Osteoporosis: causes and symptoms, prevention and treatment

One of the most common diseases among the elderly is osteoporosis. In the absence of treatment, almost everyone is diagnosed with fractures characteristic of the advanced stage of the disease. What are the causes of osteoporosis, and can the disease be prevented?

Osteoporosis is a serious disease that threatens the health of older people. Its consequences can cause severe complications. The situation is aggravated by the fact that, in the beginning, the disease proceeds without characteristic signs. A silent epidemic is what experts call osteoporosis. According to statistics, up to 1% of patients know about the presence of the disease. For the rest, the pathology is diagnosed when pains and bone fractures appear; other symptoms appear – the consequences of osteoporosis.

About 35% of women and 27% of men after 50 years of age have pathological changes in the bones.

Today, according to WHO, osteoporosis ranks fourth in prevalence, yielding leadership only to cardiovascular pathologies, oncology, and diabetes mellitus.

What is osteoporosis

This is a chronic bone disease with a change in their structure: a decrease in bone density and a decrease in bone strength. Translated from Latin, osteoporosis means “osteon” – bone and “poros” – hole, time. The rarefaction of bone tissue leads to pathological fractures, which can appear even from a slight blow or an awkward movement; often, a person cannot remember exactly where he was injured. The vertebral bodies, the neck of the femur, and the radius are most susceptible to fractures.

Why Osteoporosis Develops

Bone tissue cells are constantly destroyed and renewed – this is a natural process in the body. It involves cells responsible for synthesizing bone tissue – osteoblasts and contributing to its destruction – osteoclasts. Hormones, vitamins, and cytokines regulate the number of these cell spines. Until age 30 (on average), osteoblast activity is higher, and bone mass is constantly renewed and increased. Then comes the equilibrium, lasting about ten years; during this period, the number of osteoclasts and osteoblasts is stable. But later, the activity of osteoblasts decreases, and the process of destruction of bone tissue begins to predominate, resulting in its resorption.

Thus, the pathology develops due to an imbalance between the formation of new bone tissue and the destruction of the old one, and the ability to continuously restore is lost. The body is either unable to create new bone tissue sufficiently, or the process of bone destruction is too active. However, both processes are often observed.

Causes and risk factors

The main cause of primary osteoporosis is the age-related body restructuring associated with the attenuation of sexual function, so the main category of patients is people over 50 years old. But in women, the disease develops more often, which is explained by the cessation of estrogen synthesis and initially lower bone mass. In osteoporosis in women after menopause, 1-2% of bone tissue is lost yearly. However, primary osteoporosis can also be divided into:

• senile osteoporosis associated with the loss of bone tissue as a result of the aging of the body,
• idiopathic, developing for unclear reasons,
• juvenile, arising at the age of 8-14 years.

However, there is a secondary form of osteoporosis. The disease develops as a consequence of ongoing conditions such as:

• endocrine diseases,
• deficiency states (due to a lack of calcium, magnesium, vitamin D, and protein),
• inflammatory processes (arthritis, colitis, etc.),
• blood diseases,
• Conditions lead to a violation of the bone structure (after resection of the stomach, malabsorption syndrome, imperfect osteogenesis, removal of the ovaries, anorexia, prolonged fasting, etc.).

In addition, some adverse factors sometimes increase the likelihood of the disease. For example, prolonged immobility, taking certain medications, alcoholism, salt abuse, excessive intake of vitamin A, etc.

Symptoms of osteoporosis: how the disease manifests itself

The disease is asymptomatic until the loss of 20-30% of bone tissue. The first symptoms of osteoporosis that a person pays attention to may be a pain in the spine, the area of ​​​​the ribs, the pelvis, and large joints. Over time, the pain intensifies. However, as a rule, older patients ignore the painful manifestations, explaining them by aging the body, attributing them to existing diseases of the musculoskeletal system.

As for the spine, it becomes less mobile over time, the shape of the vertebrae changes, stoop appears, and scoliosis occurs. Due to the deformation and flattening of the vertebrae (and at an advanced stage, the vertebra is flattened by more than 50%), a person’s height decreases, the stomach protrudes, and a hump often appears.

Mostly, the disease is diagnosed for the first time when a bone fracture occurs. As a rule, even a small injury is enough for this: an awkward movement, a fall from a small height. There are cases when the cause was a straining cough. Fractures are also possible due to the load created by the weight of its weight. Sometimes situations arise when a person cannot determine the cause of the fracture since there was no significant injury.

Unfortunately, fractures are often accompanied by erased symptoms, and a person may not see a doctor for a long time. Only fractures of the radius have a more pronounced pain syndrome. A femoral neck fracture is of particular danger due to the forced restriction of mobility in elderly patients; complications often develop pneumonia, blood clots, loss of limb function, etc.

What to do? Get Tested

As a rule, osteoporosis develops over a long period. But there are examination methods that allow you to recognize the disease at the beginning of development. Enough time to see a doctor. For diagnosis, laboratory methods are used: determination of the level of calcium, phosphorus, vitamin D, hormonal indicators, etc.

In addition, there is an effective, safe and painless way – densitometry, with which you can assess the density of bone tissue even before it begins to break down. However, one of the available and effective diagnostic methods is still an x-ray, during which it is possible to determine the deformation and fractures of the bones.

Treatment options

As a conservative therapy, medications can slow the progression of the disease, improve bone density, prevent fractures and eliminate pain. For this, various drugs are prescribed :

• antiresorptive (act on osteoclasts, inhibit bone resorption),
• anabolic (promotes bone formation),
• hormone replacement (used in the treatment of osteoporosis in postmenopausal women),
• painkillers, etc.

In the secondary form of the disease, correcting disorders that provoke changes in the bones is carried out: endocrine diseases, deficient conditions, etc. Also, in the medical treatment of osteoporosis, calcium and vitamin D intake is recommended, the effectiveness of which has been clinically confirmed. In the course of studies, it was confirmed that with the combined intake of calcium and vitamin D, the risk of fractures is 25% lower than with monotherapy.

It will take several years to stop the further development of osteoporosis. But drugs must be prescribed by a doctor. After all, if calcium and vitamin D is effective for prevention, they will not be enough to treat osteoporosis. No less important is the correction of nutrition; the diet should be dominated by foods containing sufficient amounts of vitamins and minerals.

To reduce the load on the thoracic and lumbar spine, orthoses and corsets are recommended, which provide mechanical support and limit movement in areas where fractures most often occur. But the use of corsets should be agreed upon with a specialist who can choose the right model and give recommendations regarding wearing. For example, using corsets that restrict movement is not advisable for a long time since immobilization contributes to even greater demineralization of bone tissue.

When is surgery needed?

Surgical treatment is indicated for compression fractures of 2-3 degrees and spinal instability when there is a risk of damage to the spinal cord and nerve roots. Also, surgical treatment is recommended for bone fractures. Today, there are various techniques: vertebroplasty, kyphoplasty, osteosynthesis, endoprosthesis, etc. It is important to approach the possibilities of surgical treatment and the choice of the optimal technique individually.

Particular attention should be paid to postoperative rehabilitation since the recovery in patients with osteoporosis is slow. The amount of load during exercise therapy for each patient should be selected by his age and physical form. It is important to remember that the operation eliminates the consequences of osteoporosis but not the cause; due to the characteristics of the bone tissue, there is still a risk of fracture, which should be taken into account when doing exercises. In addition, you need to continue drug treatment. Therefore, rehabilitation should be performed under the supervision of a group of specialists: a rehabilitation specialist, an orthopedist, in the presence of secondary osteoporosis: an endocrinologist, a rheumatologist, etc.

Is there any prevention?

Simple recommendations should be followed to prevent the disease or prevent the development of complications caused by osteoporosis.

Nutrition

The key word is calcium. It’s assigned the main role in the prevention and treatment of osteoporosis. Natural sources are:

• milk,
• cottage cheese,
• sour cream,
• cheese,
• a fish,
• beef,
• beans,
• olives,
• green vegetables,
• nuts, etc.

Vitamin D is no less important for the body which is contained in large quantities in salmon, cod, and egg yolk. However, for the normal absorption of calcium, the body also needs phosphorus, magnesium, zinc, and other elements. In short, nutrition should be balanced.

Stay outdoors

Vitamin D is produced in the body by exposure to sunlight. You can make special preparations to replenish its reserves in the winter months.

What is better to refuse

“Opponents” of calcium are refined foods and coffee, which prevent absorption. Limiting salt intake in the body is also better; just one spoon a day can reduce bone mass by 1.5% per year.

Physical activity

Lack of regular exercise can contribute to bone loss. According to meta-analyses, people who lead an active lifestyle have 30% higher bone density than those who prefer inactivity. In addition, gymnastics, massage, swimming, and just walking improve the condition of the muscular frame, which supports the spine.

Stop smoking

Nicotine is the main enemy of calcium. When smoking, it is more quickly excreted from the body, and in combination with excessive consumption of salt and alcohol, the deterioration occurs rapidly.

Osteoporosis is a chronic disease that is asymptomatic for a long time, hence the late diagnosis. In the absence of high-quality and timely treatment of osteoporotic fractures, the risk of disability is high: about a third of patients remain bedridden. But to detect trouble in time, there are different diagnostic methods. All that is needed for this is periodically undergoing an examination, especially in cases with a risk of developing pathology. So do not miss the chance to be able to move independently until old age!