer

These medications can disrupt the hormonal balance necessary for maintaining bone density.

Glucocorticoids (Steroids)

Long-term use of glucocorticoids, particularly when taken orally, can significantly impact bone health. How do steroids affect bones? They can interfere with bone formation, increase bone resorption, and impair calcium absorption, leading to accelerated bone loss.

Other Medications

Additional medications that may contribute to bone loss include:

• Some anti-seizure medications
• Certain antidepressants
• Proton pump inhibitors (used for acid reflux)

It’s crucial to discuss the potential bone-related side effects of any long-term medication use with a healthcare provider.

Preventive Measures and Management Strategies

While some risk factors for bone loss are beyond our control, there are numerous steps we can take to maintain bone health and prevent or manage osteoporosis.

Nutrition and Supplementation

Ensuring adequate intake of bone-supporting nutrients is crucial:

• Calcium-rich foods (dairy products, leafy greens, fortified foods)
• Vitamin D sources (sunlight exposure, fatty fish, fortified foods)
• Supplements when dietary intake is insufficient

How much calcium and vitamin D do we need daily? The recommended daily intake varies by age and gender, but generally, adults need 1000-1200 mg of calcium and 600-800 IU of vitamin D per day.

Exercise and Physical Activity

Regular exercise is essential for maintaining bone strength:

• Weight-bearing exercises (walking, jogging, dancing)
• Resistance training (weightlifting, bodyweight exercises)
• Balance and flexibility exercises to reduce fall risk

Aim for at least 30 minutes of moderate exercise most days of the week.

Lifestyle Modifications

Making positive lifestyle changes can significantly impact bone health:

• Quitting smoking
• Limiting alcohol consumption
• Maintaining a healthy body weight

Regular Health Screenings

Bone density scans and regular check-ups can help detect bone loss early:

• Dual-energy X-ray absorptiometry (DXA) scans
• Blood tests to check calcium and vitamin D levels
• Assessment of fall risk and overall bone health

Advanced Treatments and Interventions

For individuals diagnosed with osteoporosis or at high risk of fractures, various medical interventions are available:

Pharmacological Treatments

Several medications can help prevent further bone loss or promote bone formation:

• Bisphosphonates
• Selective estrogen receptor modulators (SERMs)
• Hormone replacement therapy (in some cases)
• Parathyroid hormone analogs
• RANK ligand inhibitors

How do these medications work? They either slow down bone resorption or stimulate new bone formation, helping to maintain or improve bone density.

Surgical Interventions

In severe cases or after fractures, surgical procedures may be necessary:

• Vertebroplasty and kyphoplasty for spinal fractures
• Joint replacement surgeries
• Fracture repair procedures

Rehabilitation and Physical Therapy

After fractures or as part of a comprehensive treatment plan, rehabilitation plays a crucial role:

• Strengthening exercises
• Gait and balance training
• Pain management techniques
• Assistive device training

The Future of Bone Loss Prevention and Treatment

As our understanding of bone biology and osteoporosis continues to evolve, new approaches to prevention and treatment are emerging:

Emerging Therapies

Researchers are exploring innovative treatments for bone loss:

• Gene therapies targeting bone metabolism
• Stem cell treatments to promote bone regeneration
• Novel drug delivery systems for improved efficacy

Personalized Medicine

Advancements in genetic testing and biomarker analysis are paving the way for more personalized approaches to bone health:

• Genetic risk assessment for osteoporosis
• Tailored prevention strategies based on individual risk factors
• Precision medicine approaches for treatment selection

Technology and Monitoring

New technologies are enhancing our ability to monitor bone health and prevent fractures:

• Wearable devices for fall detection and prevention
• Advanced imaging techniques for early detection of bone loss
• Artificial intelligence-assisted fracture risk assessment

How will these advancements impact bone health management? They promise to provide more accurate risk assessment, earlier intervention, and more effective, personalized treatment strategies.

In conclusion, bone loss is a complex issue influenced by various factors including age, lifestyle, medical conditions, and medications. By understanding these factors and implementing appropriate preventive measures and treatments, individuals can maintain strong, healthy bones throughout their lives. As research continues to advance, we can look forward to even more effective strategies for preventing and managing bone loss in the future.

What causes bone loss? | UF Health, University of Florida Health

Description

Osteoporosis, or weak bones, is a disease that causes bones to become brittle and more likely to fracture (break). With osteoporosis, the bones lose density. Bone density is the amount of calcified bone tissue that is in your bones.

A diagnosis of osteoporosis means you are at risk for bone fractures even with everyday activities or minor accidents or falls.

Video: Osteoporosis

Alternative Names

Osteoporosis – causes; Low bone density – causes

Your Changing Bones

Your body needs the minerals calcium and phosphate to make and keep healthy bones.

• During your life, your body continues to both reabsorb old bone and create new bone. Your entire skeleton is replaced about every 10 years, though this process slows as you get older.
• As long as your body has a good balance of new and old bone, your bones stay healthy and strong.
• Bone loss occurs when more old bone is reabsorbed than new bone is created.

Sometimes bone loss occurs without any known cause. Some bone loss with aging is normal for everyone. Other times, bone loss and thin bones run in families and the disease is inherited. In general, white, older women are the most likely to have bone loss. This increases their risk of breaking a bone.

Brittle, fragile bones can be caused by anything that makes your body destroy too much bone, or keeps your body from making enough bone.

Weak bones can break easily, even without an obvious injury.

Bone mineral density is not the only predictor of how fragile your bones are. There are other unknown factors related to bone quality that are as important as bone quantity. Most bone density tests only measure the bone quantity.

Aging and Bone Loss

As you age, your body may reabsorb calcium and phosphate from your bones instead of keeping these minerals in your bones. This makes your bones weaker. When this process reaches a certain stage, it is called osteoporosis.

Many times, a person will fracture a bone before they even know they have bone loss. By the time a fracture occurs, the bone loss is serious.

Women over age 50 years and men over age 70 years have a higher risk for osteoporosis than younger women and men.

• For women, a drop in estrogen at the time of menopause is a major cause of bone loss.
• For men, a drop in testosterone as they age can cause bone loss.

What’s Your Osteoporosis Risk?

Your Lifestyle and Bone Loss

Your body needs calcium and vitamin D and enough exercise to build and keep strong bones.

Calcium source

Vitamin D benefit

Your body may not make enough new bone if:

• You do not eat enough high-calcium foods
• Your body does not absorb enough calcium from the foods you eat
• Your body removes more calcium than normal in the urine

Certain habits can affect your bones.

• Drinking alcohol. Too much alcohol can damage your bones. It can also put you at risk of falling and breaking a bone.
• Smoking. Men and women who smoke have weaker bones. Women who smoke after menopause have an even higher chance of fractures.

Younger women who do not have menstrual periods for a long time also have a higher risk of bone loss and osteoporosis.

Low body weight is linked to less bone mass and weaker bones.

Exercise is linked to higher bone mass and stronger bones.

Medical Disorders and Bone Loss

Many long-term (chronic) medical conditions can keep people confined to a bed or chair.

• This keeps the muscles and bones in their hips and spines from being used or bearing any weight.
• Not being able to walk or exercise may lead to bone loss and fractures.

Other medical conditions that may also lead to bone loss are:

Sometimes, medicines that treat certain medical conditions can cause osteoporosis. Some of these are:

• Hormone-blocking treatments for prostate cancer or breast cancer
• Some medicines that are used to treat seizures or epilepsy
• Glucocorticoid (steroid) medicines, if they are taken by mouth every day for more than 3 months, or are taken several times a year

Any treatment or condition that causes calcium or vitamin D to be poorly absorbed can also lead to weak bones. Some of these are:

• Gastric bypass (weight-loss surgery)
• Cystic fibrosis
• Other conditions that prevent the small intestine from absorbing nutrients well

People with eating disorders, such as anorexia or bulimia, are also at higher risk for osteoporosis.

What’s Next?

Talk to your health care provider about your risk for bone loss and osteoporosis. Find out how to get the right amount of calcium and vitamin D, what exercise or lifestyle changes are right for you, and what medicines you may need to take.

Images

References

De Paula FJA, Black DM, Rosen CJ. Osteoporosis: basic and clinical aspects. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ , eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 30.

Eastell R, Rosen CJ, Black DM, Cheung AM, Murad MH, Shoback D. Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society* Clinical Practice Guideline. J Clin Endocrinol Metab. 2019;104(5):1595-1622. PMID: 30907953 pubmed.ncbi.nlm.nih.gov/30907953/.

Weber TJ. Osteoporosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 230.

Osteoporosis – Diagnosis and treatment

Diagnosis

Your bone density can be measured by a machine that uses low levels of X-rays to determine the proportion of mineral in your bones. During this painless test, you lie on a padded table as a scanner passes over your body. In most cases, only certain bones are checked — usually in the hip and spine.

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Treatment

Treatment recommendations are often based on an estimate of your risk of breaking a bone in the next 10 years using information such as the bone density test. If your risk isn’t high, treatment might not include medication and might focus instead on modifying risk factors for bone loss and falls.

Bisphosphonates

For both men and women at increased risk of fracture, the most widely prescribed osteoporosis medications are bisphosphonates. Examples include:

• Alendronate (Binosto, Fosamax)
• Ibandronate (Boniva)
• Risedronate (Actonel, Atelvia)
• Zoledronic acid (Reclast, Zometa)

Side effects include nausea, abdominal pain and heartburn-like symptoms. These are less likely to occur if the medicine is taken properly. Intravenous forms of bisphosphonates don’t cause stomach upset but can cause fever, headache and muscle aches.

A very rare complication of bisphosphonates is a break or crack in the middle of the thighbone. A second rare complication is delayed healing of the jawbone (osteonecrosis of the jaw). This can occur after an invasive dental procedure, such as removing a tooth.

Denosumab

Compared with bisphosphonates, denosumab (Prolia, Xgeva) produces similar or better bone density results and reduces the chance of all types of fractures. Denosumab is delivered via a shot under the skin every six months.

Similar to bisphosphonates, denosumab has the same rare complication of causing breaks or cracks in the middle of the thighbone and osteonecrosis of the jaw. If you take denosumab, you might need to continue to do so indefinitely. Recent research indicates there could be a high risk of spinal column fractures after stopping the drug.

Hormone-related therapy

Estrogen, especially when started soon after menopause, can help maintain bone density. However, estrogen therapy can increase the risk of breast cancer and blood clots, which can cause strokes. Therefore, estrogen is typically used for bone health in younger women or in women whose menopausal symptoms also require treatment.

Raloxifene (Evista) mimics estrogen’s beneficial effects on bone density in postmenopausal women, without some of the risks associated with estrogen. Taking this drug can reduce the risk of some types of breast cancer. Hot flashes are a possible side effect. Raloxifene also may increase your risk of blood clots.

In men, osteoporosis might be linked with a gradual age-related decline in testosterone levels. Testosterone replacement therapy can help improve symptoms of low testosterone, but osteoporosis medications have been better studied in men to treat osteoporosis and thus are recommended alone or in addition to testosterone.

Bone-building medications

If you have severe osteoporosis or if the more common treatments for osteoporosis don’t work well enough, your doctor might suggest trying:

• Teriparatide (Bonsity, Forteo). This powerful drug is similar to parathyroid hormone and stimulates new bone growth. It’s given by daily injection under the skin for up to two years.
• Abaloparatide (Tymlos) is another drug similar to parathyroid hormone. This drug can be taken for only two years.
• Romosozumab (Evenity). This is the newest bone-building medication to treat osteoporosis. It is given as an injection every month at your doctor’s office and is limited to one year of treatment.

After you stop taking any of these bone-building medications, you generally will need to take another osteoporosis drug to maintain the new bone growth.

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Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

These suggestions might help reduce your risk of developing osteoporosis or breaking bones:

• Don’t smoke. Smoking increases rates of bone loss and the chance of fracture.
• Limit alcohol. Consuming more than two alcoholic drinks a day may decrease bone formation. Being under the influence of alcohol also can increase your risk of falling.
• Prevent falls. Wear low-heeled shoes with nonslip soles and check your house for electrical cords, area rugs and slippery surfaces that might cause you to fall. Keep rooms brightly lit, install grab bars just inside and outside your shower door, and make sure you can get into and out of your bed easily.

Preparing for your appointment

Your doctor might suggest bone density testing. Screening for osteoporosis is recommended for all women over age 65. Some guidelines also recommend screening men by age 70, especially if they have health issues likely to cause osteoporosis. If you have a broken bone after a minor force injury, such as a simple fall, bone density testing may be important to assess your risk of more fractures.

If the test results show very low bone density or you have other complex health issues, you might be referred to a doctor who specializes in metabolic disorders (endocrinologist) or a doctor who specializes in diseases of the joints, muscles or bones (rheumatologist).

Here’s some information to help you get ready for your appointment.

What you can do

• Write down symptoms you’ve noticed, though it’s possible you may not have any.
• Write down key personal information, including major stresses or recent life changes.
• Make a list of all medications, vitamins and supplements that you take or have taken, including doses. It’s especially helpful if you record the type and dose of calcium and vitamin D supplements, because many different preparations are available. If you’re not sure what information your doctor might need, take the bottles with you or take a picture of the label with your smartphone and share it with your doctor.
• Write down questions to ask your doctor.

For osteoporosis, basic questions to ask your doctor include:

• Do I need to be screened for osteoporosis?
• What treatments are available, and which do you recommend?
• What side effects might I expect from treatment?
• Are there alternatives to the treatment you’re suggesting?
• I have other health conditions. How can I best manage them together?
• Do I need to restrict my activities?
• Do I need to change my diet?
• Do I need to take supplements?
• Is there a physical therapy program that would benefit me?
• What can I do to prevent falls?

Don’t hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

• Have you broken bones?
• Have you gotten shorter?
• How is your diet, especially your dairy intake? Do you think you get enough calcium? Vitamin D?
• How often do you exercise? What type of exercise do you do?
• How is your balance? Have you fallen?
• Do you have a family history of osteoporosis?
• Has a parent broken a hip?
• Have you ever had stomach or intestinal surgery?
• Have you taken corticosteroid medications (prednisone, cortisone) as pills, injections or creams?

Aug. 21, 2021

Exercising with osteoporosis: Stay active the safe way

Exercising with osteoporosis: Stay active the safe way

If you have osteoporosis, you might mistakenly think exercise will lead to fracture. In fact, though, using your muscles helps protect your bones.

By Mayo Clinic Staff

Osteoporosis is a major cause of disability in older women. A bone-weakening disorder, osteoporosis often results in fractures in the hip and spine — which can severely impair your mobility and independence.

How can you reduce your risk of these life-altering injuries? Exercise can help.

Certain types of exercise strengthen muscles and bones, while other types are designed to improve your balance — which can help prevent falls.

Benefits of exercise

It’s never too late to start exercising. For postmenopausal women, regular physical activity can:

• Increase your muscle strength
• Improve your balance
• Decrease your risk of bone fracture
• Maintain or improve your posture
• Relieve or decrease pain

Exercising if you have osteoporosis means finding the safest, most enjoyable activities for you given your overall health and amount of bone loss. There’s no one-size-fits-all prescription.

Before you start

Consult your doctor before starting any exercise program for osteoporosis. You might need some tests first, including:

• Bone density measurement
• Fitness assessment

In the meantime, think about what kind of activities you enjoy most. If you choose an exercise you enjoy, you’re more likely to stick with it over time.

Choosing the right form of exercise

These types of activities are often recommended for people with osteoporosis:

• Strength training exercises, especially those for the upper back
• Weight-bearing aerobic activities
• Flexibility exercises
• Stability and balance exercises

Because of the varying degrees of osteoporosis and the risk of fracture, you might be discouraged from doing certain exercises. Ask your doctor or physical therapist whether you’re at risk of osteoporosis-related problems, and find out what exercises are appropriate for you.

Strength training

Strength training includes the use of free weights, resistance bands or your own body weight to strengthen all major muscle groups, especially spinal muscles important for posture. Resistance training can also help maintain bone density.

If you use weight machines, take care not to twist your spine while performing exercises or adjusting the machines.

Resistance training should be tailored to your ability and tolerance, especially if you have pain. A physical therapist or personal trainer with experience working with people with osteoporosis can help you develop strength-training routines. Proper form and technique are crucial to prevent injury and get the most from your workout.

Weight-bearing aerobic activities

Weight-bearing aerobic activities involve doing aerobic exercise on your feet, with your bones supporting your weight. Examples include walking, dancing, low-impact aerobics, elliptical training machines, stair climbing and gardening.

These types of exercise work directly on the bones in your legs, hips and lower spine to slow mineral loss. They also provide cardiovascular benefits, which boost heart and circulatory system health.

It’s important that aerobic activities, as beneficial as they are for your overall health, are not the whole of your exercise program. It’s also important to work on strength, flexibility and balance.

Swimming and cycling have many benefits, but they don’t provide the weight-bearing load your bones need to slow mineral loss. However, if you enjoy these activities, do them. Just be sure to also add weight-bearing activity as you’re able.

Flexibility exercises

Moving your joints through their full range of motion helps you keep your muscles working well. Stretches are best performed after your muscles are warmed up — at the end of your exercise session, for example, or after a 10-minute warm-up. They should be done gently and slowly, without bouncing.

Avoid stretches that flex your spine or cause you to bend at the waist. Ask your doctor which stretching exercises are best for you.

Stability and balance exercises

Fall prevention is especially important for people with osteoporosis. Stability and balance exercises help your muscles work together in a way that keeps you more stable and less likely to fall. Simple exercises such as standing on one leg or movement-based exercises such as tai chi can improve your stability and balance.

Movements to avoid

If you have osteoporosis, don’t do the following types of exercises:

• High-impact exercises. Activities such as jumping, running or jogging can lead to fractures in weakened bones. Avoid jerky, rapid movements in general. Choose exercises with slow, controlled movements. If you’re generally fit and strong despite having osteoporosis, however, you might be able to engage in somewhat higher-impact exercise than can someone who is frail.
• Bending and twisting. Exercises in which you bend forward at the waist and twist your waist, such as touching your toes or doing sit-ups, can increase your risk of compression fractures in your spine if you have osteoporosis. Other activities that may require you to bend or twist forcefully at the waist are golf, tennis, bowling and some yoga poses.

If you’re not sure how healthy your bones are, talk to your doctor. Don’t let fear of fractures keep you from having fun and being active.

Video: Bent-over row with resistance tubing

Show transcript for video Video: Bent-over row with resistance tubing

Edward R. Laskowski, M.D.: The bent-over row is an exercise you can do with resistance tubing to work the muscles in the back of the shoulder. Specifically, the bent-over row targets the posterior part of the deltoid in the shoulder. That’s important, because many people focus on the muscles at the front of the shoulder. For strength in the shoulder, what you really want is balance between the front and back muscles in the shoulder.

Nicole L. Campbell: To do the bent-over row with resistance tubing, start by standing with your feet shoulder-width apart on the center of the tubing.

Grasp both tubing handles with your palms facing in, and bend your knees comfortably and keep your back in a neutral position. Slowly bring your elbows back. Keep your elbows close to your body. Then slowly return to the starting position. You’ll feel as if your shoulder blades are coming together. You might imagine that you’re squeezing a pencil with your shoulder blades.

When you’re doing the bent-over row, remember to keep your back in a neutral position. Do not flatten the curve of your low back, and don’t arch your back in the other direction. Keep your movements smooth and controlled.

To make this exercise more challenging, move your foot closer to the tubing handle, then bring your elbow back just as you did before.

For most people, one set of 12 to 15 repetitions is adequate.

Remember, for best results, keep your back in a neutral position and your elbows close to your body. Keep your movements smooth and controlled.

Video: Bent-over row with dumbbell

Show transcript for video Video: Bent-over row with dumbbell

Edward R. Laskowski, M.D.: The bent-over row is an exercise you can do with dumbbells to work the muscles in the back of the shoulder. The bent-over row targets the posterior part of the deltoid in the shoulder. That’s important, because many people focus on the muscles at the front of the shoulder. What you really want is balance in the shoulder muscles.

Nicole L. Campbell: To do the bent-over row with a dumbbell, hold a dumbbell in your hand and stand with your feet comfortably apart. For most people, this is about shoulder-width apart. Tighten your abdominal muscles. Bend your knees and lean forward at the hips, keeping your spine nice and straight. Let your arms hang straight below your shoulders and slowly raise the weight until your elbow lines up just below your shoulder and parallel with your spine. Then slowly lower the weight to the starting position. You’ll feel tension in the back of your shoulder and the muscles across your upper back.

When doing the bent-over row, do not allow your shoulder to roll forward.

For most people, one set of 12 to 15 repetitions is adequate.

Remember, for best results, don’t allow your shoulder to roll forward during the exercise. Hold your shoulder as stationary as possible, keeping your spine neutral, your abdominal muscles tight, and your movements smooth and controlled.

Video: Seated row with weight machine

Show transcript for video Video: Seated row with weight machine

Dr. Laskowski: The seated row is an exercise you can do with a weight machine to work the muscles in your upper back. Specifically, the seated row targets the muscles in your upper back and also the latissimus dorsi — a muscle on the outer side of the chest wall. This exercise will help improve your posture and help protect your shoulders.

Nicole Campbell: To do the seated row with a weight machine, start by sitting on the weight bench with your knees bent and by grasping the cable attachment. Your arms should be extended and your shoulders stretched slightly forward. Slowly pull the cable to your waist, until your elbows are bent and your shoulders are back. Then slowly return to the starting position. You’ll feel tension in your back and arms.

When you’re doing the seated row, make sure you feel only a mild stretch in the starting position.

For most people, one set of 12 to 15 repetitions is adequate.

Remember, for best results, do not lean too far forward in the starting position. Also, keep your movements smooth and controlled.

June 05, 2021

Show references

1. Bone health: Exercise is a key component. The North American Menopause Society. http://www.menopause.org/for-women/menopauseflashes/bone-health-and-heart-health/bone-health-exercise-is-a-key-component. Accessed Feb. 26, 2016.
2. Rosen HN, et al. Overview of the management of osteoporosis in postmenopausal women. http://www.uptodate.com/home. Accessed Feb. 26, 2016.
3. Ask Mayo Expert. Osteoporosis: Exercise. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
4. McArthur C, et al. Suggestions for adapting yoga to the needs of older adults with osteoporosis. The Journal of Alternative and Complementary Medicine. 2016;0:1.
5. Giangregorio LM, et al. Too fit to fracture: Exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporosis International. 2014;25:821.
6. Exercise and osteoporosis: How exercise can help with bone health, fragile bones and fractures. National Osteoporosis Society. https://www.nos.org.uk/health-professionals/~/document.doc?id=770. Accessed Feb. 26, 2016.

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What Is Osteopenia? How Is It Different From Osteoporosis?

Think of it as a midpoint between having healthy bones and having osteoporosis.

Osteopenia is when your bones are weaker than normal but not so far gone that they break easily, which is the hallmark of osteoporosis.

Your bones are usually at their densest when you’re about 30. Osteopenia, if it happens at all, usually occurs after age 50. The exact age depends how strong your bones are when you’re young. If they’re hardy, you may never get osteopenia. If your bones aren’t naturally dense, you may get it earlier.

Osteopenia — or seeing it turn into osteoporosis for that matter — is not inevitable. Diet, exercise, and sometimes medication can help keep your bones dense and strong for decades.

Who Is Most Likely to Get It?

This condition happens when your body gets rid of more bone than it is creating.

Some people are genetically prone to it, with a family history of the condition. You’re also more likely to get it if you’re a woman.

Women have lower bone mass than men. Also, women live longer, which means their bones age more, and they usually don’t get as much calcium as men.

Calcium is the key to keeping bones healthy. Hormone changes that happen at menopause increase the chance for osteopenia for women, and men with lower testosterone levels have higher odds of getting it.

What Are the Medical Causes?

Sometimes, you may have a medical condition or treatment that can trigger the condition.

Eating disorders, such as anorexia and bulimia, can starve your body of nutrients needed to keep bones strong. Other causes include:

Are There Lifestyle Causes?

Problems in your diet, lack of exercise, and unhealthy habits can contribute to this condition. Watch out for:

How Is It Diagnosed?

Osteopenia usually doesn’t have any symptoms. This makes it hard to diagnose unless you have a bone mineral density test.

The National Osteoporosis Foundation recommends the test if you meet any of the following:

• You’re a woman 65 or older
• You’re a postmenopausal woman 50 or older
• You’re a woman at the age of menopause and have a high chance for breaking bones due to presence of other risk factors
• You’re a woman who has already been through menopause, younger than 65, and have other risk factors that give you a higher chance of osteopenia
• You’re a man older than 65 with risk factors
• You break a bone after age 50 without significant trauma (known as fragility fracture)

The test is painless and fast. It estimates how dense or thick your bones are by using X-rays.

Often, the first sign your bones are getting weak is a break. Many people have a fracture or a series of fractures in their spine and don’t even know it. See your doctor if you have symptoms of a spinal fracture, which include:

• Sudden, severe back pain
• Back pain that gets worse when standing or walking, but gets a bit better when you lie down
• Back pain when bending or twisting
• Loss of height
• Curved or stooped shape to your spine

Prevention and Treatment

It’s never too early to take steps to prevent osteopenia. Talk with your doctor about an exercise plan that’s right for you. Eat the right kinds of food.

But even if you already have osteopenia, it’s not too late for you to stop it from turning into osteoporosis with these strategies:

Get enough calcium and vitamin D: This may be the most important thing you can do for your bones at any stage of life. You can get calcium in:

• Dairy products such as yogurt, cheese, and milk (go for low-fat or nonfat varieties)
• Spinach and broccoli
• Dried beans
• Salmon

Vitamin D, which helps your body absorb calcium, can be found in eggs and in oily fish such as salmon and sardines.

Some foods, including orange juice, cereal, and bread, have added calcium and vitamin D.

It’s also a good idea to spend 10 to 15 minutes in the sun twice a week because this helps convert inactive Vitamin D to active form.

If your doctor doesn’t think you’re getting enough calcium and vitamin D, they may suggest that you take a supplement. Guidelines for vitamin D intake exist for different ages and situations such as pregnancy.

Weight lifting: You can do regular, weight-bearing exercises to prevent or slow osteopenia. Talk with your doctor before you start a strength-training program.

Lifestyle changes: If you smoke, try to quit. Cut down on carbonated drinks and alcohol.

Medications

Prescription medications are sometimes used to treat osteopenia if your bones are starting to get weak.

Medicines also used to treat osteoporosis might be prescribed. These include:

You might have side effects such as digestive problems and bone and joint pain. They might also make you feel tired.

Asthma, Arthritis, Diabetes, Celiac Disease, Hyperthyroidism, Lupus, Multiple Sclerosis

You probably know some of the leading risk factors for osteoporosis — being female and past menopause, smoking, or having a small frame. But did you know that some fairly common medical conditions are also among the causes of osteoporosis bone loss?

If you have one of these conditions, either because of the disease itself or because of the medications you have to take to manage it, you face an increased risk of developing osteoporosis:

1. Diabetes Mellitus and Osteoporosis

For reasons scientists still don’t fully understand, people with type 1 diabetes tend to have lower bone density.

Studies show that people with type 1 diabetes may have low bone turnover and lower than normal bone formation.

“It seems that high blood sugar may shut down bone formation, just as with steroids,” says Beatrice Edwards, MD, MPH, associate professor of medicine and director of the Bone Health and Osteoporosis Center at Northwestern University Feinberg School of Medicine. Since type 1 diabetes usually develops in childhood, when the body is still building bone, someone with type 1 diabetes may never have the opportunity to reach their peak bone density.

Even if their bone mass isn’t that much lower than normal, people with both type 1 and type 2 diabetes have a much higher risk of fractures than other people, adds Edwards.

2. Lupus and Rheumatoid Arthritis

Nearly 3 million adults in the U.S. have either lupus or rheumatoid arthritis. Both of these diseases are autoimmune conditions, in which the body attacks its own healthy cells and tissues, causing inflammation.

Any chronic inflammatory disease can put you at greater risk of osteoporosis, says Edwards, because it appears to increase the rate of bone turnover, in which old bone is replaced with healthy new bone. People with both lupus and RA usually take corticosteroids for an extended period of time to manage their symptoms. Long-term use of steroids such as prednisone is also a leading cause of osteoporosis, possibly because they slow the activity of bone-building cells.

Lupus is a particular problem because it is common in women between the ages of 15 and 45 — often during the peak bone-building years up to age 30. “Anything that impedes the growth of bone during these years puts you at greater risk for osteoporosis,” says Edwards.

3. Hyperthyroidism

Hyperthyroidism occurs when the thyroid gland — a small, butterfly-shaped gland at the base of the neck — becomes overactive and produces too much thyroid hormone.

“Hyperthyroidism increases the number of bone-remodeling cycles you go through,” explains Edwards. “And after age 30, every bone-remodeling cycle is inefficient. You lose bone mass rather than building it. So the more cycles you go through, the more bone mass you lose.”

Hyperparathyroidism, a similar condition involving related, but different glands, also ups the risk of osteoporosis.

4. Celiac Disease

A number of digestive disorders, such as Crohn’s disease, can be causes of osteoporosis. Perhaps the most common such cause, says Edwards, is celiac disease, an allergy to a protein called gluten that is often found in wheat products.

Left untreated, celiac disease can damage the lining of the digestive system and interfere with the digestion of nutrients — including the calcium and vitamin D that are so important to bone health. So even if you’re getting the recommended daily amounts of calcium and vitamin D in your diet, if you have celiac disease, you probably don’t have enough of those nutrients in your system, and you likely have low bone density.

5.

Asthma

Asthma itself does not increase your risk of developing osteoporosis, but the medications used to treat it do. Approximately 20 million people in the U.S. have asthma, including some 9 million children under the age of 18.

Many people with asthma use corticosteroids — such as asthma “inhalers” — to help control their disease. During asthma attacks it is not uncommon to start drugs like prednisone for small periods of time. These are very effective in relieving the shortness of breath and wheezing that are common with asthma or emphysema, but they may also contribute to bone loss and osteoporosis.

“In addition to this, many young people with asthma may have more difficulty participating in some activities, which means they might not get as much weight-bearing exercise as they need to help build bone,” says Andrew Bunta, MD, associate professor and vice chair of orthopaedics at Northwestern University Feinberg School of Medicine.

6. Multiple Sclerosis

Asthma and multiple sclerosis are two very different conditions, but there are very similar reasons why they both increase the risk of osteoporosis. Like people with asthma, people with multiple sclerosis take steroid-based medications to help manage their symptoms, and steroids are associated with bone loss. Since multiple sclerosis also affects balance and movement for many people, someone with MS may find it more difficult to get as much weight-bearing exercise as they need to in order to build and maintain bone.

“Anything that impedes your ability to walk accelerates bone loss,” says Edwards.

If you have one of these conditions, how can you help protect yourself from osteoporosis? First, don’t assume that your doctor will take care of it for you.

“When you are troubleshooting a primary condition like MS, asthma, or lupus, you’re not thinking about the side effects. Osteoporosis can take a back seat,” says Felicia Cosman, MD, medical director of the Clinical Research Center at Helen Hayes Hospital in Haverstraw, N.Y., and an editor of Osteoporosis: An Evidence-Based Guide to Prevention and Management. “That’s understandable — but you don’t want osteoporosis to add more disability to an already disabling condition. “

So if the doctor treating your celiac disease or rheumatoid arthritis hasn’t already brought up osteoporosis with you, ask to discuss it. Depending on your age and your specific condition, you may have several options to help prevent osteoporosis symptoms:

• Get an early bone density test. Doctors don’t usually recommend bone density tests for premenopausal women, but if you have one of these conditions, you may need to be monitored more closely, and treated for bone loss more aggressively.
• Push for more vitamin D and calcium in your diet, and supplement. Edwards recommends that people with conditions that accelerate bone loss get at least 1,000 to 1,500 milligrams of calcium and 400 to 600 international units (IU) of vitamin D from food and supplements. Look for low-fat dairy and fortified foods.
• Consider getting the vitamin D levels in your blood measured. “That’s not a specific recommendation from the National Osteoporosis Foundation, but it makes so much clinical sense,” says Cosman. “Because vitamin D levels vary so much between individuals, it’s hard to know how much supplementation is needed to reach sufficient levels.”

Learn What Osteoporosis Is and What It’s Caused by

Bone is living, growing tissue that changes throughout the lifespan.

Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and may break from a fall or, in serious cases, from sneezing or minor bumps.

Osteoporosis means “porous bone.” Viewed under a microscope, healthy bone looks like a honeycomb. When osteoporosis occurs, the holes and spaces in the honeycomb are much larger than in healthy bone. Osteoporotic bones have lost density or mass and contain abnormal tissue structure. As bones become less dense, they weaken and are more likely to break. If you’re 50 or older and have broken a bone, ask your doctor or healthcare provider about a bone density test.

Osteoporosis is Common

About 54 million Americans have osteoporosis and low bone mass, placing them at increased risk for osteoporosis. Studies suggest that approximately one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis.

Osteoporosis is Serious

Breaking a bone is a serious complication of osteoporosis, especially with older patients. Osteoporotic bone breaks are most likely to occur in the hip, spine or wrist, but other bones can break too. In addition to causing permanent pain, osteoporosis causes some patients to lose height. When osteoporosis affects vertebrae, or the bones of the spine, it often leads to a stooped or hunched posture.

Osteoporosis may limit mobility, which often leads to feelings of isolation or depression. Additionally, twenty percent of seniors who break a hip die within one year from either complications related to the broken bone itself or the surgery to repair it. Many patients require long-term nursing home care.

Osteoporosis is Costly

Osteoporosis is responsible for two million broken bones and $19 billion in related costs every year. By 2025, experts predict that osteoporosis will be responsible for approximately three million fractures and $25.3 billion in costs annually.

Osteoporosis Can Sneak up on You

Osteoporosis is often called a silent disease because one can’t feel bones weakening. Breaking a bone is often the first sign of osteoporosis or a patient may notice that he or she is getting shorter or their upper back is curving forward. If you are experiencing height loss or your spine is curving, be sure to consult your doctor or healthcare professional immediately.

Diseases, Conditions and Medical Procedures That May Cause Bone Loss

There are many health problems and a few medical procedures that increase the likelihood of osteoporosis. If you have any of the following diseases or conditions, talk to your doctor or health care provider about what you can do to keep your bones healthy.

Autoimmune Disorders

• Rheumatoid arthritis (RA)
• Lupus
• Multiple sclerosis
• Ankylosing spondylitis

Digestive and Gastrointestinal Disorders

• Celiac disease
• Inflammatory bowel disease (IBD)
• Weight loss surgery

Medical Procedures

• Gastrectomy
• Gastrointestinal bypass procedures

Cancer

• Breast cancer
• Prostate cancer

Hematologic/Blood Disorders

• Leukemia and lymphoma
• Multiple myeloma
• Sickle cell disease

Neurological/Nervous System Disorders

• Stroke
• Parkinson’s disease
• multiple sclerosis (MS)
• Spinal cord injuries

Blood and bone marrow disorders

Mental Illness

• Depression
• Eating disorders

Endocrine/Hormonal Disorders

• Diabetes
• Hyperparathyroidism
• Hyperthyroidism
• Cushing’s syndrome
• Thyrotoxicosis
• Irregular periods
• Premature menopause
• Low levels of testosterone and estrogen in men

Other Diseases and Conditions

• AIDS/HIV
• Chronic obstructive pulmonary disease (COPD), including emphysema
• Female athlete triad (includes loss of menstrual periods, an eating disorder and excessive exercise)
• Chronic kidney disease
• Liver disease, including biliary cirrhosis
• Organ transplants
• Polio and post-polio syndrome
• Poor diet, including malnutrition
• Scoliosis
• Weight loss

Pregnancy and Lactation Associated Osteoporosis (PLO)

• Temporary decreases in bone density are a normal part of pregnancy and lactation—but fractures during this time are extremely rare.
• Fractures of the spine associated with severe back pain are most commonly described, but PLO can also be associated with hip fractures or other types of fracture.
• In the most common scenario, PLO is discovered after a pregnant or breastfeeding woman develops severe back pain, and imaging reveals multiple vertebral fractures.
• Some women with PLO have a pre-pregnancy diagnosis of osteoporosis, but most women with PLO have not been previously diagnosed with osteoporosis, and never had a bone assessment prior to the onset of symptoms.

Note: This list may not include all of the diseases and conditions that may cause bone loss. Talk to your doctor and ask if any of the conditions you have may be causing bone loss.

Medicines that May Cause Bone Loss

Some medicines can be harmful to your bones, even if you need to take them for another condition. Bone loss is usually greater if you take the medication in high doses or for a long time.

It’s important to talk with your healthcare provider about the risks and benefits of any medicines you take and about how they may affect your bones, but do not stop any treatment or change the dose of your medicines unless your healthcare provider says it’s safe to do so. If you need to take a medicine that causes bone loss, work with your healthcare provider to determine the lowest possible dose you can take to control your symptoms.

The following medicines may cause bone loss:

• Aluminum-containing antacids
• Antiseizure medicines (only some) such as Dilantin® or Phenobarbital
• Aromatase inhibitors such as Arimidex®, Aromasin® and Femara®
• Cancer chemotherapeutic drugs
• Cyclosporine A and FK506 (Tacrolimus)
• Gonadotropin releasing hormone (GnRH) such as Lupron® and Zoladex®
• Heparin
• Lithium
• Medroxyprogesterone acetate for contraception (Depo-Provera®)
• Methotrexate
• Proton pump inhibitors (PPIs) such as Nexium®, Prevacid® and Prilosec®
• Selective serotonin reuptake inhibitors (SSRIs) such as Lexapro®, Prozac® and Zoloft®
• Steroids (glucocorticoids) such as cortisone and prednisone
• Tamoxifen® (premenopausal use)
• Thiazolidinediones such as Actos® and Avandia®
• Thyroid hormones in excess

Note: This list may not include all medicines that may cause bone loss.

Osteoporosis and Steroid Medicines

While steroid medicines can be lifesaving treatments for some conditions, they can also cause bone loss and osteoporosis. These medicines are often referred to as steroids, glucocorticoids or corticosteroids. They should not be confused with anabolic steroids, which are male hormones that some athletes use to build muscle.

Steroids are much like certain hormones made by your own body. Healthcare providers prescribe them for many conditions, including rheumatoid arthritis (but not osteoarthritis), asthma, Crohn’s disease, lupus and allergies. They are often prescribed to relieve inflammation. They are also used along with other medicines to treat cancer and autoimmune conditions and to support organ transplants. Common steroid medicines are cortisone, dexamethasone (Decadron®), methylprednisolone (Medrol®) and prednisone. Intravenous forms include methylprednisolone sodium succinate (Solu-Medrol®).

Taking steroid medicines as pills in a dose of 5 mg or more for three or more months can increase the chance of bone loss and developing osteoporosis. Talk with your healthcare provider about taking the lowest dose for the shortest period of time for your condition. If you need to take steroid medicines for longer than this, you should take steps to prevent bone loss. While taking steroids, it is especially important to get enough calcium and vitamin D. It’s also important to exercise and not smoke. You may also want to ask your healthcare provider if you need a bone density test.

Symptoms, Causes, Tests & Treatment

Overview

What is osteoporosis?

The word ‘osteoporosis’ means ‘porous bone.’ It is a disease that weakens bones, and if you have it, you are at a greater risk for sudden and unexpected bone fractures. Osteoporosis means that you have less bone mass and strength. The disease often develops without any symptoms or pain, and it is usually not discovered until the weakened bones cause painful fractures. Most of these are fractures of the hip, wrist and spine.

Who gets osteoporosis?

About 200 million people are estimated to have osteoporosis throughout the world. In the U.S., the figure is about 54 million people. Although osteoporosis occurs in both men and women, women are four times more likely to develop the disease than men. There are currently about two million men in the U.S. who have osteoporosis and some 12 million more who are at risk of developing the condition.

After age 50, one in two women and one in four men will have an osteoporosis-related fracture in their lifetimes. Another 30% have low bone density that puts them at risk of developing osteoporosis. This condition is called osteopenia.

Osteoporosis is responsible for more than two million fractures each year, and this number continues to grow. There are steps you can take to prevent osteoporosis from ever occurring. Treatments can also slow the rate of bone loss if you do have osteoporosis.

What causes osteoporosis?

Researchers understand how osteoporosis develops even without knowing the exact cause of why it develops. Your bones are made of living, growing tissue. The inside of healthy bone looks like a sponge. This area is called trabecular bone. An outer shell of dense bone wraps around the spongy bone. This hard shell is called cortical bone.

When osteoporosis occurs, the “holes” in the “sponge” grow larger and more numerous, which weakens the inside of the bone. Bones support the body and protect vital organs. Bones also store calcium and other minerals. When the body needs calcium, it breaks down and rebuilds bone. This process, called bone remodeling, supplies the body with needed calcium while keeping the bones strong.

Up until about age 30, you normally build more bone than you lose. After age 35, bone breakdown occurs faster than bone buildup, which causes a gradual loss of bone mass. If you have osteoporosis, you lose bone mass at a greater rate. After menopause, the rate of bone breakdown occurs even more quickly.

Symptoms and Causes

What are the symptoms of osteoporosis?

Usually, there are no symptoms of osteoporosis. That is why it is sometimes called a silent disease. However, you should watch out for the following things:

• Loss of height (getting shorter by an inch or more).
• Change in posture (stooping or bending forward).
• Shortness of breath (smaller lung capacity due to compressed disks).
• Bone fractures.
• Pain in the lower back.

Who is at risk for developing osteoporosis?

There are many risk factors that increase your chance of developing osteoporosis, with two of the most significant being gender and age.

Everyone’s risk for osteoporosis fractures increases with age. However, women over the age of 50 or postmenopausal women have the greatest risk of developing osteoporosis. Women undergo rapid bone loss in the first 10 years after entering menopause, because menopause slows the production of estrogen, a hormone that protects against excessive bone loss.

Age and osteoporosis affect men also. You might be surprised to know that men over the age of 50 are more likely to have an osteoporosis-induced bone break than to get prostate cancer. About 80,000 men per year are expected to break a hip, and men are more likely than women to die in the year after a hip fracture.

Your risk of developing osteoporosis is also linked to ethnicity. Caucasian and Asian women are more likely to develop osteoporosis. However, African-American and Hispanic women are still at risk. In fact, African-American women are more likely than white women to die after a hip fracture.

Another factor is bone structure and body weight. Petite and thin people have a greater risk of developing osteoporosis because they have less bone to lose than people with more body weight and larger frames.

Family history also plays a part in osteoporosis risk. If your parents or grandparents have had any signs of osteoporosis, such as a fractured hip after a minor fall, you may have a greater risk of developing the disease.

Finally, some medical conditions and medications increase your risk. If you have or had any of the following conditions, some of which are related to irregular hormone levels, you and your healthcare provider might consider earlier screening for osteoporosis.

• Overactive thyroid, parathyroid, or adrenal glands.
• History of bariatric (weight loss) surgery or organ transplant.
• Hormone treatment for breast or prostate cancer or a history of missed periods.
• Celiac disease, or inflammatory bowel disease.
• Blood diseases such as multiple myeloma.

Some medications cause side effects that may damage bone and lead to osteoporosis. These include steroids, treatments for breast cancer, and medications for treating seizures. You should speak with your healthcare provider or pharmacist about the effect of your medications on bones.

It may seem as though every risk factor is related to something that is out of your control, but that’s not true. You do have control over some of the risk factors for osteoporosis. You can discuss medication issues with your healthcare provider. And—you are in charge of your:

• Eating habits: You are more likely to develop osteoporosis if your body doesn’t have enough calcium and vitamin D. Although eating disorders like bulimia or anorexia are risk factors, they can be treated.
• Lifestyle: People who lead sedentary (inactive) lifestyles have a higher risk of osteoporosis.
• Tobacco use: Smoking increases the risk of fractures.
• Alcohol use: Having two drinks a day (or more) increases the risk of osteoporosis.

Diagnosis and Tests

How is osteoporosis diagnosed?

Your healthcare provider can order a test to give you information about your bone health before problems begin. Bone mineral density (BMD) tests are also known as dual-energy X-ray absorptiometry (DEXA or DXA) scans. These X-rays use very small amounts of radiation to determine how solid the bones of the spine, hip or wrist are. Regular X-rays will only show osteoporosis when the disease is very far along.

All women over the age of 65 should have a bone density test. The DEXA scan may be done earlier for women who have risk factors for osteoporosis. Men over age 70, or younger men with risk factors, should also consider getting a bone density test.

Management and Treatment

How is osteoporosis treated?

Treatments for established osteoporosis may include exercise, vitamin and mineral supplements, and medications. Exercise and supplementation are often suggested to help you prevent osteoporosis. Weight-bearing, resistance and balance exercises are all important.

What medications are used to treat osteoporosis?

There are several classes of medications used to treat osteoporosis. Your healthcare provider will work with you to find the best fit. It’s not really possible to say there is one best medication to treat osteoporosis. The ‘best’ treatment is the one that is best for you.

Hormone and hormone-related therapy

This class includes estrogen, testosterone and the selective estrogen receptor modulator raloxifene (Evista®). Because of the potential for blood clots, certain cancers and heart disease, estrogen therapy is likely to be used in women who need to treat menopause symptoms and in younger women.

Testosterone might be prescribed to increase your bone density if you are a man with low levels of this hormone.

Raloxifene acts like estrogen with the bones. The drug is available in tablet form and is taken every day. In addition to treating osteoporosis, raloxifene might be used to reduce the risk of breast cancer in some women. For osteoporosis, raloxifene is generally used for five years.

Calcitonin-salmon (Fortical® and Miacalcin®) is a synthetic hormone. It reduces the chance of spine fractures, but not necessarily hip fractures or other types of breaks. It can be injected or it can be inhaled through the nose. Side effects include runny nose or nosebleed and headaches for the inhaled form. Side effects include rashes and flushing for the injected form. It is not recommended as a first choice. There are possible more serious side effects, including a weak link to cancer.

Bisphosphonates

Bisphosphonate osteoporosis treatments are considered antiresorbtive drugs. They stop the body from re-absorbing bone tissue. There are several formulations with various dosing schemes (monthly, daily, weekly and even yearly) and different brands:

• Aledronate: Fosamax®, Fosamax Plus D®, Binosto®.
• Ibandronate: Boniva®.
• Risedronate: Actonel®, Atelvia®.
• Zoledronic acid: Reclast®.

You may be able to stop taking bisphosphonates after three to five years and still get benefits after you stop. Also, these drugs are available as generic drugs. Of these products, Boniva and Atelvia are recommended only for women, while the others can be used by both women and men.

Possible side effects of bisphosphonates include flu-like symptoms (fever, headache), heartburn, and impaired kidney function. There are potentially serious side effects also, such as the rare occurrence of jaw bone damage (osteonecrosis of the jaw) or atypical femur fractures (low trauma fractures of the thigh). The risk of these rare events increases with prolonged use of the medication (>5 years).

Biologics

Denosumab (Prolia®) is product that is available as an injection given every six months to women and men. It is often used when other treatments have failed. Denosumab can be used even in some cases of reduced kidney function. Its long-term effects are not yet known, but there are potentially serious side effects. These include possible problems with bones in the thigh or jaw and serious infection.

Anabolic agents

These products build bone in people who have osteoporosis. There are three of these products currently approved:

• Romososumab-aqqg (Evenity®) has been approved for postmenopausal women who are at a high risk of fracture. The product both enables new bone formation and decreases the breakdown of bone. You will get two injections, one right after the other, once per month. The time limit is one year of these injections.
• Teriparatide (Forteo®) and Abaloparatide (Tymlos®) are injectable drugs given daily for 2 years. They are parathyroid hormones, or products similar in many ways to the hormones.

When should osteoporosis be treated with medication?

Women whose bone density test shows T-scores of -2.5 or lower, such as -3.3 or -3.8, should begin therapy to reduce their risk of fracture. Many women need treatment if they have osteopenia, which is bone weakness that is not as severe as osteoporosis. Your doctor might use the World Health Organization fracture risk assessment tool, or FRAX, to see if you qualify for treatment based on your risk factors and bone density results. People who have had a typical osteoporosis fracture, such as that of the wrist, spine or hip, should also be treated (sometimes even if the bone density results are normal).

Supplements

It’s important to remember that dietary supplements, although available everywhere over-the-counter and online, aen’t regulated in the same way that prescription medications are. Also, even though something is ‘natural,’ that doesn’t mean that it is safe for everyone at all times.

You might be told by your healthcare provider to get adequate amounts of calcium and vitamin D. This is important if you have osteoporosis or if you are trying to prevent it. It’s best if you can meet those needs with a food plan, but you might not be able to do that. There are plant-based calcium supplements, some of which are based on algae.

The recommended amount of daily calcium intake is 1,000 mg to 1,200 mg daily via diet and/or supplements. Taking more than this amount of calcium has not been shown to provide additional bone strength but may be associated with an increased risk of kidney stones, calcium buildup in the blood vessels and constipation.

There are different ideas about the necessary levels of vitamin D, but it’s true that many people do not have adequate levels and might need to take supplements. Your healthcare provider might test your blood levels and then make recommendations based on these results.

There are other supplements that have been touted as useful for osteoporosis. One of these is strontium, which has never been approved in the U.S. for osteoporosis. A prescription version of strontium ranelate had been available in the E.U., but it was taken off the market due to serious side effects.

You and your healthcare provider will always need to discuss whether the benefits of taking something, whether is a prescription drug or a supplement, outweigh the risks.

Prevention

How can you prevent osteoporosis?

Your diet and lifestyle are two important risk factors you can control to prevent osteoporosis. Replacing lost estrogen with hormone therapy also provides a strong defense against osteoporosis in postmenopausal women.

Diet

To maintain strong, healthy bones, you need a diet rich in calcium throughout your life. One cup of skim or 1 percent fat milk contains 300 milligrams of calcium.

Besides dairy products, other good sources of calcium are salmon with bones, sardines, kale, broccoli, calcium-fortified juices and breads, dried figs, and calcium supplements. It is best to try to get the calcium from food and drink.

For those who need supplements, remember that the body can only absorb 500 mg of calcium at a time. You should take your calcium supplements in divided doses, since anything more than 500 mg will not be absorbed.

Recommended daily allowance of calcium

Vitamin D is also important because it enables the body to absorb calcium. The recommended daily allowances of vitamin D are listed below. Vitamin D can also be obtained from sunlight exposure a few times a week or by drinking fortified milk.

Recommended daily allowance of Vitamin D

Talk with your healthcare provider about these numbers. In some cases, you might be told to take more vitamin D. Your provider might also have suggestions about the calcium type; for instance, you might be told to take calcium citrate instead of calcium carbonate. Calcium citrate does not need acid to work, so it may be a better choice for people who take antacids.

Lifestyle

Maintaining a healthy lifestyle can reduce the degree of bone loss. Begin a regular exercise program. Exercises that make your muscles work against gravity (such as walking, jogging, aerobics, and weightlifting) are best for strengthening bones.

Do not drink too much alcohol. Do not have excessive amounts of caffeine. Don’t use tobacco at all.

Living With

What can you do if you are living with osteoporosis?

If you have osteoporosis, you should continue with the lifestyle measures mentioned earlier in terms of eating well, getting enough exercise, avoiding excessive caffeine and alcohol consumption, and not smoking. Make sure that you follow the suggestions of your healthcare provider.You should do all that you can to prevent falls inside and outside of your home. You might want to start with a medical evaluation, which could lead to your healthcare provider providing assistive devices.

Prevent falls inside your home

• Keep your floors free of clutter, including throw rugs and loose wires and cords. Use only non-skid items if you have mats, carpets or area rugs.
• Make sure your lighting is bright enough so that you can see well.
• Do not use cleaners that leave your floors slippery.
• Clean up any spills that happen immediately.
• Use grab bars in the bathroom and railings on stairways.

Prevent falls outside your home

• Make sure lighting is adequate in all areas outside your home.
• Use a backpack or other type of bag that leaves your hands free.
• Keep areas outside in good repair and free of clutter.
• Wear sensible shoes with non-slip bottoms.

This is in no way a complete list of things that you can do to help prevent falls, but this is a starting point. Also remember to take your time. You might be less careful if you are in a hurry.

When should you call the doctor about osteoporosis?

If you have risk factors and are concerned about osteoporosis, ask your healthcare provider about being screened, even if you are not as old as 65 (for women) or 70 (for men). Osteoporosis can be serious. Fractures can alter or threaten your life. A significant number of people have osteoporosis and have hip fractures die within one year of the fracture. Always call your healthcare provider if you fall, if you are worried about bone breaks, or if you have back pain that is severe that comes on suddenly.

Remember that you are able to lead an active and fulfilling life even if you do have osteoporosis. You and your healthcare provider can work together to make this happen.

Resources

Are there resources for people with osteoporosis?

This list of organizations is not intended to be complete, but you might find it to be helpful.

Osteoporosis: Symptoms, Treatment, Prevention | Tolbazin Central District Hospital

Many elderly people “heard” that they were supposed to have such a diagnosis as osteoporosis, but no preventive measures and treatment were offered.

Some of them will say – “Oh, osteoporosis, but everyone has it.”

Is it worth worrying if “everyone has it”?

Perhaps someone will say – “I have strong bones in my family, and this will not affect me.” Is it so? What kind of disease is osteoporosis, how is it dangerous and should it be treated?

Osteoporosis is a disease of the skeleton, the cause of which is a decrease in strength and a violation of the structure of bones.Bones become thin and brittle, resulting in fractures. The term “osteoporosis” literally means “porous bone” or “perforated bone”.

Women are most susceptible to osteoporosis – in 85% of cases. Most often, these are women with menopause. Menopause is the most important cause of osteoporosis. After the menstrual cycle stops, the ovaries stop producing estradiol, a hormone that “holds” calcium in the bones. In men over the age of 65, testosterone levels decrease, which “retains” calcium and prevents bone loss.

In addition, there are many risk factors for osteoporosis – those that cannot be influenced (such as race, gender, and age) and those that we can influence through lifestyle changes. For example, quitting smoking, drinking too much coffee and alcohol, and including more dairy products, vegetables and fruits in your diet.

Fractures in osteoporosis – low-traumatic and pathological. Such fractures occur with very minor injuries, in which a normal bone does not break For example, a person tripped over a threshold and fell, sneezed unsuccessfully, sharply turned the body of the body, lifted a heavy object, and as a result – a fracture.

The very first thing you can do on your own even before visiting a doctor is to measure your height and remember what he was like at the age of 20-30. If there is a decrease in height by at least 2-3 cm, this is already a “beacon”, and you need to be examined further. Of course, this does not mean that there is definitely osteoporosis. An accurate diagnosis can only be made by a doctor by conducting an examination, questioning and prescribing a small list of examinations.

Complaints and symptoms in osteoporosis:

• Acute or chronic back pain.Decreased growth.
• Thoracic kyphosis (pathological curvature of the spine in the thoracic region – “hump”).
• Heartburn.
• Stool disorder – frequent stools.
• Chest pain, restriction of inhalation, feeling of shortness of breath.
• Abdominal protrusion.

Instrumental studies: Currently, the most informative instrumental research method is X-ray densitometry – a study in which the density of the examined bones is determined.It is best to examine the vertebrae of the lumbar spine, the radius and the femoral neck – the most “fragile” and prone to bone fracture. Special preparation before the examination is not carried out. Densitometry is a non-invasive research method and does not bring discomfort. The radiation dose is very low. All women 65 years of age and older are recommended to have an examination of the skeletal system without fail! Women under 65 and men with multiple risk factors and symptoms of osteoporosis. If you start the prevention and treatment of osteoporosis on time, you can not only stop further destruction of bones, but also restore them, while reducing the risk of fractures by more than 50%!

The good news is that osteoporosis prevention does not require special financial costs and is available to everyone. You just need to keep in mind that preventive measures must be carried out in a comprehensive manner, and only then can a good result be achieved. Osteoporosis treatment consists of prevention and medication.

So, for the prevention of osteoporosis it is necessary: ​​

• Increase consumption of foods rich in calcium (calcium tablets if necessary).
• Vitamin D intake (sun exposure, foods rich in vitamin D, vitamin D in solution).
• Adequate physical activity (walking, Nordic walking, gymnastics).
• Smoking cessation, moderate alcohol consumption.
• Coffee limitation (up to 2 cups per day).
• Maintain normal body weight.
• Eat more vegetables and fruits (more than 500 g per day).
• Avoid falling.

The goal of osteoporosis treatment is to stop the destruction of bone and restore it. Treatment includes the preventive measures described earlier and drug therapy.

Whatever drug the doctor prescribes, the drug treatment of osteoporosis is long-term, at least 5-6 years. But you need to understand that treatment for each person is individual, depending on the severity of osteoporosis, concomitant diseases and many other factors.Therefore, such drugs should only be prescribed by a doctor.

Take care of yourself. It’s never too late to think about the health of your bones. Osteoporosis can have serious consequences that can be difficult to reverse. Your social role may change, your well-being and attitude to life may suffer. If you start the prevention and treatment of osteoporosis on time, further destruction of bones will stop, they will recover, while the risk of fractures will decrease by more than 50%!

Be healthy!

Physician-therapist LS Kilmukhametova.

90,000 Osteoporosis (bone loss) is a widespread disease.

What is osteoporosis

Osteoporosis, also known as bone loss, is a metabolic disease of the skeleton in which bones lose their strength. They become porous and brittle. The disease is asymptomatic. The first symptom may be a fracture of the spine or hip.

According to the World Health Organization (WHO), osteoporosis is one of the most common diseases of our time. Osteoporosis affects approximately one in four women over the age of 50. The incidence of osteoporosis is higher than that of breast cancer, stroke, and heart attack. ¹

The main task for doctors and patients is to identify the disease as soon as possible. If osteoporosis is diagnosed early, its manifestations can be effectively treated, although there is no cure yet.

Exercise and a healthy diet (vitamin D and calcium) are effective measures The precursor to osteoporosis is osteopenia (decreased bone density). With regular supervision and following the recommendations of a doctor, osteopenia may never progress to osteoporosis. In case of progression, osteoporosis occurs and the need to visit the doctor again so that he prescribes the appropriate therapy.

How does osteoporosis develop?

Some people believe that bones are strong structures that are not subject to change.In fact, this is not the case. Bone is constantly renewed by the simultaneous destruction of bone matter and the formation of new. Hormones, vitamins and other active substances control this process (bone remodeling). In adolescence and youth, the process of bone formation prevails over destruction. Bone formation slows down with age. After a shift in balance towards destruction of bone tissue, the bone gradually loses its strength.

Bone density can be estimated using a special study – densitometry.

Osteoporosis is divided into two forms: primary and secondary .

Primary osteoporosis

Primary osteoporosis

Approximately 95% of bone loss is due to primary osteoporosis.

Osteoporosis type I:
The first type of osteoporosis develops in postmenopausal women (postmenopausal osteoporosis).In this type of osteoporosis, vertebrae are most susceptible to fractures.

Osteoporosis type II:
Osteoporosis type II usually occurs after age 70 (senile osteoporosis). In this type of osteoporosis, the vertebrae, hip bones, and forearm bones are most likely to break.

Risk factors for primary osteoporosis:

• Aging
• Changes in hormonal levels (late menarche, early menopause)
• Hypodynamia
• Long period of immobilization
• Weight deficit
• Diet with insufficient intake of calcium or diet (food in fast food chains, sugary carbonated drinks)
• Alcohol abuse, coffee
• Smoking

Secondary osteoporosis

Secondary osteoporosis

Secondary osteoporosis occurs as a result of other diseases or is a side effect of certain medications:

• Anti-inflammatory hormonal drugs for the treatment of asthma or rheumatism (cortisone)
• Hormonal dysfunctions, such as hyperthyroidism
• Tumor diseases

Risk factors for secondary osteoporosis:

• Long-term use of hormonal drugs (asthma, rheumatism)
• Long-term use of coumarin derivatives (marcumar)
• Systematic disruption of the gastrointestinal tract, including diseases of the pancreas, intestines, liver
• Chronic kidney disease
• Impaired metabolism of thyroid hormones (hypothyroidism) and pancreas (diabetes)
• Cancer

Diagnosis of osteoporosis

A correct and prompt diagnosis is critical for immediate initiation of treatment.Therefore, it is recommended to regularly visit a doctor and conduct screening studies (densitometry) in the presence of risk factors. This applies to postmenopausal women, as well as elderly and senile men. Whenever there is a suspicion of a decrease in bone mass, these suspicions should be confirmed or refuted by instrumental diagnostic methods. Symptoms that suggest osteoporosis are:

• Decreased growth and formation of hyperkyphosis of the thoracic spine (hump)
• Severe chronic pain in the back or sternum
• Bone fractures for no apparent reason, especially spinal fractures under the weight of their own weight

Prevention of osteoporosis

There are various ways to slow down the process of bone destruction.Prevention of osteoporosis should be started already in adolescence, when it is possible to form more massive bones, which will take additional time to weaken after decades. Preventive measures include:

• regular exercise and moderate muscle training (special exercises to train different muscle groups slow down bone loss),
• a healthy and balanced diet with sufficient intake of vitamins, proteins and calcium.

The combination of physical activity and proper nutrition keeps bones and muscles healthy for many years.

Osteoporosis Treatment

Treatment of osteoporosis is aimed at improving the quality of life of patients. Therapy consists of a combination of several approaches, which are combined by specialized specialists in clinical guidelines for osteoporosis. An effective therapy for osteoporosis should be multi-component:

Drug therapy

The following groups of drugs are used for the treatment of osteoporosis:

SMRE

SERMs (Selective Estrogen Receptor Modulators) are chemically similar to the hormone estrogen, the production of which decreases after menopause.SERMs activate estrogen receptors and increase bone formation. Moreover, this group of drugs, unlike estrogen, does not increase the risk of breast cancer and cardiovascular diseases.

Bisphosphonates

Bisphosphonates slow down the degradation of bone tissue and thus slow down the process of bone loss.

Calcium and vitamin D

Calcium and Vitamin D.Calcium is the main element of the mineral component of bone tissue. He must enter the body in sufficient quantities with food. If calcium intake is insufficient, calcium supplementation is recommended. Vitamin D facilitates the absorption of calcium from the gastrointestinal tract and the incorporation of the element into the bone structure.

Parathyroid hormone / teriparatide

Parathyroid hormone / teriparatide stimulates the formation of osteoblasts and increases their activity.Osteoblasts are special cells responsible for bone formation and bone remodeling.

Analgesics

Pain medications relieve pain immediately after fractures (in the acute phase) and relieve chronic pain resulting from vertebral fractures. As you know, pain limits activity, so patients with osteoporosis should receive adequate pain relief therapy.

Motor mode

Exercise is a treatment for osteoporosis. Special physical exercises, developed by physiotherapy specialists and doctors, increase physical activity, improve the functional state of muscles and coordination, and have a positive effect on the overall emotional state.

Therapeutic exercises, especially exercises for training the strength of the muscles of the trunk, must be performed continuously.

A special biofeedback trainer-corrector supports the spine in a physiological position and trains the abdominal and back muscles. In addition to physical therapy, the following types of physical activity are recommended for patients with osteoporosis:

The ideal combination is a combination of strength and endurance training. The more muscle mass, the better the prognosis for bone quality.
Exercising outdoors is especially effective because sunlight stimulates the natural production of vitamin D in the skin.

Important Information: Patients with osteoporosis should always check with their doctor about their level of physical activity and exercise therapy.

Strength training promotes bone formation

Strength training creates biomechanical and biochemical stimuli for bone formation.At the same time, these exercises contribute to the formation of good posture. Strong muscles work in a harmonious and coordinated manner.

The Spinomed Corrector Trainer, when used correctly, also trains muscles. The harness system and aluminum splint create a force that stimulates your own muscles. Thus, the product works almost on a subconscious level. The use of Spinomed is consistent with clinical guidelines for the treatment of osteoporosis. ³

Training Planning

A combination of different types of sports activities is ideal.As a result, muscle mass is increased, bone quality, general condition and a sense of balance are improved. Your attending physician or physiotherapy doctor will help you find the right sports and exercise for you.

Functional orthosis

The work of the skeletal and muscular systems is closely related, therefore, there is usually a simultaneous loss of bone and muscle mass.

For this reason, the treatment of spinal fractures should be functional, not just medication.A vertebral fracture dramatically increases the likelihood of a subsequent fracture and is the cause of chronic pain, low physical activity and associated muscle loss. Modern rehabilitation means for spinal fractures simultaneously train muscles and correct posture at the same time.

In the past, immobilization after spinal fractures in rigid corsets was practiced, but this only led to the progression of osteoporosis. Currently, an increasing number of doctors refuse to use rigid corsets for spinal fractures against the background of osteoporosis, because there are modern means, for example, the Spinomed simulator-corrector.

Medi products: orthotics for osteoporosis

Fractures of the vertebrae in osteoporosis are accompanied by chronic back pain, which severely limits the patient’s physical activity and leads to an even greater progression of the disease. The Spinomed Corrector exercise machine trains muscles and reduces pain, which has been confirmed in clinical studies. ^4.5

The effectiveness of Spinomed and Spinomed active has been confirmed in several clinical studies 5,6:

• the strength of the muscles of the abdomen and trunk increases by 73 and 56%, respectively,
• the deviation of the body from the vertical axis decreases by 25%,
• there is a decrease in the angle of the thoracic hyperkyphosis by 11%,
• there is a decrease in pain intensity by 47%,
• physical activity becomes more comfortable – by 18%,
• respiratory function of the lungs improves by 19%.

Proofreaders Spinomed and Spinomed active were developed by Prof. Helmut W. Minne in collaboration with medi. Spinomed is similar in design to a backpack. Spinomed active is designed as a bodysuit and can be used under outerwear. All Spinomed models act on the biofeedback principle.

Sources

¹ Epidemiologie der Osteoporose: Bone Evaluation Study, Deutsches Ärzteblatt 2013.4, 52 ff.
² Hadji P et al. Dtsch Arztebl Int 2013; 110 (4): 52-57.
³ Lesnyak O.M., Benevolenskaya L.I. Osteoporosis. Diagnostics, prevention and treatment. Clinical guidelines. Ed. 2nd. – M .: “GEOTAR-MED”, 2010.
⁴ Pfeifer M et al. Die Wirkungen einer neu entwickelten Rückenorthese auf Körperhaltung, Rumpfmuskelkraft und Lebensqualität bei Frauen mit postmenopausaler Osteoporose. Eine randomisierte Studie. Am J Phys Med Rehabil 2004; 83 (3): 177-186.
⁵ Pfeifer M et al.Die Wirkungen von zwei neu entwickelten Rückenorthesen auf Rumpfmuskelkraft, Körperhaltung und Lebensqualität bei Frauen mit postmenopausaler Osteoporose. Eine randomisierte Studie. Am J Phys Med Rehabil 2011; 90 (5): 805-815.

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Trainer-corrector for osteoporosis treatment

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Diagnostics and treatment

Types, causes and treatment of back pain

Backache

90,000 Symptoms and diagnosis of osteoporosis

Osteoporosis is a disease that affects human bone tissue. In a progressive form, bone density decreases and, accordingly, their fragility increases.

In a healthy person, there is a natural balance between the formation and degradation of bone tissue. In other words, up to the age of 20, the process of formation and growth of bone tissue constantly takes place. And already upon reaching this age, the process of formation slows down, and the process of destruction of bone tissue gradually begins to prevail. The chemical composition of bone tissue changes and its density decreases.In old age, bones become weaker and can break with minor injuries.

Reasons

However, there are reasons that contribute to destructive processes and accelerate them. These can be various chronic and endocrine diseases, the consumption of foods low in nutrients (magnesium, calcium and vitamin D). In women, bone breakdown increases rapidly during menopause. The risk of developing osteoporosis increases with low body weight and fragile physique, alcohol and smoking abuse, and a sedentary lifestyle.Some medications (corticosteroids, antidepressants, anticonvulsants, hormones, chemotherapy drugs) cause bone breakdown. The risk of fractures is increased if the next of kin under the age of 50 has been diagnosed with osteoporosis. Bone tissue becomes thinner and destroyed as a result of injuries and heavy loads, which is typical for athletes, builders and others who are engaged in hard physical labor.

Symptoms

Osteoporosis is a latent threat to humans, because for a long time the disease does not manifest itself in any way. Night cramps, muscle spasms and sudden pain during movement, aching pain in the bones and in the lower back, sudden sharp pain in the back with prolonged standing, deformation of the bones, and a decrease in human height can be an alarm signal. With osteoporosis, fractures heal slowly, injuries appear after a slight load. Subsequently, if left untreated, osteoporosis can lead to disability or death. It is difficult to independently recognize osteoporosis; only examination will help to identify the disease.

Where to get tested for osteoporosis?

In the medical laboratory “Sinevo” for the diagnosis of osteoporosis, a detailed analysis is carried out – package No. 9.1 “Examination of bone tissue” (1228). Timely examination allows you to diagnose the disease at an early stage, reduce the number of fractures and prevent serious consequences.

You can get tested for osteoporosis at any point of Sinevo in Minsk, Baranovichi, Bobruisk, Borisov, Brest, Vitebsk, Gantsevichi, Gomel, Grodno, Zhlobin, Lida, Mogilev, Mozyr, Novodechno, Novolotshrudok, Ordogrudok , Polotsk, Rechitsa, Svetlogorsk, Slutsk, Smorgon, Soligorsk.

Although many are susceptible to this disease, it can be successfully prevented. To keep your bones strong, you need to stop smoking, excessive consumption of alcohol, coffee and carbonated drinks. A balanced diet and regular intake of calcium and magnesium, vitamins D and K, vitamins of group B slow down the destruction of bone tissue. You will not maintain strong bones if you do not exercise regularly and move little.

Alteration of bone tissue is a natural process of the life cycle of the human body.And with a careful attitude towards yourself, with a healthy lifestyle and constant control, serious consequences can be prevented.

Osteoporosis / Diseases / Clinic EXPERT

Osteoporosis is a systemic disease of the skeleton, the main manifestations of which are a decrease in bone mass and a violation of the microarchitectonics of bone tissue, leading to an increased risk of fractures. The disease is associated with a decrease in bone strength and manifested by bone fractures with inadequately small trauma.

We treat our skeleton as a kind of strong frame, which after the completion of growth remains unchanged until the end of life. This is not at all the case: bone tissue is a living, constantly changing structure, where two opposite processes continuously occur – the destruction of the “old” bone and the formation of a “new” one. Bone is also a storehouse of trace elements (calcium, phosphorus, magnesium). Any pathological change in the amount of these elements in the blood will immediately affect the bone – it will begin to produce missing minerals into the blood, supporting metabolism.Naturally, such “donation”, especially if it becomes frequent, cannot but affect the quality of the bone. There are a great many diseases of the skeletal system, osteoporosis is just one of them.

Classification

Primary osteoporosis

This is the most common form of the disease. It includes:

• postmenopausal osteoporosis
• senile (i.e. senile) osteoporosis
• juvenile (i.e. osteoporosis in adolescence)
• idiopathic osteoporosis (when no clear cause of bone suffering is found).

Secondary osteoporosis

It has many reasons, when there is not a primary damage to the bone tissue, but completely different diseases of the body, one of the manifestations of which is osteoporosis.

This group includes osteoporosis in endocrine diseases, in diseases of the gastrointestinal tract, kidney disease, systemic diseases, blood diseases and even taking many medications.

Symptoms

Basically, osteoporosis is an asymptomatic, for the time being “silent” disease.It can be recognized by the following manifestations:

• sometimes patients may complain of chronic pain in the back or in the bones of the extremities, in the ribs. Pain can be present both at rest and intensify with a prolonged static position (standing, sitting), with little physical exertion
• patients can independently notice a change in posture – the back has become “round”, the distance between the ribs and the pelvic bones has decreased, the abdomen has increased ( became “protruding forward” and does not retract when pulled in)
• a decrease in growth may become noticeable, as a rule, relatives pay attention to this symptom or the patient himself may notice that “he used to reach the furniture shelves, but now I cannot reach it”, “I can’t hang up the laundry, becausebecause I can’t reach the clothesline that was hung several years ago. ”
• Bone fractures that cannot go unnoticed (these are mainly fractures of the bones of the extremities, and fractures and deformities of the vertebrae may not manifest themselves clinically – and the patient will not know about them until the X-ray examination). Fractures from minimal trauma, inadequate force of the traumatic agent should be especially alert. These are the so-called low-energy fractures (falling from the height of their own growth, sharp turns of the body, lifting weights, intensive massage, etc.)etc.).

For a long time it was believed that only elderly and senile women get sick (this was a disease of older women). Of course, this is more often the case – the disease affects women in the older age group who are in menopause. But osteoporosis can affect young men and women, and sometimes even children.

Diagnostics

The “gold standard” of diagnostics is X-ray densitometry of the lumbar spine and hip. This method allows you to assess the mineral mass of the bone, which will be informative in establishing a diagnosis, and, which is important, when monitoring the state of the bone during treatment.Bone mass determined by densitometry is able to orient the patient’s risk of getting an osteoporotic fracture.

Traditional X-ray examination (X-ray of the bones of various parts of the skeleton) may be required. This long-known method is not a thing of the past; it allows one to determine bone deformities, fractures, and the presence of bone tissue remodeling zones.

Clarification of the state of phosphorus-calcium metabolism – laboratory examination of blood and urine, according to the results of which the necessary individual treatment will be determined.

It is also necessary to evaluate the laboratory function of the kidneys and liver. Sometimes, an endoscopic examination of the gastrointestinal tract with a minimally invasive and painless biopsy of the gastric mucosa and duodenum, which is painless for the patient, may be required to clarify changes in these parts.

Often, it is necessary to clarify laboratory parameters reflecting the function of the endocrine glands. The functional state of these organs can significantly affect the bone tissue.

Only a competent endocrinologist should prescribe the necessary examination after an internal examination of the patient.It is in the power of the doctor to provide the patient with information on the disease from him, to discuss further treatment, and why this particular treatment is the choice for the patient; how to observe, examine and what to look for during therapy.

Treatment

Since the development of osteoporosis is based on the predominance of bone destruction over the formation of bone tissue, the general principle of osteoporosis treatment is the prescription of drugs that inhibit bone resorption (i.e. further loss of bone mineral mass).Sometimes it is necessary to prescribe drugs that stimulate the formation of bone tissue. This is a pathogenetic therapy (aimed at the very pathological mechanism of bone suffering). The drug for the treatment is “not alone”, therefore, only a specialist with experience in the treatment of osteoporosis can navigate the correct treatment.

Treatment of osteoporosis is also not complete without the additional prescription of calcium and vitamin D. Therapy with calcium and vitamin D preparations is not an independent treatment of osteoporosis, it is, as it were, a background of treatment designed to provide building material for the bone.Those. calcium is the “stone” in “building bone,” and vitamin D is the “worker” to help build.

In our clinic, we have experience in the use of the entire arsenal of medications for the treatment of osteoporosis, experience in control during the treatment of the disease, which ensures the best effect of therapy.

Forecast

With proper treatment and monitoring of the patient, the progression of bone loss and the risk of fractures can be slowed down. Already existing fractures of the vertebrae and peripheral bones, of course, cannot be corrected.But even stopping the progression of the disease against the background of osteotropic therapy is considered a success in treatment. If it is possible to achieve an increase in bone mass, then this has an even more positive effect on the course of the disease.

Since in the treatment of such a serious disease as osteoporosis, we work more “for the future”, trying to stop the progression of the disease, the effect of treatment is not noticeable quickly.

It is important for the patient not to quit treatment halfway through, but to constantly be in contact with the attending physician to discuss the details of the treatment.

This is possible only with competent supervision (the so-called “management” of the patient by the main attending physician with the assistance of the advice of doctors of other specialties, if required by the specific clinical situation). The prognosis with this approach to therapy is most favorable in relation to the patient’s quality of life and the treatment of the disease.

Recommendations and Prevention

We cannot change the genetic predisposition to osteoporosis, but we can influence other factors contributing to the disease.Lifestyle correction: an active lifestyle, exercise, quitting smoking and moderate alcohol consumption, maintaining a normal body weight (without fanatical achievement of low weight, bordering on exhaustion, but also without obesity), active consumption of foods that provide a positive calcium balance will allow prevent bone loss. Discussion with the attending physician of the drugs taken for the treatment of other diseases and their effect on bone tissue, discussion of measures to protect bones from the side effects of drugs can also save bones from osteoporosis.

As you know, the best treatment is disease prevention. Since a disease can have many causes, prevention should also be multifaceted.

Frequently Asked Questions

How to suspect osteoporosis?

Of the simplest and most affordable means, you just need to measure your height and pay attention to your posture. In ordinary adult life, we do not measure our height, and when a doctor turns to us with this question, we simply indicate our “growth in youth” or focus on the height indicated on the tag of our clothes.However, it is helpful to update your height annually. A decrease in height of more than 5 cm in comparison with growth in youth or a decrease in growth of more than 2.5 cm per year indicates a high probability of osteoporosis. The fact is that changes in posture, rounding of the back, and bending are external signs of osteoporosis when the height of the vertebrae decreases (pathological compression fractures of the vertebral bodies occur). Sometimes patients pay attention to the “not retractable belly” in the absence of general excess weight.This may also indicate osteoporosis, when, as a result of asymptomatic fractures and deformities of the vertebrae, the height of the spine decreases, therefore, the volume of the abdominal cavity decreases. The internal organs need the same volume for their comfortable placement, so the abdomen protrudes forward.

Fracture of the bones of the skeleton with inadequately small trauma is the main symptom of osteoporosis. True, the fracture that has happened indicates a far-reaching process of bone suffering, when the loss of bone mass is already great and its return to normal is simply impossible.Patients rightly ask: “Is it really necessary to just sit and wait for a fracture to make sure of the disease ?!” It is believed that a universal examination of all patients for the detection of osteoporosis is impractical, but it will definitely be required for people who are more at risk of developing osteoporosis than others.

Which skeletal fractures are typical in osteoporosis?

Since osteoporosis is a process that affects the entire skeleton, an osteoporotic fracture can occur in any part of the skeleton.The most common, “favorite places” are the bones of the forearm (“fracture of the wrist,” as patients call it), the femoral neck (a very severe fracture, after which the patient often dies or becomes disabled), vertebrae.

Should I go to a doctor’s appointment and start an examination? Who exactly needs examination and monitoring of the state of bone tissue?

You are at risk for the development of osteoporosis and skeletal fractures, and you may already be sick if:

1. You have had bone fractures from minimal trauma: spontaneous or when falling from a height of your own height, compression fractures of the spine accidentally discovered on X-ray
2. Your age is over 65 years
3. There are patients with osteoporosis in your family (this diagnosis does not have to be on the outpatient card), i.e.i.e. if the family has close relatives: mother, father, sisters and brothers who have suffered bone fractures from minimal trauma after the age of 45-50 years
4. You have a low body weight, your body mass index (BMI) is less than 20 kg / m2 or weight less than 57 kg
5. You have been diagnosed with a deficiency of sex hormones. Early menopause in women (40-45 years old), surgical menopause (removal of the uterus and / or appendages), prolonged amenorrhea (more than a year) in young patients; lack of testosterone in men are signs that indicate the possibility of osteoporosis.
6. Alcohol abuse, smoking are significant factors in the development of osteoporosis
7. You do not like dairy products (the main source of calcium). Low dietary calcium intake contributes to the development of osteoporosis. The human body does not synthesize calcium on its own. We are entirely dependent on the supply of this mineral from the outside. And if this element (extremely important, participating in all life processes – from blood clotting to the transmission of a nerve impulse) is not enough, it is washed out of the bone tissue.
8. You have at least one of the chronic diseases such as diabetes mellitus, rheumatic diseases, inflammatory diseases of the gastrointestinal tract, celiac disease, chronic liver diseases, conditions after resection of the stomach, intestines, diseases of the endocrine system, kidney disease, blood diseases.
9. You are taking prednisolone or its analogues (for any medical condition), or have to take anticonvulsants, or are taking psychotropic drugs.

(Based on the “Clinical guidelines for osteoporosis” edited by Prof. Lesnyak, Prof. Benevolenskaya, 2010).

You have identified risk factors for osteoporosis, what should be done next?

Naturally, it is necessary to carefully consider the assessment of the state of the bone tissue, the possible preservation of the available bone mass in order to avoid bone fractures. To do this, you need to consult a doctor and discuss a plan for further examination. It is a face-to-face conversation with a doctor that will allow not to miss important examinations and avoid “unnecessary” tests.

The examination revealed osteoporosis. Still nothing worries, there were no bone fractures, but is it necessary to be treated?

With established osteoporosis, it is necessary to treat and monitor the condition of the bone tissue. Here we are working “for the future” in order to halt or minimize bone loss.

If a disease has appeared and it still cannot be “completely cured”, but only slowed down, are there any drugs against this disease?

There are drugs for the prevention and treatment of osteoporosis.Basic therapy is necessary to prescribe calcium supplements, so that the intake of calcium into the body with medications and food corresponds to normal (1000-1500 mg per day). But it is impossible to limit ourselves to the appointment of calcium preparations – this is not the main treatment of the disease, calcium is only one of the “building blocks in bone restoration”. Further, special drugs are required to inhibit bone destruction or stimulate bone formation.

Only an endocrinologist can prescribe treatment, decide on the choice of a drug, track the tolerance and effectiveness of treatment.

I am receiving treatment for osteoporosis and “I feel nothing”, how do I know if the medicine is working and is it helping?

It is not possible to track the effectiveness of the treatment right away, the bone is gaining weight rather slowly, therefore, only after 1-2 years of treatment, we can make a special X-ray examination and clarify the bone growth. Laboratory indicators of calcium metabolism can and should be repeated during treatment, they will also help to orientate in the correct choice of therapy.

Is the fact that I receive treatment for osteoporosis a 100% guarantee that there will be no bone fractures?

Unfortunately, doctors are not able to give such a 100% guarantee even with proper treatment. Bone fracture is possible both during treatment and after the end of treatment. Nevertheless, if we put the patients with osteoporosis who were treated and those who did not receive treatment in one row, then in the first group (treated) the frequency of fractures will be much lower.

Treatment histories

Case No. 1

Patient S., 58 years old. Complains of back pain that occurs when walking and with prolonged upright position. After resting in the supine position, the pain diminishes, but the back is “constantly tired.” The patient’s relatives noticed that the patient became shorter and hunched over. The patient herself noted that she stopped reaching the hanging shelves in the kitchen, and associated it with age. ” I independently used various gels and ointments for back pain, which produced a temporary effect. The patient privately turned to a masseur for help.No X-ray examination was performed prior to the procedure. Against the background of the third session of intensive back massage, there was a sharp pain in the spine. The back pain did not subside, the patient could not get out of bed due to pain. She was admitted to the traumatology department, where a “fresh fracture” of one of the vertebrae in the thoracic spine and multiple “old” fractures and deformities of the vertebrae in the thoracic and lumbar spine, which the patient had not previously known about, was found.

Diagnosed with osteoporosis. In a conversation with the patient, it was found that menstruation stopped early (from 41 years old), and hormone replacement therapy with sex hormones was not carried out. There is a concomitant pathology of the gastrointestinal tract – chronic atrophic gastritis, duodenitis. The patient practically does not consume dairy products (she does not like it, taking milk often gives bloating, loosening of the stool). When clarifying the heredity, it became known that the patient’s mother died at the age of 74 after a hip fracture.

The patient underwent a laboratory examination to clarify the state of calcium metabolism. She was prescribed therapy for the treatment of osteoporosis. After improving her health, the patient underwent rehabilitation treatment in a specialized department. She notes the effect of the treatment, but regrets that she did not know about such a disease as “osteoporosis” and did not seek help earlier.

Case No. 2

Patient K., 52 years old. Within 4 years, she began to notice pain in the back, in the bones of the pelvis, in the legs.Cramps in the muscles of the arms and legs. General weakness was present, weight began to decrease spontaneously (in 4 years she lost 18 kg).

Due to back pain limiting movement, several examinations were performed: MRI, radiography of various parts of the spine. The signs of widespread osteochondrosis with herniation in the lumbar and sacral spine were described. She received therapy with anti-inflammatory, analgesic, anticonvulsant drugs, but there was no tangible effect of the therapy.Due to the continuing weight loss, growing complaints of general weakness, the patient was examined to exclude oncological pathology, during the examination this assumption was not confirmed. Gradually, the state of health worsened even more, fractures of bones (ribs, collarbone, shin bones) appeared with a minor injury (fell at home), she stopped moving herself even in an apartment. Laboratory examination revealed a significant decrease in hemoglobin, low blood calcium levels and very high levels of parathyroid hormone.Severe osteoporosis has been identified.

Due to the data obtained, during a follow-up examination, the patient was diagnosed with celiac disease. This diagnosis in this patient was first established already in adulthood. Previously, the patient did not know about this disease.

With a retrospective questioning, the patient indicated that “it was always difficult to gain weight, she was thin all her life”, the stool was frequent (3-5 times a day), diarrhea occurred when taking some products (bread, oatmeal). Since childhood, my stomach often hurt.At that time, proper attention was not paid to these disorders. The patient herself has long been accustomed to the peculiarities of the function of her gastrointestinal tract, considering this to be her individual norm, and tried to “adjust” to the situation. A progressive clinic (pain, fractures, changes in laboratory parameters) appeared only at the age of more than 50 years, after the onset of menopause.

Correctly established diagnosis and treatment in the form of a permanent specialized diet, with minimal drug treatment, made it possible to stop the progression of the disease.The patient feels well, there were no fractures, and she does not bother with bone pain. Dynamic examination revealed an improvement in the state of bone density.

These examples demonstrate the need for a comprehensive examination of patients to identify the cause of osteoporosis, without attributing all manifestations of bone tissue pathology only to “age”. Pathology of the gastrointestinal tract can significantly alter bone metabolism, leading to the development of severe osteoporosis.

Osteoporosis: Classification of Osteoporosis, Causes of Osteoporosis, Diagnosis of Osteoporosis | doc.ua

Osteoporosis of bones can be systemic or diffuse, when the process of destruction covers all bones of the skeleton.

Bones are divided into two types: compact and spongy. Compact tissue is dense, has a homogeneous structure and consists of bone plates. A compact fabric covers the outside of the bone. The thickest layer of compact substance is located in the middle part of long tubular bones: femur, shin bones, ulna, humerus, radius.

The heads of bones, as well as flat and short bones, are covered with a thin layer of a compact substance, under which is a cancellous substance. It has a porous structure, since it is made up of bone plates located at an angle to each other and forming special cells.

In healthy bone, the spongy substance consists of pronounced bone plates and has small pores. The spongy tissue plates are positioned so that the bone can withstand various loads when walking, running or playing sports.Osteoporosis of bones leads to the fact that bone tissue loses its mineral composition, due to which the bone plates become thin or disappear. As a result, the thickness of the compact substance decreases and the spongy substance is discharged. Bone mineral density becomes poor, and the structure of bone tissue changes. The plates do not line up along the lines of compression-tension, therefore, the resistance of the bone decreases even to light loads.

Classification of osteoporosis

The disease is divided into primary and secondary.

Primary osteoporosis occurs in the region of 95 percent. They are divided into several types:

• type 1 (postmenopausal) – usually occurs between the ages of 50–75. This osteoporosis is more common in women than in men of the same age group. It is tied to some hormone – estrogen, which is responsible for bone formation;
• second type – occurs after 70 years, also more often in women. It occurs due to a quantitative calcium deficiency;
• idiopathic – occurs during childhood or adolescence.In principle, it is rare. May occur in women due to prolonged lactation.

Secondary osteoporosis is uncommon and usually depends on external factors.

Causes of osteoporosis

The reason for the development of osteoporosis is associated with a lack of certain hormones in the body: estrogens in women and androgens in men. The female body is most susceptible to this disease, since during menopause, after 50 years, the level of estrogen decreases. Other reasons that lead to the destruction of bone tissue in old age are a lack of calcium and vitamin D in the blood, inactivity, and other changes in the endocrine system associated with age.

The occurrence of osteoporosis depends on how much bone mass has developed before the age of 25-30 and how quickly it is lost after this period. The higher the bone mass, the lower the risk of developing this disease.

Other causes and risk factors for osteoporosis include:

• thin women, short stature, women in old age;
• menopause, women who have undergone surgery to remove reproductive organs or menstrual irregularities;

90,025 women, white or Asian, especially if you have relatives with osteoporosis;

• poor diet, smoking, anorexia or bulimia, lack of calcium in food, frequent alcohol consumption, lack of exercise, use of anticonvulsants;
• thyroid hormone levels – high levels of thyroid hormones lead to bone loss, this is due to increased thyroid function or when taking a large amount of hormones to treat hypothyroidism;
• the presence of rheumatoid arthritis;
• taking corticosteroid drugs – the constant use of drugs such as prednisolone, hydrocortisone, dexamethasone, leads to fragility of bones;
• bad heredity.
• among the diseases that cause the destruction of bone tissue, Crohn’s disease, celiac disease, Cushing’s syndrome are distinguished.

Several factors may increase the risk of osteoporosis in women:

• the presence of rheumatoid arthritis;
• diseases of the endocrine system: thyroid and parathyroid glands;
• vitamin D deficiency due to lack of sunlight;

90,025 chronic bowel diseases;

90,025 frequent drinking and smoking;

• lack of calcium in the diet;
• long-term use of glucocorticoid hormones;
• genetic predisposition.

Osteoporosis Symptoms

In most cases, changes in the structure of bone tissue begin even before the onset of symptoms of osteoporosis. Many patients come to the doctor already in the serious stages of the disease. Among the primary signs of osteoporosis are: discomfort in the area between the shoulder blades, muscle weakness, pain in the lower back and back, arms and legs. Strong pain, changes in posture in the form of a stoop and curvature of the spine, frequent fractures, a decrease in human growth can be observed in a more neglected state.

Osteoporosis can have several stages depending on the degree of bone damage:

• Grade 1 – the lightest, it is characterized by a slight decrease in bone density. The patient is worried about periodically painful symptoms in the spine or arms, legs, muscle tone decreases.
• Grade 2 – moderate, accompanied by pronounced changes in the structure of bone tissue. Chronic pain is observed, a stoop occurs, since the spinal column suffers from destruction.It is difficult for the patient to move, stiffness and sluggishness in movement is felt.
• Grade 3 – the most severe, at this stage there is a destruction of most of the bone tissue and a decrease in bone mass. Posture is noticeably impaired, growth is significantly reduced, severe pains in the back and lower back occur. The patient is practically unable to walk, movements are slow and constrained, often leading to disability and loss of vigorous activity.

Osteoporosis often manifests itself as prolonged and severe pain symptoms in the lumbar and cervical spine.The pain occurs after a prolonged stay in one position for half an hour or after a long walk for an hour. The patient is often tired, feels pain in the muscles and legs, and severe weakness occurs.

There is a decrease in growth, as the destruction of the spinal column and compression fractures occur. The vertebrae become lower in height, their base becomes thin and they collapse. Posture changes, the person begins to slouch and lean forward. Posture is disturbed due to the fact that the vertebrae become wedge-shaped.With osteoporosis, a person loses weight a lot. Because of the fragility of the bones, frequent fractures occur without heavy loads or impacts: in half of the cases, the vertebrae break, in 20% there is a hip fracture and in 15% – the wrist joint.

The danger of the course of osteoporosis is that the patient does not feel such severe pain as in other diseases of the musculoskeletal system. This is because the process of decreasing bone density and thinning occurs slowly over an extended period.

Other signs of osteoporosis

Due to a violation of mineral metabolism in bone tissue, osteoporosis may be accompanied by the following symptoms:

• Cramps in the calf muscles at night;
• fragility and fragility of nails, hair;
• fast graying of hair;
• due to calcium deficiency in the body, there is an increased heart rate and arrhythmia, shortness of breath;
• Disease of teeth and gums: bleeding gums, tartar, thinning of enamel, caries;
• fatigue and weakness.

Diffuse osteoporosis

With the development of diffuse osteoporosis, the bone mineral density becomes thinner, it becomes porous and fragile. The balance of bone metabolism and destruction is disturbed, bone tissue is destroyed faster than it is restored. These processes lead to loss of bone mass, fragility of bones, which increases the risk of developing fractures of the vertebrae, hip, wrist and other areas. The disease can cause partial or complete immobility, disability and, in some cases, death of the patient.Osteoporosis not only impairs quality of life, but also shortens life expectancy by 20%.

Osteoporosis of the knee joint

This is a condition in which deformation of the large cartilage, joints and tissues of the knee occurs. Over time, knee joints become less elastic, causing cartilage to wear out. The patient is in severe pain and cannot walk or climb stairs normally.

At the beginning, osteoporosis of the knee joint does not manifest itself in any way, therefore, patients often do not notice the changes and the disease becomes more complicated.The disease requires immediate treatment, as it can lead to serious complications.

According to statistics, overweight people are at risk, as there is a lot of stress on the legs. It also includes people who have suffered a deformity of the knee joint as a result of congenital or acquired injuries, athletes, people in the elderly and suffering from joint pain.

A serious complication of osteoporosis of the knee joint is fractures with a slight load on the bone, which heals slowly and painfully.An imaginary joint is formed between the joints, the so-called pseudarthrosis, which interferes with normal walking and movement. A fracture can occur from minor loads such as a slight impact on the surface, falling, coughing and sneezing, stress on bones during movement.

The most dangerous is osteoporosis of the knee joint of the 3rd degree. With this disease, knee atrophy, an increase in the size of the joint, a curvature of the shape of the legs occur, a person cannot move independently.The third degree most often leads to disability.

Osteoporosis of the spine

This is a pathological condition in which there is a violation of bone density and a decrease in the strength of the vertebrae. The destruction of the vertebrae occurs for many reasons, develops slowly, without pronounced symptoms, until the vertebrae are fractured.

Osteoporosis of the spine is a serious disease, since the spinal column is subject to heavy loads during movement, it takes part in maintaining balance and vertical position of the body.The collapse of the vertebrae can often lead to compression fractures, which limits the person’s mobility and can render them disabled.

This disease is an urgent problem. According to statistics, 250 million people worldwide suffer from osteoporosis. It is detected during diagnosis in persons over 50 years old, in 33% of women and 20% of men. By the age of 70, more than 50% of women and 20% of men have severe osteoporosis. Women over 50 are at risk of spinal fractures in 15.5% of cases.Every 8 men over 59 years old has a fracture due to osteoporosis, of which 20% of cases are a spinal fracture.

Osteoporosis of the spine can be primary or secondary. In the first place is postmenopausal osteoporosis, which occurs in women after menopause, before the age of 70. Senile osteoporosis develops in men and women over the age of 70 due to age-related changes and calcium loss. These types of the disease are most common. Idiopathic osteoporosis can occur due to unexplained factors in women aged 20-50 years, in men – from 25 to 60 years old.

Osteoporosis of the spine can be observed at a very young age, at 10-11 years old, both in girls and boys. It is juvenile osteoporosis that affects the thoracic region. It develops within 1 to 5 years, then the growth of the vertebrae is restored. In some cases, a curvature of the spine may occur, which remains for life.

Secondary osteoporosis of the spine occurs due to heredity, taking certain medications such as glucocorticoids, immunosuppressants, anticoagulants, aluminum-containing drugs, gonadotropin antagonists, thyroid hormones.Certain diseases of the blood, kidneys, digestive tract, endocrine system, Itsenko-Cushing’s syndrome can also lead to the development of osteoporosis.

Osteoporosis of the foot

Osteoporosis of the foot develops against the background of destructive processes in the bone tissue of the foot. Bones lose important trace minerals and become brittle. This disease is dangerous, since the weight of the body presses on the leg and the main load falls during movement.

Pain symptoms are severe when moving and walking, but can also be observed with complete rest.With the development of osteoporosis of the foot, the leg swells and redness occurs. A person cannot walk and move normally. General signs of the disease can also be observed: weakness, fatigue, decreased growth, stoop, brittle hair and nails, early graying.

Diagnosis of osteoporosis

Before treating a disease, it is necessary to diagnose osteoporosis.

Diagnostics consists of several steps

• consultation of a rheumatologist, traumatologist and neuropathologist;
• laboratory tests: analysis of daily urine to determine the level of calcium, as well as a blood test for hormones, calcium and other elements, taking a biopsy;
• instrumental examination: ultrasound of bone density, radiography of the spine and bones, magnetic resonance imaging, osteodensitometry, bone biopsy, computed tomography and 2-energy X-ray absorptionometry.

Usually, preventive diagnostics should be carried out by those who are at risk: women 50 years and older, men 60 years and older, as well as people who have suffered injuries and fractures in the past.

Osteoporosis Treatment

Maximum bone density is reached by age 25, so it is important to maintain the required amount of calcium in the body by this age and beyond. Osteoporosis treatment involves the use of several medications to repair bone tissue.

Treatment of osteoporosis in women

Since the main cause of the disease is a lack of estrogen, women are prescribed hormone therapy, which replenishes the level of female sex hormones. These drugs stop the destruction of bone tissue and restore metabolic processes. Several types of medications are used to treat osteoporosis in women.

Preparations for osteoporosis

• Bisphosphonates – Alendronate, Ostalon and others, which help restore bone structures.They are used in combination with calcium supplements. To maintain bone mass, special drugs are used, for example, Bivalos. It increases bone mineral density, promotes bone tissue renewal.
• Vitamin therapy, calcium acidate and vitamin D supplements are used to eliminate the symptoms of the disease and strengthen bones. In some cases, hormone replacement therapy is used with preparations containing the thyroid, parathyroid and other endocrine glands.
• Preparations for the restoration of bowel function to improve the ability to absorb and assimilate calcium.

Taking medication for osteoporosis

When using bisphosphonates, it is necessary to take a sufficient amount of calcium with vitamin D every day. Bisphosphonates in the form of tablets can lead to discomfort in the stomach and intestines in the form of heartburn and nausea, so they should be drunk at least half an hour before meals. Calcium supplements are not recommended to be taken within 2-3 hours after taking bisphosphonates. It is forbidden to drink calcium along with this drug.

Osteoporosis tablets can cause inflammation of the mucous membranes of the stomach, esophagus and duodenum.To prevent inflammation, after taking the pill, you need to stand or walk for 30-60 minutes, so the pills will have minimal contact with the surface of the mucous membrane.

At the first intravenous administration of bisphosphonates, flu symptoms may appear: temperature drops, muscle pain. You should tell your doctor about this, but they do not require treatment. With the second administration of bisphosphonates, such an acute reaction will no longer occur.

At one time, doctors believed that estrogens protect the heart and blood vessels, but later studies showed that the drug can cause coronary heart disease, stroke and venous thromboembolism.Estrogens can have side effects such as breast swelling and pain, weight gain, and vaginal bleeding. They can be avoided by combining with other drugs and reducing the dose.

Women with osteoporosis who are unwilling and unable to use estrogens may be prescribed selective estrogen receptor modulators (SERMs), such as raloxifene. These drugs should be taken if there are relatives with breast cancer. The substance raloxifene also affects bone tissue and cholesterol levels like estrogens.However, it does not stimulate the uterus or mammary glands, so the risk of developing tumors is minimal. The substance may cause hot flashes. Blood clots may form in the vessels. The therapy also uses the drug Tamoxifen, which is used in the treatment of certain types of breast tumors, which prevents bone destruction and restores bone mass.

As a supplement, a calcium and vitamin D complex is prescribed to increase bone mass. Each should be taken at 1200-1500 mg with foods and calcium supplements.You can consume 600 mg in one dose, since a large amount of calcium is not well absorbed. It is better to take calcium in two doses: in the morning and in the evening. It is also necessary to take 800-100 mg of vitamin D every day, which is needed for the complete absorption of calcium and helps to build bone mass.

Bisphosphonates are used to restore bone tissue. They can be taken orally: alendronate, risedronate, etidronate, and intravenously: Reclast, Aklasta. They stop bone loss and can increase bone mineral density.

Good nutrition is essential to prevent osteoporosis. When bone tissue is formed, food should be rich in calcium and vitamin D: dairy products, broccoli, nuts, seeds, fish. It is recommended to stay in the sun more, but only in the morning and afternoon hours, since with the help of ultraviolet radiation, vitamin D is produced in our body. With osteoporosis, food supplements and mineral complexes with calcium, phosphorus, vitamin D are taken.

Studies have shown that sports and physical activity contribute to the growth of muscle and bone tissue.Women of all ages should exercise to increase bone mass and prevent bone breakdown. Moderate physical activity at a young age and during menopause effectively fights calcium leaching from bone tissue and prevents the development of osteoporosis.

Regular exercise makes muscles and bones stronger, as the amount of calcium and bone density depends on the surrounding muscle tissue. To prevent osteoporosis, sports such as cycling, horse riding, running, walking, tennis, jumping rope, dancing, and aerobics are suitable.They help increase bone mass and strengthen bones.

When playing sports, you should choose moderate loads so as not to injure the body and bones. Many girls are actively fond of diets and exercises, which lead to a strong decrease in fatty tissue in the body, menstrual disorders and metabolic disturbances in the body occur, which leads to early menopause. This can be a factor in the development of osteoporosis.

In case of osteoporosis it is necessary to adhere to some recommendations:

• Maintain correct posture.Correct posture will help relieve heavy stress on the spine. While sitting or driving, place a rolled towel under your lower back. When reading or doing manual work, you should not bend over strongly; when lifting weights, you need to bend your knees, not your back, keeping it straight. When working in the garden or vegetable garden, it is better to use a small chair or work on your lap with a soft mat underneath.
• Choose the right shoes with low heels, non-slip soles to avoid falls, as there is a high risk of bone fracture.
• For chronic pain, see a doctor to treat it with medication. Chronic pain restricts movement and causes more pain when sedentary.
• Stop smoking and drinking alcohol.
• You need to move more and lead an active lifestyle, choose the type of physical activity that will be useful and not traumatic.

Nutrition for osteoporosis

In the treatment and prevention of osteoporosis, it is recommended to maintain a diet rich in calcium and protein.Foods that are high in calcium and strengthen bone: low-fat milk, low-fat yogurt, broccoli, nuts, seeds, cauliflower, oranges, sesame seeds, salmon, tofu, and green leafy vegetables.

After menopause, women are advised to include more plant estrogen-rich foods such as soy milk, tofu and other soy products in their diet to maintain estrogen levels and prevent osteoporosis. However, there are no reliable studies that would prove a direct connection of these products with the prevention of osteoporosis.

In addition to the diet fortified with calcium, you should exclude foods that contain phosphorus, as it leads to bone loss. Foods high in phosphorus include red meat, sodas, and phosphorus supplements. Increased consumption of alcohol and caffeine leads to a decrease in the amount of calcium and its leaching from the bones. It is worth giving up nicotine, as it interferes with the normal absorption of calcium into the bone.

How to cure osteoporosis at home:

• Add low fat dairy products to your daily diet, including soups, stews, and baked foods.A tablespoon of milk powder contains about 20 mg of calcium. It is recommended to drink a glass of milk a day or eat a handful of almonds, sesame seeds, dried fruits if you are lactose intolerant.
• Add a little vinegar to the bone broth water used for making soups. Vinegar releases calcium from the bones, so the soup will be high in calcium. 500 ml can contain up to 1000 mg of calcium.

In addition to proper nutrition and therapy, it is necessary to maintain physical activity.Studies have shown that strength exercises and sports that put stress on bones, such as walking, tennis, running, ballet, climbing stairs, aerobics and lifting weights, strengthen bone mass and prevent the development of osteoporosis. For the effectiveness of prevention, sports should be practiced 3 times a week, lasting 40 minutes. Cycling and swimming are recognized as the best for the prevention of cardiovascular disease, but not for osteoporosis, as they do not put a lot of stress on the bones.

Physical activity should be moderate, especially during the treatment period, as there is a high risk of injury. It is necessary to choose a complex of health-improving gymnastics, yoga, it is useful to walk. Exercises should be done slowly, avoid sudden movements, turns and lifting weights, running and jumping are excluded.

Trace elements for osteoporosis

It is equally important for osteoporosis to include foods with trace elements in the diet. To strengthen bones, phosphorus is needed, which is part of the tooth enamel and bone tissue.The diet should include foods rich in phosphorus: poultry, beef, veal, egg white, liver, nuts, grain bread.

Copper is also involved in the formation of bone tissue. It is essential for bone formation, protein metabolism, and cartilage formation. A high content of copper is found in buckwheat, nuts, seafood, sunflower and olive oil. Copper is found in cherries, cocoa, raisins, cream.

Boron is another important trace element for bones. Thanks to boron, vitamin D is actively absorbed in the body, which is involved in the formation of bones, the absorption of calcium, phosphorus and magnesium.With a lack of boron, osteoporosis can develop, so it is necessary to include in the diet fruits and vegetables such as carrots, pears, grapes, cherries, cabbage, peaches, beets, nuts and all legumes.

Nutrition for osteoporosis should include foods with zinc. He takes part in the formation of bone tissue. Foods with calcium can disrupt the balance of zinc in the body, so you should diversify the menu with oatmeal, peanuts, wheat and millet cereals, nuts, seafood, pumpkin and seeds.

Calcium and vitamin D preparations are used for the prevention and complex treatment of all types of osteoporosis and bone fractures, as well as for replenishing the lack of calcium and vitamin D in food. For the prevention of osteoporosis, you need to take 1-2 tablets per day of calcium and vitamin D for better absorption. For the treatment of the disease, the dose of vitamins and minerals is determined by the doctor.

To enhance the effectiveness of treatment, nutrition must be combined with a complex of physiotherapy exercises, walks, walking, dancing.You should avoid increased loads, lifting weights, running and jumping, injuries, so that there are no fractures. During the recovery period, therapeutic exercises should be performed at a calm pace, it is forbidden to make sudden movements, bend over and turn. It is recommended to walk outside more often, as the sun’s rays contribute to the active production of vitamin D in the body.

Treatment of osteoporosis with folk remedies

These recipes will help eliminate inflammation, strengthen bone tissue and relieve pain.Treatment of osteoporosis at home must be combined with the main complex of drugs and therapeutic exercises.

Parsley and dill greens. For cooking, you need to take 200 grams of dill and 200 grams of parsley. The greens need to be washed well, then bring half a liter of water to a boil and pour the greens. The broth must be infused for 3 hours, then strain through cheesecloth or a sieve.

You need to take a decoction of 300 ml every day for 6 months, divide the decoction rate into 3 parts and drink it throughout the day.This decoction is useful in the treatment of osteoporosis and prevents the development of fractures. It also helps with atherosclerosis, which is common in the elderly.

Chicken egg shells. One of the most effective and simple folk recipes for osteoporosis. When eating eggs, do not discard the shell, remove the film from the inside of the shell, dry the shell and save. It contains a large amount of calcium, which is necessary to restore bone density.

In order not to become infected with salmonellosis, the egg shell must be sterilized. To do this, you can wash the shell with soap or heat it in a pan. If you are going to give the shell to a child, put it in boiling water for 5 minutes. Eggshells need to be wiped with a mortar into a fine powder. Then you need to take a few lemons and squeeze the juice out of them. Mix the ground shell with lemon juice in a one-to-one ratio.

This mixture should be consumed every day in the morning, one fourth teaspoon, for several weeks.It is better to take the egg mixture at the beginning of the year, since at this time in the body there is a significant lack of calcium. Eggshells are useful for strengthening bones, increasing bone mass, and preventing fractures. In case of urolithiasis, you should consult your doctor before using this mixture.

Onion soup is a useful and affordable remedy for osteoporosis. You need to take 2 large onions with the peel and chop finely, then fry in vegetable oil until golden brown.Pour a liter of water into a saucepan and boil it. When the onions are fried, put them in boiling water and simmer for 15 minutes. Then the onion should be left to brew for half an hour, then we filter so that there is no husk left. Divide the resulting broth into 3 equal parts and drink one of them every day. For the treatment of diffuse osteoporosis, such a decoction should be consumed within one month.

Lemon juice. Lemon juice is a good remedy for osteoporosis. One tablespoon of fresh juice should be dissolved in a glass of warm water, you can add a spoonful of honey and drink every day after a meal.

Folk remedies for osteoporosis

In osteoporosis, a fairly effective remedy is a decoction of various herbs, which can be consumed as tea or made compresses from it to eliminate pain and inflammation:

• Take 100 grams of fresh sweet clover and chamomile grass and pour over them with vodka (500 grams), then leave to infuse for 3 days. This tincture should be used for compresses that are applied to a sore spot. It is better to put a compress before going to bed for the whole night.It is recommended to apply compresses every day for 2 weeks.
• Take 200 grams of fresh birch buds and pour half a liter of vodka over them, then leave to infuse in a dark place for 7 days. The resulting tincture is used in the form of a compress, which is applied at night to a sore spot. The course of treatment is 30 days.
• Take 300 ml of tincture of bird knotweed and pikulnika each, add 400 ml of tincture of horsetail to them. Mix the liquid well.Take this mixture every day, 1 tablespoon before meals for several weeks. The tincture is good for osteoporosis of the feet and hands.
• St. John’s wort decoction is widely used in any type of osteoporosis. Take 1 tablespoon of dry St. John’s wort and fill it with a glass of boiling water. Leave the broth to infuse for 40 minutes. After that, you need to strain the broth and drink 3 tablespoons a day. To improve the taste, you can add a spoonful of honey or lemon juice to the broth.
• Another folk remedy for osteoporosis is a decoction of walnut leaves. The walnut leaves need to be dried. Prepare the broth: pour 1 teaspoon of chopped leaves with one glass of boiling water. The resulting broth should be drunk twice a day before meals. The course of treatment is 2 weeks.
• Comfrey or bone breaker is good for bone fracture or fracture. You need to buy a 10% tincture of comfrey root and drink 10 drops twice a day for 10 days. After that, you need to take a break for 2 weeks, and then repeat the course of treatment.

Prevention of osteoporosis

Osteoporosis prevention measures should be carried out even in childhood and adolescence to provide favorable conditions for normal growth and development of the skeleton. The formation of the skeleton and an increase in bone mass occurs from the moment of birth until the age of 20-30. At this age, peak bone mass is reached.

Children and adolescents should get adequate calcium from food or special supplements. The body must receive the necessary amount of vitamin D under the influence of sunlight or with food.At a young age, it is necessary to go in for sports and physical activity, exclude smoking and drinking alcohol.

After reaching peak bone mass, slow bone loss begins due to age-related changes. The destruction process prevails over the restoration process. During this period, it is necessary to especially actively observe measures for the prevention of osteoporosis in order to prevent the disease at a later age:

• Observe a diet rich in calcium and other trace elements;

90,025 play sports, move a lot;

• to exclude nicotine and the use of alcoholic beverages;
• Take calcium and vitamin D supplements as needed.

Diet prevention

With menopause, food should be enriched with foods with calcium, magnesium, phosphorus, copper and zinc. It is recommended to eat foods such as cabbage, especially broccoli, nuts, especially cashews and pine nuts, whole grains from all types of cereals and legumes, milk and sour milk products, dried fruits, especially dried apricots and prunes, sesame seeds, various greens, especially lettuce and spinach , fresh vegetables and fruits.

Food should be enriched with magnesium and phosphorus necessary for bone tissue restoration, as well as vitamin D.The menu should include dairy products, egg yolk, liver, sea fish, fresh herbs and sprouted grains. Cereals and soybeans contain natural estrogen – an analogue of the female sex hormone estrogen, which stops the destruction of bone tissue. Zinc enhances the effect of vitamin D, which is involved in the absorption of calcium, therefore, the diet should contain seafood, poultry, processed cheese, legumes, buckwheat, oatmeal, barley and wheat, peanuts, pine nuts.

Nutrition should limit fatty, fried foods, salt, sugar and sweets, as they contribute to increased excretion of calcium from the body.It is also worth limiting the consumption of coffee and carbonated drinks, as they contain fluoride. However, the diet should not be meager, as constant diets increase the risk of osteoporosis. Lean women often suffer from bone destruction, so olive and sunflower oil, fatty fish, avocados and nuts should be included in the diet. These are healthy fats that will help keep your skin slim and beautiful.

Prophylaxis with drugs

The prevention of osteoporosis in menopause includes the intake of dietary supplements with calcium and vitamin D.These are preparations based on an easily digestible form of calcium salts: gluconate, lactate and others. Calcium gluconate is recommended more often, as lactate leads to urolithiasis. It is better to take vitamin preparations containing a balanced mineral complex, which includes potassium, phosphorus and magnesium. They are essential for nourishing bone tissue and building bone mass, as well as protecting against fractures.

Women during menopause are shown taking drugs based on female sex hormones – estrogens.They must be taken strictly within the specified time frame, as they can have severe side effects: breast cancer, blood clots in the vessels. Modern medicine has developed preparations with phytoestrogens, which contain plant analogues of estrogen that can replace its deficiency without side effects.

An effective drug is bisphosphonates, which suppress the activity of osteoclasts – cells that destroy bone tissue. They are used as a prophylaxis and treatment for various types of osteoporosis.You can take them once a month.

Special biologically active supplements with herbal substitutes for thyroid and parathyroid hormones have been developed for women, which improve calcium metabolism. Supplements are not medicine and do not cause side effects, they are safe for health. You can take it without a doctor’s prescription, but it is better to get advice.

Prevention through exercise

Exercise plays an important role in the prevention of osteoporosis in women.They help build bone mass and strengthen bones. It is necessary to devote to sports for 40 minutes 3 times a week, as weak muscles lead to bone loss and bone destruction. Studies have shown that with a sedentary lifestyle, the volume of bone mass decreases by 10-15%. Regular sports activities for the same period of time are able to restore bone tissue only by 1–2%.

Physical activity should be forceful in order to build muscle tissue and bone tissue.Among them, first of all, running, jumping, training on simulators, dancing, fitness, aerobics are distinguished. Swimming and cycling are great for preventing cardiovascular disease, but not really for preventing osteoporosis. Hiking and walking are helpful. In this case, it is necessary to limit the lifting of weights, heavy loads in order to avoid fractures. Wear low-heeled shoes to reduce the strain on your back.

In addition to preventive measures, it is necessary to regularly undergo bone tissue diagnostics.To do this, you need to examine using X-ray, which shows the mineral density of the bones. This method allows you to find out how much bone mass is lost. Women over 40 years old and during menopause need to undergo this diagnosis once a year in order to prevent the disease or start treatment in the early stages of development.

Prices for drugs for the treatment of osteoporosis can be found on our website, as well as on the “Pharmacy” tab, any user has the opportunity to book them.

Why are women more likely to suffer from osteoporosis?

23 November 2018

Hormones are “turned off”

Osteoporosis occurs primarily in women. The onset of menopause “helps” this. When sex hormones – the main protectors of bone tissue – are turned off, bone destruction is accelerated. Postmenopausal osteoporosis is the most common. Even a healthy woman, with the onset of hormonal changes, begins to lose bone very quickly.And if her bones were initially more fragile, then the form of the disease will be more severe.

– The processes of bone renewal are ongoing. From the moment of birth, bone formation prevails over destruction up to 25-30 years. Then the processes are balanced for several years, after which the person slowly begins to lose bone mass. With the onset of menopause in women, destruction accelerates dramatically. For some, this process occurs faster due to bad habits, insufficient calcium intake, vitamin D deficiency, chronic diseases, – explains Maria Rafaelevna.

In men, the period of bone destruction lasts more slowly and the representatives of the stronger sex usually encounter osteoporosis by the age of 65-70.

Osteoporosis does not hurt or cause discomfort until the first fracture. It often happens that the diagnosis is made only on an X-ray, this is a late diagnosis.

Although all bones are affected, osteoporosis most commonly occurs in the vertebrae, forearm bones, and femur.The most severe manifestation of the disease is a fracture of the femoral neck. Up to half of patients with such an injury die within a year. Of those who survived, only ten percent return to normal life. The rest remain either bedridden, or can move no further at home.

Another manifestation of osteoporosis is decreased growth, poor posture.

Not a sentence

It is possible to suspend the development of the disease, the main thing is to identify it in time.Now there is the possibility of early diagnosis by bone denitometry. Checking bone density is primarily necessary for those whose relatives have had fractures.

The development of osteoporosis is significantly reduced if a strong skeleton has been formed from childhood. Sports, the sun and a healthy diet with the obligatory inclusion of dairy products, which contain a lot of calcium, contribute to strengthening bones at any age.

According to Maria Rafaelevna, those who already have problems with bone density or who cannot tolerate dairy products will need to take additional calcium supplements.At the same time, the trace element will not be absorbed if a person does not have enough vitamin D, which works as a conductor for calcium. In our region, there is not enough “solar” vitamin, so its level must also be monitored. To find out whether or not there is a vitamin D deficiency, you need to pass special tests.

– A healthy person needs at least 1000 mg of calcium per day, the elderly – 1200 mg, pregnant women – 1500 mg, – says Maria Rafaelevna.

It is impossible to make the bone the same as it was at 25 at the age of 70.But it is important to stop the progression of osteoporosis, and if it is possible to “return” 5-10% of the bones, then this is already a very good result.

By the way, as the chief freelance therapist of the Tyumen region notes, osteoporosis is not a sentence even for the elderly. After all, 20-30% of grandparents do not suffer from this disease. However, according to the doctor, it is impossible to give the same optimistic forecast for the next generations. A sedentary lifestyle, unhealthy diet and bad habits do not strengthen bones at all.

TO THIS TOPIC

The amount of calcium consumed with food per day can be calculated using the table below.

Calcium content in food (per 100 g of product)

Most of all calcium is found in dairy products.One liter of milk or kefir contains the daily calcium requirement.

To calculate your daily dietary calcium intake, you can use the following formula: Daily Calcium Intake (mg) = Dairy Calcium (mg) + 350 mg

BY THE WAY

Although most of our vitamin D is produced by the body through exposure to the sun, we can also get significant amounts of it from food. Fatty fish (including herring, mackerel, sardines, and tuna) and eggs contain vitamin D naturally.Many juices, dairy products and grains are specially fortified with vitamin D. However, it is not possible to get the 800 IU vitamin D needed for adults under 70 from food sources alone. It is contained only in some foods and in an insufficient amount to meet the needs of the body. Vitamin D needs to be obtained from a variety of sources, including diet, sunlight, and sometimes supplementation.

Vitamin D deficiency only increases with age.The body weakens and may not be able to convert enough sunshine vitamin to its active form.

On a note

Strength training is very good so that bone density does not decrease with age. However, if a person already has osteoporosis or significant bone loss, and he suddenly begins to lift weights, this can provoke a compression fracture of the spine. The set of physical exercises for patients with osteoporosis and for healthy people cannot be the same.

Osteoporosis

Osteoporosis is a progressive disease of the skeleton in which bone density decreases, increases their fragility and increases the risk of fractures.

In the initial stages, it can be asymptomatic and is often diagnosed only after a fracture with minor trauma.

Older women are most susceptible to the disease.

Treatment of osteoporosis consists in drug therapy aimed at preserving bone mass and stimulating the formation of new bone tissue, in taking calcium and vitamin D preparations, in performing a set of special exercises.

Russian synonyms

Primary osteoporosis, secondary osteoporosis.

English synonyms

Osteoporosis.

Symptoms

In the early stages, osteoporosis is usually asymptomatic. With the progression of the disease, the following symptoms may appear.

• Aching pains in the bones due to fractures with microtrauma or in the absence of obvious trauma. When moving, the pain may worsen.Fractures of the bones of the thoracic and lumbar spine, hips, and wrists are common.
  • Fractures of the bones of the thoracic and lumbar spine lead to acute pain localized in the injured area. Multiple fractures of the vertebral bodies can cause kyphosis (curvature, stoop) of the thoracic spine with a simultaneous increase in cervical lordosis (“widow’s hump”), while chronic aching back pain appears.
  • With hip fractures, pain occurs in the hip, radiating to the knee, groin, buttocks.
  • With fractures of the bones of the hands, aching pain occurs and the range of motion of the injured bone is limited.
• Pain may be accompanied by muscle spasms that are aggravated by movement.
• Unless the fractures are multiple, acute pain usually resolves in 4-6 weeks. With multiple fractures, it sometimes persists for several months or permanently.
• Reducing the patient’s height.

General information about the disease

Osteoporosis is a progressive disease of the skeleton, in which the density of bones decreases, they become more fragile, and the risk of fractures increases.

Osteoporosis in the initial stages can be asymptomatic and is often diagnosed only after a fracture with minor trauma.

Elderly women are most susceptible to the disease.

Normally, bone tissue is constantly renewed, while maintaining a balance between the formation of new tissue and the destruction of old, that is, between the processes of calcium deposition and leaching. The activity of osteoblasts (cells responsible for the formation of bone tissue) and osteoclasts (cells that destroy bone tissue), the absorption of calcium in the intestine, the degree of its excretion in the urine is regulated by parathyroid hormone, calcitonin, estrogens, vitamin D, etc.

At a young age, the rate of formation of new bone tissue exceeds the rate of destruction of the old one, as a result, bone growth occurs.As a rule, this process ends at the age of 20, when the highest bone mass is reached, the volume of which is 80% dependent on genetic factors. At the age of 20-30, the volume of bone mass remains constant, after which the process of formation of new bone tissue slows down.

In osteoporosis, existing bone tissue is destroyed faster than new bone is formed. If the body does not have a sufficient supply of bone mass, the density of bones decreases, they become fragile. Fractures can occur even with microtrauma, with minor falls.

Complications of osteoporosis not only cause severe pain, but can also lead to disability and death.

Osteoporosis is primary and secondary.

1. Primary osteoporosis accounts for more than 95% of cases. It can be of several types.

• Idiopathic osteoporosis is rare and occurs in children and young people.
• Osteoporosis type I (postmenopausal) develops at the age of 50-75, 6 times more often in women than in men.It is associated with a deficiency of the hormones estrogen, which is responsible for the formation of new bone tissue. Fractures of the vertebrae and wrists are most common in this type of osteoporosis.
• Osteoporosis type II occurs, as a rule, after 70 years, in women 2 times more often than in men. It develops gradually and is associated with a decrease in the concentration of calcium and vitamin D. It often leads to fractures of the hip, pelvis and vertebrae.

  In older women, osteoporosis types I and II are often combined.

  2.Secondary osteoporosis accounts for less than 5% of cases. The risk of its development can be increased by various congenital diseases, deficiency or excess of hormones, insufficient intake of nutrients, chronic diseases, alcoholism, smoking, pregnancy, etc.

  Causes of osteoporosis

  • Genetic diseases
  • Renal hypercalciuria
  • Cystic fibrosis
  • Gaucher disease
  • Glycogenosis
  • Marfan Syndrome
  • Osteogenesis imperfecta
  • Hemochromatosis
  • Endocrine diseases
  • Hyperthyroidism
  • Diabetes mellitus
  • Cushing’s Syndrome
  • Adrenal insufficiency
  • Estrogen deficiency
  • Hyperparathyroidism
  • Hypogonadism
  • Inflammatory diseases
  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Deficit States
  • Calcium deficiency
  • Magnesium deficiency
  • Protein deficiency
  • Vitamin D deficiency
  • Celiac disease
  • Malnutrition
  • Malabsorption (malabsorption of nutrients)
  • Hematological and tumor disorders
  • Hemochromatosis
  • Hemophilia
  • Leukemia
  • Sickle cell anemia
  • Bone cancer, bone metastases
  • Taking certain drugs (anticonvulsants, antipsychotic, antiretrovirals)
  • Other factors
  • Alcoholism
  • Smoking
  • Pregnancy, lactation
  • State of Immunodeficiency
  • Amyloidosis
  • Depression
  • Sedentary lifestyle
  • Multiple sclerosis
  • Chronic kidney and liver diseases

  Who is at risk?

  • Women.
  • People over 50 years old.
  • Persons with a hereditary predisposition to the development of the disease.
  • People of asthenic constitution.
  • Persons with low estrogen levels.
  • Women with late onset of menses, early onset of menopause; nulliparous.
  • Women with amenorrhea (absence of menstruation).
  • Pregnant, lactating women.
  • Suffering from diseases of the endocrine system.
  • Those who consume calcium, vitamin D in insufficient quantities.
  • Malnourished; patients with anorexia.
  • Alcoholics.
  • Smokers.
  • Leading a sedentary lifestyle.
  • Cancer patients.
  • Taking certain medications (anticonvulsants, systemic steroids, chemotherapy drugs, insulin).
  • Depression sufferers.

  Diagnostics

  Osteoporosis can be suspected in any adult who has suffered a fracture with minimal trauma.It is often detected by chance during an X-ray examination, prescribed for another reason. The most reliable method for diagnosing osteoporosis is the determination of bone mineral density.

  Laboratory tests (carried out to determine the causes of osteoporosis)

  • Complete blood count. The level of hemoglobin and red blood cells may be reduced, which indicates the development of anemia. Examination of a blood smear under a microscope reveals a change in the shape of red blood cells, characteristic of sickle cell anemia.
  • Erythrocyte sedimentation rate (ESR). Its significant increase is a sign of multiple myeloma.
  • Serum calcium. An increase in calcium levels may indicate the presence of a malignant tumor or an increased activity of the parathyroid glands. Decreased calcium levels are characteristic of type II osteoporosis.
  • Calcium in daily urine. This test detects congenital renal hypercalciuria, a condition associated with impaired renal excretion of calcium.
  • Alkaline phosphatase is an enzyme found in large quantities in the liver, bones and intestines.
  • Magnesium in serum. It is essential for normal calcium metabolism. Decreased magnesium levels can affect the body’s absorption of calcium.
  • Vitamin D.
  • Thyroid stimulating hormone (TSH). A change in its level may indicate a malfunction of the thyroid gland.
  • Parathyroid hormone. The normal concentration of this hormone makes it possible to exclude the pathology of the parathyroid glands as the cause of the development of osteoporosis.
  • Serum iron and ferritin. A significant decrease in the level of these indicators may indicate a malabsorption of nutrients in the intestine.
  • Testosterone and Free Testosterone. Their deficiency can also lead to the development of osteoporosis.
  • Free cortisol in urine is produced by the adrenal glands and affects bone metabolism. Its increased level will indicate its excessive production, which is characteristic of Itsenko-Cushing’s syndrome.
  • Serum protein electrophoresis shows the distribution of different protein groups in the blood and helps to rule out multiple myeloma.
  • Markers of bone turnover. Some of them reflect the rate of bone formation (alkaline phosphatase, N-Osteocalcin), others – the rate of its destruction (hydroxyproline, beta-CrossLaps, and pyrilinks-D). They can be used to assess the risk of fracture in women with menopause, as well as to early assess the effectiveness of treatment for osteoporosis.

  Other research methods

  • Dual Energy X-ray Absorptiometry (DXA) accurately measures bone density and assesses the risk of fracture. The most reliable is the DXA in the lumbar spine and femoral neck. Recommended for routine use for all people over 65 years of age.
  • Densitometry is an easy way to determine bone mineral density.
  • Quantitative computed tomography of the skeleton (CKT).Another method for determining bone mineral density. It is more costly than DXA and requires more radiation for the patient.
  • Ultrasound examination of the skeleton (ultrasound). Its fabric accuracy is lower than that of DRA. However, it is often used for routine medical examinations due to its low cost.
  • X-ray examination of bones. It is performed to assess the integrity of the skeleton if a fracture is suspected.
  • Biopsy – taking a sample of bone tissue for examination under a microscope.The study is carried out in diagnostically difficult cases and makes it possible to diagnose “malignant bone tumor”.

  Treatment

  The goal of osteoporosis treatment is to prevent fractures and reduce pain. For this, a change in the patient’s lifestyle is recommended, calcium and vitamin D preparations are prescribed, as well as drugs that help preserve bone mass.

  • Lifestyle changes include exercising to increase muscle strength, quitting smoking, and reducing caffeine and alcohol intake.
  • Patients with osteoporosis are shown regular intake of calcium and vitamin D supplements.
  • Medicines
  • Bisphosphonates. As a rule, they are appointed first. Their mechanism of action is based on a decrease in the activity of osteoclasts (cells responsible for the destruction of bone tissue).
  • Salmon Calcitonin. It also reduces the activity of osteoclasts. Its intravenous administration reduces fracture pain. For long-term use, a nasal spray is used.
  • Estrogens. Female sex hormone drugs that can slow down bone loss and reduce the risk of fractures. They are especially effective for women in the first 4-6 years after menopause.
  • Parathyroid hormone. The only drug that stimulates the formation of bone tissue. It is usually used when the risk of fractures is high in patients who cannot tolerate other drugs.

  Prevention

  • Adequate calcium intake is essential.The norm is 1000-1200 mg per day. Sources of calcium: low-fat dairy products, parsley, dill, canned sardines, sesame seeds, poppy seeds. If necessary, calcium supplements are prescribed.
  • Adequate intake of vitamin D, which promotes the absorption of calcium. Typically, people get it by being in the sun. If necessary, vitamin D preparations are prescribed.
  • Regular exercise. They will strengthen the bones and muscles that support the skeleton.
  • Smoking cessation, moderation in alcohol consumption.
  • Fall prevention (as a rule, this is important for the elderly) – wearing shoes with a flat, non-slip soles. You should also protect the apartment from electrical wires, rugs that you can trip over.

  Recommended analyzes

  Literature

  • Dan L. Longo, Dennis L. Kasper, J. Larry Jameson, Anthony S.Fauci, Harrison’s principles of internal medicine (18th ed.). New York: McGraw-Hill Medical Publishing Division, 2011.