Causes, symptoms and treatment of osteoporosis, prevention
Osteoporosis is a disease of bone tissue, increased fragility of bones due to lack of calcium. For a patient with osteoporosis, even minor injuries can turn into a fracture. Osteoporosis usually occurs due to metabolic disorders.
Let's say a person stumbled, unsuccessfully opened a heavy door, or dropped a heavy book on the floor. For someone with osteoporosis, any seemingly simple situation can end very badly - a fracture. Women are more susceptible to this disease, especially during a period of hormonal disruption, with menopause, men suffer from this disease much less often.
It is most often found in women who have experienced the onset of menopause and are in the period of menopause. They, who are in the "risk group", should be especially attentive to their health and take into account all the manifestations of the disease.
A very interesting video in which you will learn the true essence of osteoporosis and how to protect yourself from fractures?
Content:
- Osteoporosis symptoms
- Osteoporosis causes
- Degrees of osteoporosis
- Osteoporosis of the hip joint
- Diagnosis of osteoporosis
- How is osteoporosis treated?
- Which doctor should I go to?
Osteoporosis symptoms
Symptoms of osteoporosis most often do not appear, people can live for many years, unaware that such processes are going on in their body. But nevertheless, scientists note a decrease in bone tissue as the main symptoms of osteoporosis, sometimes aching pain in the lower back, frequent fractures can disturb.
Ordinary doctors most often cannot determine the cause of frequent fractures, only such narrow specialists as orthopedists or surgeons can suspect this disease, after which they are sent for bone x-rays, etc., women are sent to a gynecologist. With osteoporosis, the patient may decrease in size due to a decrease in bone tissue, even become 10-15 cm lower in height.
Symptoms of osteoporosis include:
- significant fatigue (indicates a general weakening of the body, a deterioration in metabolism and a slower compensation of all functions);
- cramps in the lower extremities, which appear mainly at night;
- excess plaque on the tooth enamel;
- periodontitis;
- pain in the bone or lower back;
- obvious fragility and predisposition of nails to delamination;
- premature graying (quite rare);
- hernia of the intervertebral region;
- problems associated with the functioning of the gastrointestinal tract (provoked by serious deformities of the spine, which literally presses on the internal organs of the woman. Including the stomach);
- the onset of diabetes mellitus (osteoporosis is also an endocrine disorder, therefore, consultation with this specialist is necessary);
- allergy;
- other ailments that are associated with dysfunction of metabolism and salt metabolism.
- excessive heartbeat.
One cannot but pay attention to such serious symptoms as:
- bone fractures;
- a feeling of heaviness in the area between the shoulder blades;
- general muscle weakness;
- change in growth downward;
- rachiocampsis.
They, in turn, are evidence that the disease is at a later stage. Often osteoporosis at this stage is already irreversible, it is only possible to suspend its progression or slow down all its effect on the body.
Osteoporosis causes
Osteoporosis can be caused by long smoking history, alcohol abuse, digestive problems, metabolic malfunctions, or the disease is inherited. In old age, osteoporosis often occurs due to poor absorption of calcium, as well as nutrients in the intestines.
But most often the cause of osteoporosis is, as a rule, hormonal imbalance. Osteoporosis predominantly occurs in women and is associated with menopause. The point is not at all a lack of calcium in the body, but in disruption of the functioning of the building cells of bone tissues. We have two types of cells in our body: building and destructive. During menopause, the work of building cells is disrupted. You need to go to a gynecologist or look for remedies that will restore the body during menopause.
If you take synthetic corticosteroid drugs for a very long time, then your body begins to suffer. A lack of hormones due to drugs can lead to diseases such as osteoporosis.
With age, all people experience a decrease in the degree of bone density, their strength and tone are significantly reduced. These are quite understandable changes that occur in the body as a result of aging. But in certain categories of people, such changes are formed much earlier in time and proceed more intensively. A significant number of causes of this disease have been identified.
There are also reasons that cannot be changed:
- belonging to the female sex;
- Caucasoid or Mongoloid race (it has been proven that African Americans have almost zero risk of developing osteoporosis. This is possible due to the fact that they are often exposed to the sun for a long time, which strengthens the bone structure);
- weakened or thinned bone tissue of the skeleton;
- the age category is over 65 years old (at this age, the natural loss of calcium by the human body begins. It is possible to replenish it only partially);
- genetic factor (while the degree of closeness of kinship does not really matter).
There are also risk factors that may be affected:
- food unsaturated with calcium and vitamin D (you should consume as much calcium and vitamin from this group as possible);
- the use of certain medications, for example, corticosteroids and anticonvulsants (they should be minimized, if possible. If this is not possible, then immediately after the end of their intake, it is recommended to consult a chiropractor and in the future to remember the risk of an illness);
- frequent use of hormonal drugs;
- a hypodynamic lifestyle (it has been proven that the more a woman leads a mobile lifestyle, the less she is at risk of developing osteoporosis);
- any form of smoking;
- excessive consumption of alcoholic beverages (more than three groups per day with varying degrees of strength);
- dysfunction of the digestive system, endocrine, and pancreas;
- changes in hormonal levels that occur throughout the climax;
- violation of the functioning of the ovaries or their removal (leads to hormonal imbalance or early menopause. This, in turn, can become a catalyst for the development of osteoporosis);
- problems in the work of the adrenal glands (in itself is not the cause of the formation of the disease, however, taking medications may well provoke it);
- all other diseases of the endocrine glands (they are most often directly related to hormonal imbalance).
Thus, the appearance of osteoporosis will be quite expected if you know all the reasons that will affect the formation of the presented disease.
Senile-type osteoporosis occurs due to a calcium deficiency associated with age and a loss of balance between the acceleration of bone tissue destruction, as well as the rate of formation of new bone-type tissue. Senile means that the presented condition is formed at an older age, most often in people from 70 years of age or more. This ailment is twice as common in women as in males. In women, it is almost always combined with the postmenopausal stage.
It should be especially noted that in less than 5% of cases, the disease is caused by some other ailment or taking certain medications. This is a form of osteoporosis known as secondary. It can form under the conditions indicated above. Let's say problems with the kidneys or endocrine gland. Excessive alcohol consumption and addiction to smoking only aggravate the presented disease.
There is also idiopathic "youthful" osteoporosis. This is the rarest type of osteoporosis, the cause of which is currently unknown. It is formed in infants, children and young people who have quite normal levels of hormones and vitamins in their blood. In addition, they do not have any understandable reason for the decrease in the degree of bone density.
Degrees of osteoporosis
Determine such severity of osteoporosis as:
- the primary degree, which is manifested in a decrease in bone density. X-ray diagnostics reveals significant transparency of the X-ray shadow and striation of the silhouettes of the vertebrae. This degree of the disease is determined exclusively by medical research;
- secondary or mild osteoporosis - an apparent decrease in bone density. In this case, the vertebral bodies acquire a specific biconcave shape, a wedge-shaped deformation of one of the vertebrae is formed. This degree of the disease manifests itself in the strongest painful sensations;
- severe osteoporosis, or tertiary degree - a sharp transparency of the vertebrae is revealed during X-ray examination. Otherwise, it is called glazing and the presence of a wedge-shaped deformity at the same time in several vertebrae. At this stage, osteoporosis is already evident.
Osteoporosis of the hip joint
Such a form of this ailment is known as osteoporosis of the hip joint. By its genesis, it is no different from osteoporosis of other bones, except for localization in the area of the same name. The most vulnerable place in this manifestation of the disease is the neck of the femur. The fracture of the presented area in older people often ends in death or inability to move in the usual normal mode.
In the vast majority, arthroplasty exclusively makes it possible to fully restore the functioning of the hip joint.
Osteoporosis of the presented type can have the following three types of localization:
- local - there is a decrease in the degree of bone density and the top of the femur at the initial stage of such ailments as specific necrosis of the top of the femur and Perthes disease;
- regional - it is formed exclusively with arthrosis of the hip joint;
- common - it develops due to dysfunction of blood circulation in the lower extremities.
Osteoporosis of the hip joint can form as a consequence of systemic osteoporosis, which is much more typical for this disease.
With the presented form of the disease, bone tissues lose the ability to maintain optimal physiological loads. The total defeat of the hip and knee joints in this case is provoked by the fact that it is mainly on them that the most significant load "falls" during movement.
Osteoporosis of the hip joint begins to develop for a whole list of reasons:
- prolonged loss of motor functions of the lower extremities during long-term treatment of fractures, dislocations and other injuries. This causes atrophy of motor functions, which is almost impossible to bring to a normal state;
- significant load on one limb in the event that the work of the second was removed or disrupted. This option also negatively affects the functioning of a particular limb, as a result of which it loses muscle memory;
- complication of blood circulation in some specific conditions. We are talking about burns, frostbite, phlegmon (inflammatory or purulent decomposition of tissues) and others, which also become catalysts for muscle and tissue atrophy;
- a special form of osteoporosis of the hip joints in women should be considered transient osteoporosis. It develops in females in the later stages of pregnancy and in men between the ages of 30 and 40.
It is possible to detect this form of the disease on x-rays or by palpation (in some cases). Timely detection is very important, because this will make it possible to start adequate treatment as soon as possible.
Regardless of the reasons for the manifestation of the presented disease, the mandatory components of the treatment process should be considered, first of all, physical therapy. It is she who makes it possible to bring the metabolic processes in bone tissues "into shape", to regulate the degree of joint mobility and muscle activity. Such recovery takes a very long time, and the older the person, the more complications it goes away.
A strict verified meal schedule and frequent exposure to passive and active sun are very important. The second makes it possible to make the production of vitamin D faster, and, accordingly, strengthen bone tissue. Taking medications is also allowed, but only as prescribed by a specialist. These can be both medicines containing calcium and vitamin D3 (or its other metabolites), and bisphosphonates. It is undesirable to take any hormonal drugs for those women who have reached the age of 70 years. However, sometimes this is the only way to bring the structure of bone tissue back to normal.
Diagnosis of osteoporosis
A sufficient number of methods have been developed by which the diagnosis of osteoporosis is carried out. Radiography makes it possible to detect depletion of bone tissue only when their loss has reached more than 30%. Therefore, it makes sense to resort to this method exclusively with a secondary degree of the disease.
A more modern method, which is almost always carried out in osteoporosis, is the analysis of the height of the spine and the calculation of their relationship. Densitometry should be considered the best method. This is what makes it possible to define as accurately as possible the degree of bone density, the ratio of calcium in the human body, as well as the number of muscle and fat deposits.
This method should be considered the safest, because only it does not use the so-called isotopic methods of irradiation, which are definitely harmful to humans. It is based on the determination of the density of the skeleton and reveals the mineral and other active components of bone tissue. Its advantage is the speed of obtaining results and perfect painlessness.
Also, one should not underestimate the standard delivery of blood and urine tests, which make it possible to realistically assess the state of phosphorus-calcium metabolism.
This is helped by data such as:
- General analysis of calcium is one of the fundamental specific components of bone tissue, the most important trace element that is involved in the creation of the skeleton, the functioning of the heart muscle, nervous and muscular activity, as well as blood clotting and all other processes. Variations in the form and stage of osteoporosis are manifested in various shifts in the degree of calcium concentration. The optimal calcium values are: 2.2 to 2.65 mmol per liter.
- Inorganic phosphorus is a component of the mineral substance of bone tissue, which is present in the human body as salts (calcium and magnesium phosphates) and takes part in the process of bone tissue formation and energy metabolism of the cellular type. 85% of all phosphorus is located in the bones. Modifications in terms of the ratio of phosphorus in the blood can be noted with all kinds of changes in bone tissue, this is not only about osteoporosis. The optimal parameters for phosphorus should be considered from 0.85 to 1.45 micromoles per liter.
- A substance called parathyroid hormone, which is produced by the parathyroid glands and is responsible for the exchange of calcium and phosphorus types in the body. The identification of the concentration of parathyroid hormone can provide the most important information base for identifying various forms of osteoporosis. The optimal parameters of parathyroid hormone are from 9.5 to 75.0 pg per ml. This amounts to 0.7 to 5.6 pmol per liter.
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Deoxypyridonoline, which is referred to as DPID, is a designation of the degree of bone destruction. It can be found in urine. Urinary excretion increases with postmenopausal osteoporosis, osteomalacia, thyrotoxicosis, and initial hyperparathyroidism.
Optimal DPID scores vary by gender:
- for males, this is from 2.3 to 5.4 nmol;
- for a woman, from 3.0 to 7.4 nmol.
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Osteocalcin is the main specific protein in bone tissue, which is actively involved in the process of bone repair and the production of new tissue of this type. Excessively high levels of osteocalcin are present at the initial stage of hyperparathyroidism, in those with hyperthyroidism and acromegaly. With osteoporosis of the postmenopausal type, it is within the optimal range or increased. With osteomyelia and renal ostiodystrophy, the ratio of osteocalcin decreases. The presented examination is needed to detect osteoporosis and control treatment, while increasing the ratio of calcium in human blood.
The optimal values for osteocalcin are as follows:
- men - from 12.0 to 52.1 ng per ml;
- women in the premenopausal period - from 6.5 to 42.3 ng per ml;
- postmenopausal women - from 5.4 to 59.1 ng per ml
Thus, in the process of diagnosing osteoporosis in women, it is important to pay attention to any fluctuations in the data and to carry out all available research. This is what will make it possible to make an accurate, timely diagnosis and, as a result, receive optimal treatment that will help in the shortest possible time.
How is osteoporosis treated?
Osteoporosis is treated with medication, people with endocrine system disorders are prescribed drugs that will help restore hormonal levels. Elderly people are prescribed dietary supplements rich in calcium and vitamin D. Women during menopause are prescribed hormone replacement therapy, as well as bisphosphonates.
Also, patients can sometimes be prescribed physiotherapy exercises, massage, all this in small dosages - due to the fragility of the bones. They can, if necessary, prescribe the wearing of special supporting corsets.
It is not possible to fully treat osteoporosis, but it is possible to learn to live with it and stop the further development of the disease. For this, there is a need for walks, jogging, dancing. All this is able to provide bone tissues with the healthy "stress" they need and make them stronger. Activities like these will give you the opportunity to strengthen your muscles and modify your coordination and balance.
Another way to treat osteoporosis, which is recommended for all women, should be considered a "healthy" diet with an individually selected ratio of calcium and vitamin D. It is best to check with a balanced diet, which is based on the postulates of the food pyramid.
In this case, it is especially necessary to make sure that the patient receives the necessary amount of not only calcium, but also vitamin D. This can occur both in the process of eating food and when using food additives.
A detailed and visual video of how to properly treat osteoporosis?
Treatment with bisphosphonates
One of the most modern methods of treating this disease in women is bisphosphonates. They are the most stable analogs of pyrophosphates that are naturally formed. They function on the female body in this way: they are embedded in the structure of bone tissue, remain in it for a long period of time and slow down bone reservation by reducing the activity of osteoclasts.
At the moment, bisphosphonates should be considered a recognized method of prevention and treatment of osteoporosis, not only in women, but also in men.
Studies that have been successfully performed on many thousands of patients have demonstrated that bisphosphonates:
- absolutely not dangerous;
- well tolerated by the human body;
- have a small number of side effects;
- oppress bone reservation;
- have a positive effect on increasing bone mineral density (BMD);
- reduce the likelihood of fractures.
To date, only a certain amount of bisphosphonates is used in active practice, namely alendronate, risendronate, ibondronate, and zoledrinic acid. They are characterized by a variety of ways and methods of introduction into the body.
The most famous and well-studied bisphosphonate is alindronate. Its degree of effectiveness has been proven in numerous examinations in those with osteoporosis. The studies were carried out in the presence of vertebral fractures.
Also, this drug is effective in the prevention of osteoporosis in postmenopausal women with osteopenia. On average, alindronate reduces the likelihood of fractures of various locations by 50%, and the likelihood of more specific fractures in the vertebral region by 90%.
This drug is prescribed at a dosage of 70 mg, that is, one tablet, once a week. For postmenopausal osteoporosis, risendronate is also used at a dosage of 30 mg per week.
The drug "Miacalcic"
In addition to the previously presented primary-line methods, salmon calcitonins can be used in some cases in the treatment of osteoporosis. This agent is a specific analogue of the endocrine gland hormone calcitonin, which takes an active part in the restoration of calcium homeostasis.
The peculiarity of the drug "Miacalcic", which contains salmon calcitonin, should be considered that it significantly reduces the risk of fractures while excluding the obvious dynamics of the disease. This became possible due to its positive effect on the quality of bone tissues (their micro and macroarchitectonics).
The likelihood of new fractures in the spine during treatment with Miacalcic decreases by 36%. At the same time, the drug is characterized by another parameter, which is actively used in active medical practice: "Miacalcic" produces an obvious analgesic effect in those sensations that are provoked by fractures.
Hormone replacement therapy
It should also be noted and hormone replacement therapy (HRT). It is she who can boast of a high degree of effectiveness in female representatives in the postmenopausal period. There is a serious side effect of this therapy, which is venous thrombosis. In this connection, in the process of prescribing this treatment, a woman must be informed about the possible complications without fail.
But, despite this, it is HRT that remains a fundamental preventive measure for women with menopause up to 45 years old. In addition, it is such a remedy that really effectively relieves all vegetative symptoms of the clinical type that are characteristic of menopause.
In each individual case, the problem of prescribing HRT to a woman needs careful gynecological and mammological examination and monitoring.
With constant pain in the lumbar region, certain exercises that strengthen the muscles of the back can be quite effective. Lifting weights and falling can only make symptoms worse. Therefore, a constant physical load is recommended.
Prevention of osteoporosis
Preventing osteoporosis is many times easier than curing it. Preventive measures are to maintain or increase the degree of bone density by applying the required ratio of calcium. There is a need for the implementation of physical loads with weights and, for certain categories, the intake of active drugs.
An increase in the degree of bone density is also positively influenced by special exercises with pressure on the bones, for example, walking and running up stairs. The same exercises that are not associated with such a load - swimming, do not have any effect on the degree of bone density. Therefore, it is very important to consult with a specialist and in no case do self-treatment. This can be fraught with even greater complications in osteoporosis in women.
Which doctor should i go to for osteoporosis?
For the purpose of testing for the presence of osteoporosis, it is advisable to contact such specialists as an endocrinologist, rheumatologist, gynecologist and orthopedic traumatologist. Such an impressive number of doctors is necessary because the female body is a single whole and osteoporosis can be caused by a variety of malfunctions in the body.
This means that it will be necessary to treat not only the presented ailment, but also what provoked it. In order to detect deeper problems, it is necessary to be examined by a significant number of specialists. It is necessary to be examined by each of the presented doctors after the onset of 40 years of age at least once a year. This approach will make it possible to prevent the onset of the disease and help mitigate its manifestations, in particular, to prevent fractures.
First of all, it is necessary to undergo examinations by an endocrinologist and a gynecologist, who will indicate the need for testing for hormone groups and, if the need arises, will be sent to a rheumatologist or orthopedist. It is these specialists who determine the appropriate treatment, and will help solve all the emerging health problems.
The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist
Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).
