What are the main causes of osteoporosis. How is osteoporosis diagnosed and treated. Can osteoporosis be prevented or reversed. What lifestyle changes can help manage osteoporosis.

Understanding Osteoporosis: A Silent Bone Disease

Osteoporosis is a condition characterized by weak and thinning bones, significantly increasing the risk of fractures. While it can affect people of all genders, women are particularly susceptible, especially after menopause. This silent disease often progresses without noticeable symptoms until a fracture occurs, making early detection and prevention crucial.

What exactly is osteoporosis?

Osteoporosis is a metabolic bone disease that causes bones to become porous and fragile. It occurs when the body loses too much bone mass or makes too little bone tissue, or both. As a result, bones become weak and may break from minor falls or, in serious cases, even from simple actions like sneezing or bumping into furniture.

The Hidden Culprits: Causes and Risk Factors of Osteoporosis

While the exact cause of osteoporosis remains unknown, several factors contribute to its development:

• Age: As we grow older, bone density naturally decreases
• Gender: Women are at higher risk, especially after menopause
• Genetics: Family history of osteoporosis increases risk
• Hormonal changes: Decrease in estrogen (in women) and testosterone (in men)
• Lifestyle factors: Lack of exercise, smoking, excessive alcohol consumption
• Nutritional deficiencies: Low calcium and vitamin D intake
• Certain medical conditions and medications

Are there specific risk factors for osteoporosis?

Indeed, several factors can increase your likelihood of developing osteoporosis:

1. Being female, especially post-menopausal
2. Advanced age (risk increases with age)
3. Small body frame or low body weight
4. Ethnicity (Caucasian and Asian women are at higher risk)
5. Sedentary lifestyle
6. Smoking and excessive alcohol consumption
7. Low calcium and vitamin D intake
8. Use of certain medications (e.g., long-term corticosteroids)
9. Medical conditions affecting bone health (e.g., rheumatoid arthritis, celiac disease)

Recognizing the Signs: Symptoms of Osteoporosis

Osteoporosis is often called a “silent disease” because bone loss occurs without symptoms. Many people are unaware they have osteoporosis until they experience a fracture. However, there are some signs that may indicate the presence of osteoporosis:

• Back pain, often caused by a fractured or collapsed vertebra
• Loss of height over time
• A stooped posture
• Bones that break much more easily than expected

When should you seek medical attention for potential osteoporosis?

It’s crucial to consult a healthcare provider if you:

• Experience persistent back pain
• Notice a decrease in height
• Develop a curved or stooped posture
• Suffer a bone fracture after a minor fall or bump
• Have risk factors for osteoporosis and haven’t been screened

Diagnosing Osteoporosis: Tools and Techniques

Diagnosing osteoporosis involves a combination of medical history review, physical examination, and specialized tests. The most common diagnostic tool is the bone density test, also known as dual-energy X-ray absorptiometry (DXA or DEXA scan).

How is a bone density test performed?

A bone density test is a non-invasive procedure that uses low-dose X-rays to measure bone mass in various parts of the body, typically the hip and spine. The test compares your bone density to that of a healthy young adult and to people of your age, gender, and ethnicity. The results are expressed as T-scores and Z-scores, which help determine if you have normal bone density, low bone mass (osteopenia), or osteoporosis.

Are there other tests used to diagnose osteoporosis?

In addition to bone density tests, healthcare providers may use other diagnostic tools:

• Blood and urine tests to check calcium levels and other markers of bone metabolism
• X-rays to identify fractures or bone deformities
• Vertebral fracture assessment (VFA), an X-ray of the spine to check for vertebral fractures
• FRAX score calculation, which estimates the 10-year probability of a major osteoporotic fracture

Treatment Strategies: Managing and Preventing Osteoporosis

The primary goals of osteoporosis treatment are to prevent fractures, minimize further bone loss, and reduce pain. Treatment typically involves a combination of medication, lifestyle changes, and fall prevention strategies.

What medications are used to treat osteoporosis?

Several types of medications can help prevent or treat osteoporosis:

• Bisphosphonates (e.g., alendronate, risedronate): These drugs slow bone loss and may help build bone density
• Hormone therapy: Estrogen for women or testosterone for men can help maintain bone density
• Selective estrogen receptor modulators (SERMs): These drugs mimic estrogen’s beneficial effects on bone density
• Denosumab: A biologic drug that helps reduce bone breakdown
• Teriparatide and abaloparatide: These drugs stimulate new bone growth
• Romosozumab: A newer medication that both increases bone formation and decreases bone loss

How can lifestyle changes help manage osteoporosis?

Adopting healthy habits can significantly impact bone health:

1. Regular weight-bearing and resistance exercises
2. Adequate calcium and vitamin D intake through diet or supplements
3. Quitting smoking and limiting alcohol consumption
4. Fall prevention measures (e.g., removing tripping hazards at home)
5. Maintaining a healthy body weight

Living with Osteoporosis: Coping Strategies and Support

While osteoporosis can be challenging, many people lead active, fulfilling lives with the condition. Coping strategies include:

• Educating yourself about the condition
• Joining support groups or online communities
• Working with a physical therapist to improve balance and strength
• Using assistive devices when necessary
• Maintaining open communication with your healthcare team

How can you prevent falls when living with osteoporosis?

Fall prevention is crucial for people with osteoporosis. Some strategies include:

• Keeping your home well-lit and free of clutter
• Using non-slip mats in the bathroom and kitchen
• Wearing sturdy, low-heeled shoes
• Using handrails on stairs and in the bathroom
• Exercising regularly to improve balance and coordination

The Future of Osteoporosis Research and Treatment

Ongoing research in the field of osteoporosis is promising, with scientists exploring new treatment options and prevention strategies. Some areas of focus include:

• Gene therapy to promote bone formation
• New medications that target specific pathways in bone metabolism
• Advanced imaging techniques for earlier detection of bone loss
• Personalized treatment approaches based on genetic profiles
• Novel drug delivery systems for more effective medication administration

What are some emerging treatments for osteoporosis?

Researchers are investigating several innovative approaches:

1. Stem cell therapy to regenerate bone tissue
2. Nanotechnology for targeted drug delivery to bones
3. Combination therapies using existing medications in new ways
4. Development of bone-forming agents with fewer side effects
5. Use of artificial intelligence in predicting fracture risk and treatment outcomes

Osteoporosis Prevention: Starting Early for Stronger Bones

While osteoporosis often develops later in life, prevention should start early. Building and maintaining strong bones throughout life can significantly reduce the risk of osteoporosis.

How can you build strong bones from an early age?

To promote optimal bone health throughout life:

• Ensure adequate calcium and vitamin D intake from childhood
• Engage in regular weight-bearing exercises
• Avoid smoking and excessive alcohol consumption
• Maintain a healthy body weight
• Consider bone density screening if you have risk factors

By understanding osteoporosis, recognizing its risk factors, and taking proactive steps to maintain bone health, individuals can significantly reduce their risk of developing this condition. For those already diagnosed with osteoporosis, a combination of medical treatment, lifestyle modifications, and support can help manage the condition effectively and maintain a high quality of life. As research continues to advance, we can look forward to even more effective strategies for prevention, diagnosis, and treatment of osteoporosis in the future.

Osteoporosis: Causes, Symptoms & Treatment

Osteoporosis results in weak, thinning bones with a higher risk of fracture. It affects all genders but especially women.

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Osteoporosis results in weak, thinning bones with a higher risk of fracture. It affects all genders but especially women.

Find a doctor

Find a location

Make an appointment

Key points about osteoporosis

• Osteoporosis is a disease that causes weak, thinning bones. This leaves the bones at greater risk of breaking. The bones most often affected are the hips, spine, and wrists.
• Women are 4 times more likely to get osteoporosis than men because of a decrease in estrogen after menopause.
• Risk factors for osteoporosis include aging, race, body weight, and certain medicines.
• The goals of managing osteoporosis are to decrease pain, prevent fractures, and minimize further bone loss.
• For postmenopausal osteoporosis in women, medicines can maintain bone health.
• Rehab programs can help regain bone health.

What is osteoporosis?

Osteoporosis is a disease that causes weak, thinning bones. This puts the bones at greater risk of breaking. The bones most often affected are the hips, spine, and wrists.

What are the symptoms of osteoporosis?

People with osteoporosis may not have any symptoms. Some may have pain in their bones and muscles, particularly in their back. Sometimes a collapsed vertebra may cause severe pain, decrease in height, or spinal deformity.

The symptoms of osteoporosis may look like other bone disorders or health problems. Always talk with your healthcare provider for a diagnosis.

When should I contact my doctor?

Seek care immediately if:

• You believe you’ve fractured your hip. Hip fractures require surgery within 24 hours, and signs may include pain in your hip or knee, low back pain, the inability to stand or walk, bruising or swelling, or a foot turned out at an odd angle, making your leg look shorter.
• You have sudden numbness in your arms or legs with severe back pain.

Call your doctor if:

• You’re experiencing bone or muscle pain, especially in your back, that impacts your ability to take part in daily activities.

If you have symptoms of osteoporosis, schedule an appointment with a primary care physician. Once you receive a diagnosis, you may be referred to a specialist, such as a:

• Rheumatologist
• Endocrinologist
• Physical therapist
• Dietitian
• Orthopedic surgeon

They can help you determine the extent of your osteoporosis, discuss your symptoms and figure out the best course of care.

If you choose “BOOK PRIMARY CARE ONLINE,” select “Family Medicine” or “Internal Medicine” to make an appointment with a primary care provider.

Osteoporosis care at UW Medicine

Seeking osteoporosis care at UW Medicine means working with physicians who are well prepared to help you with your unique needs. We also believe that each patient should be treated as an individual rather than receiving a one-size-fits-all plan. If you think you have osteoporosis, you may start with your primary care physician who can help you with the initial screening and offer treatment options. Your doctor can refer you to a specialist in endocrinology, geriatrics and rheumatology to treat you and determine the best path forward from bone fractures or complications. We also have a Strong Bones Clinic at Northwest Outpatient Medical Center.

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What causes osteoporosis?

Researchers don’t know the exact cause for osteoporosis. But a number of factors contribute to the disease.

Who is at risk for osteoporosis?

Women are 4 times more likely to get osteoporosis than men. Here are other things that may put you at risk for osteoporosis:

1. Older age. Bones become less dense and weaker with age.
2. Race. White and Asian women are most at risk. But all races may get the disease.
3. Body weight. People who weigh less and have less muscle are more at risk for this condition.
4. Lifestyle factors. Lack of physical activity, caffeine, heavy alcohol use, smoking, dietary calcium, and vitamin D deficiency may all increase your risk.
5. Certain medicines. Some medicines may increase your risk.
6. Family history. Having a family history of bone disease may increase your risk.

Having low bone mass (osteopenia) also puts you at a greater risk for osteoporosis.
Low estrogen is one of the main causes of bone loss in women during and after menopause. Women may lose up to 20% of their bone mass in the 5 to 7 years after menopause.

How is osteoporosis diagnosed?

Your healthcare provider will review your personal and family health history and do a physical exam. Other tests include:

• Bone density test (bone densitometry). This test measures the mass of bone and its volume to find the risk of getting osteoporosis.
• Blood tests. These tests measure calcium and potassium levels.
• FRAX score. This is a score given to estimate the risk of a fracture within 10 years. The score uses the results of a bone density test as well as other things.
• X-rays. This test uses energy beams to make images of tissues, bones, and organs on film.

Women are encouraged to:

• Review lifestyle practices with their healthcare provider regularly.
• Have their personal risk for falls checked at least once a year after menopause.
• Have their height and weight checked yearly.
• Get checked for the development of a rounded humped in the spine and back pain (kyphosis).

How is osteoporosis treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.
The goals of managing osteoporosis are to:

• Decrease pain
• Prevent fractures
• Minimize further bone loss

Some of the ways to treat osteoporosis are also ways to prevent it. They include:

• Staying at a healthy body weight
• Doing more walking and other weight-bearing exercises
• Limiting caffeine and alcohol
• Stopping smoking
• Getting enough calcium and vitamin D through diet and supplements
• Installing hand railings, or assistive devices in the bathroom or shower to prevent falls
• Asking your healthcare provider about medicines that may help

These medicines help maintain bone health in women with osteoporosis at menopause:

• Estrogen replacement therapy (ERT) and hormone replacement therapy (HRT).  ERT reduces bone loss, increases bone density, and reduces the risk for hip and spinal fractures in postmenopausal women. But talk with your healthcare provider before taking them. Research found several important health risks linked to this therapy. For many women, the risks of ERT outweigh the benefits.
• Bisphosphonates. These medicines reduce bone loss, increase bone density, and reduce the risk for fractures.
• Selective estrogen receptor modulators (SERMS).  These medicines help prevent bone loss.
• Parathyroid hormone. This medicine is a form of parathyroid hormone. It helps form bone.
• Monoclonal antibody. This medicine is given by shot (injection) under the skin. It’s approved for women with osteoporosis at high risk for fractures. It’s also used for women who are being treated with cancer medicines that can weaken bones.

Living with osteoporosis

An osteoporosis rehab program can be vital to a full recovery. It can help you obtain the best possible bone health and quality of life. The focus of rehab is to decrease pain, help prevent fractures, and minimize further bone loss.
To help reach these goals, programs may include:

• Exercise programs and conditioning to increase weight-bearing and physical fitness
• Methods to manage your pain
• Nutritional counseling to improve how much calcium and vitamin D you get and to limit caffeine and alcohol
• Assistive devices to make you safer at home
• Education, especially on ways to prevent falls

These rehab programs can be done as an outpatient or inpatient. Many skilled people are part of the team. They include:

• Dietitian
• Internist
• Occupational therapist
• Orthopedist/orthopedic surgeon
• Physiatrist
• Physical therapist
• Psychologist/psychiatrist
• Recreational therapist
• Rehabilitation nurse
• Social worker
• Vocational therapist

What Causes Osteoporosis? And Why?

Think you know what causes osteoporosis? Think again — some of the causes may surprise you.

Written by Rebecca Buffum Taylor

• Osteoporosis: The “Silent Thief” As You Age
• Causes of Osteoporosis: Low Estrogen in Women
• Causes of Osteoporosis: Low Testosterone in Men
• Causes of Osteoporosis: Other Hormone Imbalances
• Causes of Osteoporosis: Lack of Calcium
• Causes of Osteoporosis: Lack of Vitamin D
• Causes of Osteoporosis: A Sedentary Lifestyle
• Causes of Osteoporosis: Thyroid Conditions
• Causes of Osteoporosis: Smoking
• Causes of Osteoporosis: Medications
• Causes of Osteoporosis: Medical Conditions
• Causes of Osteoporosis: Too Much Alcohol
• More

Your bones are alive and constantly growing — not static, like you see them drawn in books. Bones continually change throughout your life, with some bone cells dissolving and new bone cells growing back in a process called remodeling. With this lifelong turnover of bone cells, you replace most of your skeleton every 10 years.

But for people with osteoporosis — a thinning of the bones — bone loss outpaces the growth of new bone. Bones become porous, brittle, and prone to fracture. Look at an X-ray of a hip with normal bone density, and you see a dense matrix of bone cells. But look at a hip with osteoporosis, and you see mostly air. The bony matrix has all but dissolved, with only a few thin strands left.

As many as 10 million Americans have osteoporosis and 34 million more have low bone mass, called osteopenia, says the National Osteoporosis Foundation. Why is bone loss so common? WebMD went to the experts to find out. The causes of osteoporosis may surprise you.

Bone density is greatest in your early 20s. But as you age, you can lose bone mass from a variety of factors. Osteoporosis or its early warning sign, osteopenia, signals an imbalance in the remodeling process: Too much bone is broken down, and too little new bone is built back up. Brittle bones result, prone to fracture.

You probably know that you need calcium to build strong bones, but a low-calcium diet isn’t the only culprit. There are lesser-known causes of osteoporosis. The experts now believe that a combination of causes is often to blame for bone loss.

What’s the most common cause of osteoporosis? “In general, it’s estrogen deficiency in women,” says Paul Mystkowski, MD, an endocrinologist at Virginia Mason Medical Center in Seattle and clinical faculty member of the University of Washington in Seattle. Bone loss accelerates after menopause, when older women have a quick drop in estrogen. Over time, the risk of osteoporosis and fracture increases as older women lose more bone than they replace.

Younger women who stop menstruating — such as thin athletes or girls with anorexia — also have compromised bone density, says the U.S. Surgeon General’s latest report, “Bone Health and Osteoporosis.”

Having both ovaries surgically removed, called a bilateral oophorectomy, may also cause osteoporosis and low bone density. In one study, this surgery caused a 54% increase in hip, spine, and wrist fractures in postmenopausal women.

Men need both testosterone and estrogen for bone health. That’s because men convert testosterone into bone-preserving estrogen. “There’s a clear consensus that when you’re evaluating men with osteoporosis,” says Mystkowski, “you always evaluate for testosterone deficiency.”

Several other hormones play a role in regulating your bone density, including parathyroid hormone and growth hormone. They help orchestrate how well your bones use calcium — and when to build up and break down bone.

But too much parathyroid hormone, called hyperparathyroidism, causes calcium loss in the urine at the expense of bone, says Mystkowski. Less calcium means weaker bones. And as you age, your body produces less growth hormone, which you need to build strong bone.

Without calcium, you can’t rebuild new bone during the lifelong process of bone remodeling.

Bones are the reservoir for two minerals — calcium and phosphorus. You need a constant level of calcium in your blood since many of your organs, especially your heart, muscles, and nerves, depend on calcium. When these organs demand calcium, they’ll steal it from the mineral storehouse in your bones. Over time, as you deplete the mineral reservoir in your bones, you end up with thin, brittle bones.

Too little vitamin D can lead to weak bones and increased bone loss. Active vitamin D, also called calcitriol, is more like a hormone than a vitamin, says Mystkowski. Among its many benefits, vitamin D helps your body to absorb and use calcium.

Bones weaken if they aren’t worked. Remember the early astronauts? They suffered rapid bone loss from being weightless in space. For people who are sedentary or have a condition like paralysis or muscular dystrophy, bone loss happens quickly. As a cause of osteoporosis, this one’s in your hands. You can help “remodel” your bones with weight-bearing exercise, where you’re putting gentle stress on bones.

High levels of thyroid hormone have long been linked to an increase in bone loss. “That’s always been a concern of most physicians,” says Mystkowski, “but if you look at the long-term bone densities of patients who are on high doses of thyroid pills, they’re not dramatically different, and their fracture risk isn’t dramatically different. “

Still, most doctors would agree: anyone on high doses on thyroid hormone can benefit from getting regular exercise and taking enough calcium and vitamin D. These lifestyle factors are potent ways to manage your overall fracture risk, along with monitoring bone density with testing.

Smokers suffer from lower bone density and a higher risk of fracture than non-smokers. Studies on smoking and bone health have turned up a host of other dire effects, from direct toxic effects of nicotine on bone cells to blocking the body’s ability to use estrogen, calcium, and vitamin D.

Taking certain medications may lead to bone loss and an increase in bone fractures. Most common are corticosteroids, also known as cortisone, hydrocortisone, glucocortisoids, and prednisone. These drugs are used to treat asthma, rheumatoid arthritis, psoriasis, colitis, and a wide range of other conditions. Antiseizure drugs are linked to bone loss, as well.

A host of medical conditions can lead to bone loss, from genetic diseases like cystic fibrosis to digestive diseases to the tumors called multiple myeloma, which infiltrate bones with abnormal cells. Abnormal calcium excretion also contributes to bone loss. “Some people just don’t trap calcium like they should,” says Mystkowski, “and they excrete it through the urine at the expense of the bone.”

Alcohol can arrest bone remodeling and increase your calcium loss. Being tipsy increases the risk of falling, and with osteoporosis, that means you’re risking a fracture.

The good news in all this? Your bone health is largely in your control. Many of the causes of osteoporosis are lifestyle factors you can change — like getting plenty of calcium, vitamin D, and weight-bearing exercise to build strong bones. If bone loss is still a problem, ask your doctor about what you can do to correct any hormone imbalances or other medical causes of bone loss.

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symptoms, types, causes, diagnosis and treatment

According to WHO, osteoporosis is the fourth most common noncommunicable disease, behind only cardiovascular disease, cancer and diabetes. It usually occurs in older people.

Contents

• What is osteoporosis
• Causes and types of osteoporosis
• Symptoms of osteoporosis
• Diagnosis of osteoporosis
• Treatment of osteoporosis
• Complications of osteoporosis
• Prognosis, prevention of osteoporosis

What is osteoporosis

Osteoporosis is a chronic pathology of the bones of the skeleton, caused by metabolic disorders, manifested by a decrease in density, as well as disturbances in the composition of bone tissue. Such deviations provoke fractures even with minor injuries.

With osteoporosis, the mass of bones gradually decreases, which leads to a decrease in their strength, an increase in fragility. The disease has mild symptoms and is usually detected after a fracture.

Postmenopausal osteoporosis develops in women aged 45-55 during menopause due to a lack of estrogen. The disease is characterized by a decrease in bone mass, an increase in their fragility. This leads to the fact that fractures occur even with minor injuries. As a result, the woman receives a diagnosis of “postmenopausal osteoporosis with a pathological fracture.”

Most often, fractures are localized in the region of the femoral neck, as well as in the vertebrae and in the distal epiphysis of the radius. Moreover, after the first fracture, the probability of getting it again increases two, then four or more times. Bones grow together poorly, which often leads to disability.

Osteoporosis occurs more frequently in women than in men, often in postmenopausal women. Since the disease does not have specific signs indicating its onset, you need to know what can provoke it.

Causes and types of osteoporosis

Depending on the cause of development, primary and secondary forms of the disease are distinguished.

Primary osteoporosis occurs in 85% of patients. It comes in four types:

1. Postmenopausal (type 1). It occurs as a result of a decrease in estrogen production, calcium deficiency, reduced motor activity. At the same time, the woman’s bone mass rapidly decreases. As a result, pathological fractures occur.
2. Senile (senile, type 2). It is accompanied by a lack of vitamin D, as well as the inability of the body to absorb calcium and an increase in parathyroid hormone values. The disease develops in people of both sexes due to a decrease in bone mass due to age, and provokes fractures.
3. Juvenile. It is a pathology of bone tissue in persons under eighteen years of age, due to insufficient bone metabolism, and, subsequently, a strong decrease in bone mineralization. At an early stage of this pathology, the child quickly gets tired of the muscles, especially the back, there are discomfort or pain in the lower back. The first clear sign of the disease is usually a pathological fracture (often the bones of the forearm).
4. Idiopathic. The reasons for its development cannot be established.

The disease is considered polyetiological. It usually develops as a result of changes in bone tissue with age. In more rare cases, primary osteoporosis occurs due to hereditary burden or for unknown reasons.

Factors of its development:

• family history;
• advanced age;
• asthenic complexion;
• small stature;
• weight reduction;
• start of menstruation in girls at 15 years of age or later;
• infertility;
• menstrual disorders;
• prolonged breastfeeding;
• many pregnancies, childbirth.

Secondary osteoporosis develops against the background of other pathologies, which include:

1. Endocrine diseases.
2. Violations in the work of the digestive tract.
3. Diseases of the kidneys.
4. Rheumatic diseases.
5. Diseases of the blood.
6. Genetic abnormalities.
7. Conditions accompanied by dysfunction of the gonads.
8. Deficiency of calcium, vitamin D.
9. Chronic inflammatory processes.

The secondary form of the disease can be provoked by taking certain drugs, for example, furosemide, lithium, SSRIs, omeprazole, long-term treatment with heparin. Sometimes it is caused by: amyloidosis, alcoholism, COPD, long immobilization.

Symptoms of osteoporosis

As a rule, the disease remains unrecognized for a very long time. Its only symptom is sometimes pain in the region of the sternum, lower back. In some cases, pain syndrome appears in the region of the ribs, bones of the lower extremities. Usually it is unexpressed, increases after physical activity, when the weather changes.

For most patients, the first obvious symptom of osteoporosis is a fracture with minor trauma. Most often, vertebral fractures occur.

Other signs of osteoporosis usually appear after multiple compression fractures. These include:

• decrease in height;
• protrusion of the abdomen forward;
• reflux esophagitis;
• rapid satiety when eating;
• weight loss;
• limited range of motion;
• pain syndrome in the back, hip region;
• bending, hyperextension of the neck;
• increase in distance from the wall for the back of the head;
• contact of the pelvic region with the ribs.

In severe pathology in elderly people, a hump often appears, which is explained by a decrease in the height of the vertebral bodies due to compression fractures.

Osteoporosis diagnostics

The disease is diagnosed by an orthopedic traumatologist. He examines and interviews the patient, and also prescribes procedures to measure bone mineral density (BMD). The following diagnostic methods are used:

1. Densitometry. It allows you to install the IPC. Dual energy x-ray absorptiometry (DXA, DXA) is considered the “gold standard” in the detection of osteoporosis with a minimum measurement error.

   To determine BMD, single-photon (provides little information) and two-photon densitometry, as well as quantitative CT of the spine, are sometimes used. Ultrasound densitometry is used for screening.

2. X-ray. It provides little information for the detection of osteoporosis and allows you to detect its manifestations only with a significant decrease in bone mass (over 30%). X-rays are taken to see recent fractures, as well as calluses and deformities from trauma, indicating a history of bone damage.
3. Laboratory studies. They allow you to determine the level of calcium, vitamin D, phosphorus in the blood, as well as other indicators. If the doctor suggests secondary osteoporosis, then he can refer the patient to the determination of thyroid hormones, testosterone, liver tests.

According to the WHO criteria, “osteoporosis” is diagnosed with a decrease in BMD by 2.5 or more relative to the standard value of the average BMD of people of thirty years of the same sex as the patient.

Treatment of osteoporosis

Treatment of the disease is aimed at reducing or preventing fractures, as well as increasing bone density.

To prevent fractures, the patient needs:

• increase body weight, exercise to strengthen muscles;
• consume enough calcium, vitamin D.

Medical therapy

In the treatment of the disease, drugs are taken for long courses. The patient is advised to use hormonal agents, vitamin D, bisphosphonates, calcitonin, and other drugs. The treatment plan is drawn up, taking into account the age, gender, health characteristics of the patient.

The doctor may prescribe the following drugs:

1. Anabolic drugs. They are aimed at increasing bone strength, lengthening the phase of bone formation and helping to heal small fractures.
2. Anti-catabolic agents. They reduce the activity of bone resorption, prevent the violation of the structure of bone tissue.
3. Hormonal drugs. The patient may be prescribed gestogens, estrogens, androgens.
4. Vitamin D, calcium preparations. They are used together with other drugs to normalize metabolic processes.

When treating with hormones, it is necessary to monitor blood pressure indicators and conduct oncocytological studies. Every year, the patient is recommended to go for ultrasound of the pelvic organs, mammography.

Physiotherapy

Physiotherapy is used as part of complex therapy. It helps to reduce pain, slow down the destruction of bones, and speed up their recovery. The patient may be prescribed physiotherapy: electrophoresis with drugs, magnetotherapy, ultraviolet radiation, laser therapy.

Operation

The main indication for surgical intervention in osteoporosis is a pathological fracture of the femoral neck. The operation helps to return the patient to normal life, increase his mobility, and, therefore, reduce the risk of complications caused by prolonged bed rest.

Operation types:

1. Osteosynthesis of the femoral neck. It is carried out with the use of special needles, nails, curved plates, which help fix the fragments, and also provide normal connective tissue fusion. In this case, the patient can continue to walk.
2. Total hip arthroplasty. As a rule, it is performed by physically active people of advanced and middle age. This operation allows you to gradually restore the function of the limb.

In the recovery period, the patient is prescribed analgesics, antibacterial drugs, physiotherapy, exercise therapy, massage.

Complications of osteoporosis

Complications and signs of the disease are considered pathological fractures – damage to the bone, the strength of which is reduced due to a disease or pathological condition.

Fractures of the radius often lead to limited mobility of the wrist joint, a decrease in hand strength. With repeated fractures of the spine, persistent pain appears that worsens a person’s mobility, limiting his ability to perform daily activities.

A fracture of the femoral neck is dangerous because the bones do not fuse on their own, therefore, if the patient refuses the operation or it is impossible to perform it, then the supporting function of the limb is not restored. In a quarter of cases, such injuries lead to death in osteoporosis in the first six months after the injury, and in slightly less than half of the cases, to severe disability.

Prognosis, prevention of osteoporosis

The prognosis depends on the cause of the disease and the severity of its course. If the pathology proceeds in a mild form, progresses slowly, and the treatment was timely, then the outcome is good. Late detection of the disease, a pronounced decrease in bone strength and the development of complications usually worsen the quality of life.

Prevention of pathology should begin in youth and last a lifetime. It consists in good nutrition, eating foods rich in calcium, engaging in feasible physical activity, limiting the use of alcoholic beverages, coffee and smoking.

Elderly people need to identify risk factors for osteoporosis in time and, if necessary, take supplements with calcium, vitamin D. Prophylactic use of hormonal drugs is allowed on the recommendation of a doctor. Before and after menopause, you need to increase the intake of dairy products containing calcium.

To prevent osteoporosis, you need to regularly undergo medical examinations, as well as take medications prescribed by your doctor.

In the rehabilitation clinic in Khamovniki, you can get advice on the prevention and treatment of the disease. Remember that by detecting health problems in time, you can quickly eliminate them.

causes, symptoms, diagnosis, treatment and prevention

• What is osteoporosis?
• Symptoms of osteoporosis
• Diagnostics of osteoporosis
• Treatment of osteoporosis
• Advantages of ON CLINIC
• Prevention of osteoporosis
• Doctors
• Shares

Osteoporosis is a common disease in which bones become brittle and break easily. The disease is more common in women than in men. According to statistics, approximately 80% of patients with osteoporosis are female, and the disease occurs most often over the age of 60 and after menopause. The most severe complications of osteoporosis are fractures of the femoral neck and spine. But people of any age are susceptible to osteoporosis, even in children it can develop due to a deficiency of building materials for bones.

Dangerous osteoporosis makes the absence of characteristic signs of the development of the disease. Because of this, it is called the “silent epidemic of the 21st century.” It is important to have an understanding of the risk factors for osteoporosis and its prevention.

The greatest bone strength is approximately achieved by the age of 30, which increases the need for strength training and physical activity to maintain and renew the musculoskeletal corset of the body after 30 years. Minimum physical activity should last at least 45 minutes 3 times a week.

Come about ON CLINIC! Each doctor of our Center has extensive experience, thanks to which you will receive effective medical care and improve your health.

What is osteoporosis?

Osteoporosis is a slowly developing disease of the musculoskeletal system, in particular bone tissue.

Bones are constantly being renewed, which means that two processes always take place – the destruction of old bone tissue and the construction of a new one instead. Over time, the former begins to prevail for various reasons. Deficiencies of minerals necessary for the construction of bone tissue (calcium and magnesium, as well as phosphorus and fluorine) may appear due to a lack of their supply or powerful hormonal changes. Hormones regulate metabolic processes in the body, in particular in the bones. And a decrease in the activity of the reproductive system (with menopause in women) leads to a loss of calcium from the bones.

By the age of 60-70, every 3rd woman develops osteoporosis, about 60% of women after 80 years of age suffer from it. Men are less likely to develop osteoporosis, but the likelihood of developing it also increases with age. Deficiency of elements (such as calcium and vitamin D) can occur even in children, leading to osteoporosis.

The following factors increase the risk of osteoporosis:

• age,
• malnutrition,
• deficiency of minerals, mainly calcium, and vitamin D,
• disorders of the gastrointestinal tract, in which the efficiency of absorption of nutrients, macro- and microelements, vitamins decreases, resulting in deficient conditions,
• low physical activity,
• kidney disease,
• endocrine diseases, decreased production of sex hormones (both women and men),
• female,
• genetic (presence of osteoporosis or a tendency to fracture in parents, brothers or sisters),
• delicate build, low weight,
• frequent fractures, increased tendency to fall,
• prolonged immobility (e.g. after injury),
• bad habits (smoking, drinking large amounts of alcohol or coffee),
• long-term use of certain medications.

Osteoporosis is divided into primary and secondary. The primary develops on its own, it is classified by origin into:

• I postmenopausal,
• II senile (senile),
• III juvenile (child),
• IV idiopathic (of unclear origin, that is, when it is not possible to determine exactly why the disease developed).

Secondary develops due to some other disease. These can be diseases:

• rheumatic,
• endocrine system,
• genetic,
• kidneys,
• circulatory system,
• gastrointestinal tract.

In addition, secondary osteoporosis can appear against the background of taking certain medications, eating disorders, alcoholism, chronic lung diseases, operations and prolonged immobilization.

Complications of osteoporosis are fractures in which severe pain occurs, a person temporarily loses his ability to work, or may even become disabled. Timely prevention and treatment can prevent severe fractures, as well as detect osteoporosis at an early stage. Rheumatologists at ON CLINIC are always ready to help you with this! Modern equipment, own diagnostic laboratory and friendly atmosphere of ON CLINIC clinics make the reception and diagnosis quick and pleasant.

Symptoms of osteoporosis

The danger of osteoporosis lies in the absence of obvious symptoms until the moment of injury. In the vast majority of cases, the diagnosis is made after a fracture during the examination.

A bone fracture with a slight external impact is considered a complication of osteoporosis. Most often there is a fracture of the femoral neck, the bones of the hands and the spine are slightly less affected. Even heavy lifting or violent shaking while driving can lead to flattening of the vertebrae due to osteoporosis. Sometimes, unnoticed by a person, compression fractures of the vertebrae can occur, that is, flattening of the vertebrae under the weight of one’s own body.

Signs of osteoporosis may include:

• stoop and shortening of height,
• change in posture (formation of the chest hump),
• pain in the lumbar or thoracic spine after prolonged sitting for several hours,
• night cramps.

If you suspect the development of osteoporosis, contact ON CLINIC. Our experienced specialists will help to identify and start treatment or effectively prevent the development of the disease.

ON CLINIC medical centers in Moscow

Osteoporosis diagnostics

ON CLINIC uses the following methods for diagnosing osteoporosis:

• Physical examination: the height of the patient, the distance between the back of the head and the wall, and between the lower ribs and the superior point of the ilium (to detect flattening of the vertebrae) are assessed.
• Calculation of body mass index.
• Laboratory and diagnostic studies: general and biochemical blood tests (assessment of the state of the body, mineral metabolism, search for deficiencies), the study of the content of antibodies (to exclude autoimmune diseases).
• Densitometry – analysis of bone mass and bone mineral density. This method can examine the bones of the limbs, spine and even teeth. There are two types of densitometry: ultrasonic and radiological.

  In the first case, ultrasound of a certain frequency is passed through the area under study, by changing the frequency when passing through the bone tissue, bone density is determined. This method is absolutely harmless and painless. It is excellently used during pregnancy and various other restrictions with prohibitions on irradiation.

  The second option involves a study using X-ray radiation, by its decrease, bone density is also determined. In this way, you can examine the spine and bones of the limbs. X-ray densitometry allows visualization of bone structures at high resolution. This test uses a low dose of radiation, so it can be used during pregnancy.

• Magnetic resonance and computed tomography for visualization of structural changes in bones and joints.

Depending on the complaints of patients, in addition to receiving a rheumatologist, it may be necessary to consult a doctor of another specialty (gastroenterologist, oculist, endocrinologist, nutritionist, etc. ). In ON CLINIC you can quickly visit all the necessary doctors – we have a huge staff of experienced doctors in various fields.

Treatment of osteoporosis

The main objectives in the treatment of osteoporosis are:

• Reduced release of minerals from bone tissue.
• Increased bone strength.
• Reduced risk of fracture.
• Getting rid of pain.
• Restoration of habitual physical activity and lifestyle.

To relieve pain, slow down the process of destruction, establish metabolic and regenerative processes in bone tissue, the following treatment methods are used:

• Drug therapy: drugs may include bisphosphonates (to reduce bone damage), anabolic drugs (to improve metabolic processes). With insufficient production of hormones, hormone replacement therapy may be performed. In case of identified deficiency states, calcium and vitamin D preparations are prescribed (vitamin D helps the absorption of this microelement). In each case, the choice of a complex of drugs occurs individually, based on the characteristics of the person and the disease.
• Therapeutic exercise: the doctor teaches the patient a set of exercises from therapeutic and restorative gymnastics with a suitable physiological load, which must be done regularly. Beneficial effect of classes in the pool.
• Correction of nutrition: it is necessary to organize a full and regular diet. With the help of a doctor, the client forms a list of products and a detailed diet. It remains only to follow the chosen path.
• Means of orthopedic correction: wearing and using corsets and other means of orthopedic correction can reduce the load on the spine and reduce the destructive process in the bones, and sometimes relieve pain.
• Physiotherapy: magnetotherapy, ultrasound therapy and phonophoresis (combination of drugs with ultrasonic waves), thermal baths, massage, etc.

ON CLINIC doctors are always ready to help! Make an appointment at a convenient time for you. We work from 8.00 to 21.00 without holidays and weekends.

Advantages of ON CLINIC

• Qualification of specialists. Experienced and competent doctors of ON CLINIC are specialists of the highest category, candidates of medical sciences. They follow the latest achievements in rheumatology, regularly exchange experience with colleagues in Russia and abroad, and conduct scientific activities.
• Excellent clinical and laboratory facilities. Our clinics have the most modern, efficient and safe equipment in order to successfully diagnose, treat and carry out preventive measures. Our own clinical diagnostic laboratory allows you to quickly perform laboratory examinations.
• Fast and efficient diagnostic methods. The excellent equipment of the clinics allows performing a wide range of diagnostic methods: MRI, CT, X-ray and other highly informative studies are performed to make a diagnosis and obtain detailed body data.
• Integrated approach. ON CLINIC has a widespread practice of consultation between doctors of different specialties.
• Effective therapy. An integrated comprehensive approach to treatment and prevention, which is aimed at suppressing various mechanisms of osteoporosis development and includes a large number of cutting-edge methods.
• Individual approach. The appointment of treatment taking into account the characteristics of the patient.
• Comfort. Clinics of our Center are conveniently located in the center of Moscow. You can make an appointment at any convenient time from 8.00 to 21.00 by phone.

Prevention of osteoporosis

The recommendations for preventing osteoporosis are quite simple:

• Maintain normal weight. With weight loss, adipose tissue decreases, which leads to a slowdown in the production of fat-soluble vitamins, as a result, the level of hormones that affect the growth and destruction of bone tissue decreases.
• Eat well, so that all the substances necessary for the body to renew bones come from food.
• Eliminate bad habits (smoking, alcohol).
• Regularly go in for sports and / or exercise yourself physically (therapeutic, restorative gymnastics, Nordic walking, etc.). Such activity improves blood circulation and normalizes the formation of the musculoskeletal frame of the body.
• Exercise balance to reduce the likelihood of falls.

Maintaining physical activity, balance training and eye care are especially important for older people, as they are at higher risk of developing osteoporosis and related complications (fractures of the femoral neck, spine).

Competent and experienced doctors of ON CLINIC will always suggest methods of lifestyle correction that are suitable for you, support and guide you on the way to your health!

Frequently Asked Questions

Is bone density always needed?

No. Densitometry is optional. Your doctor prescribes it based on your risk factors for osteoporosis.

What is the difference between osteopenia and osteoporosis?

The term “osteopenia” refers to the initial phase of osteoporosis. It is distinguished by bone density according to the T-criterion with x-ray densitometry. Normal T-score from 2.5 to -1 standard deviations from peak bone mass, osteopenia – from -1 to -2.5, osteoporosis – T-score below -2.5.

According to the results of densitometry, I have a norm. So I’m not in danger of fractures?

Unfortunately, it is not. The result of the examination will not protect you from fractures, but indicates that their risk is low. Keep in mind that bone loss occurs with age, so prevention becomes especially important to reduce the risk of fractures.

I have been diagnosed with osteoporosis. All my relatives are sure that from any vigorous activity I will break something for myself. Is it so?

The probability of fractures is, but not 100%. Osteoporosis increases the risk of fractures, but there are other important factors besides it. To a greater extent, the likelihood of fractures is determined by habits and lifestyle. In osteoporosis, the risk of fractures must be minimized. For example, to eliminate, if possible, slippery surfaces in your own house, shaky steps, obstacles that you can stumble on, etc. The volume of necessary physical activity will be prompted by the doctor and will show a set of exercises. You will also receive calcium and vitamin D during treatment.

How often should densitometry be done?

For osteoporosis, it is recommended to do this test once a year.

Why is it important to detect and treat osteoporosis early?

Lack of timely prevention and treatment of osteoporosis leads to bone fragility. The most dangerous can be severe and complex fractures, for example, of the spine, femoral neck, etc. Such fractures lead to disability, immobility and inability even to self-care. In addition, with a long-term development of the disease, fractures can occur from a minimal load from the outside, because of which even ordinary activities become problematic, for example, cleaning or gardening.

Article reviewed by physician

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