Osteoporosis - treatment, prevention


остеопороз фото Osteoporosis (fragility of bones) is a progressive systemic disease of the bone system, in which the structure is broken and bone tissue density is reduced. This disease is manifested by the degradation of the structure of bone tissue and loss of bone mass, which leads to increased brittleness of bone structures, thereby increasing the risk of fracture of the wrist, hip and vertebrae (most often). Vertebral fractures disrupt the stability of the vertebral column and biomechanics of the spine. Women suffer most from this disease, which is confirmed by the following observations: after 70 years in 30% of women there was at least one vertebral fracture

Osteoporosis causes

Osteoporosis begins its development after the age of thirty and can affect any person, regardless of gender, but most often this disease develops in postmenopausal women (bone loss in women is associated with an age-related decline in estrogen levels). Due to loss of bone tissue, the bones become brittle and weak, thereby increasing the risk of fractures from various, even minor injuries. Fractures in elderly women can occur even without falls, with the usual torso torso, or when lifting from a bed. In very severe cases, this can often lead to disability. The loss of bone tissue in men is associated with a decrease in testosterone levels, and in women - with a decrease in the level of estrogen. The main reasons for the development of osteoporosis include:

- Elderly age. During this period, the body begins to poorly absorb calcium

- Long-term compliance with various diets, especially if from the daily diet were excluded dairy products

- Hysterectomy (removal of the uterus) with the removal of both or one ovary

- Excessive physical exertion, due to which the production of female sex hormones is exhausted (marathon run, inadequate strength exercises, etc.)

- Alcohol abuse and heavy smoking

- Insufficient amount of calcium in the diet

- The period of pregnancy. In the case of a lack of calcium in the diet, the fetus begins to take it from the maternal bones

- Menopause

Osteoporosis is divided into primary and secondary. Most often, there is primary osteoporosis (in women six times more often than men)

Primary osteoporosis (the first type) is a rapidly progressive disease, resulting in a rapid loss of trabecular bone tissue (internal spongy bone). Normally, this bone tissue is present in a large enough number in the limbs and vertebrae, so when the loss of trabecular bone tissue significantly increases the risk of fracture of the wrist and vertebrae.

Primary osteoporosis (the second type) is observed twice as often in women, usually after seventy years. Its development is associated with an increase in activity of parathyroid glands and a violation of absorption of vitamin D and calcium. With this type of osteoporosis, bone tissue decreases rather slowly and is observed both from the inside of the bone and from the outside. Due to the fact that the rate of loss of bone tissue is negligible, the consequences are not as rapid as in the first type of development of this disease. The most common fractures in the second type of osteoporosis are hip fractures

Secondary oteoporosis develops in the case of development in the human body of processes that change the exchange of bone tissue (a decrease in its mass). The reasons for the development of secondary osteoporosis include the following disorders of hormonal metabolism: increased thyroid activity ( hyperthyroidism ), diabetes mellitus , hyperparathyroidism, hypercorticism (developed as a result of prolonged use of corticosteroids, or as a consequence of chronic diseases). In addition, the causes of secondary osteoporosis may be: leukemia (leukemia), myeloma, metastatic bone damage, thalassemia

Osteoporosis symptoms

The main danger of the clinical picture is that the onset of osteoporosis is low-symptomatic or completely asymptomatic, skillfully masked for arthrosis of joints or osteochondrosis of the spine . Often, the disease is diagnosed after a fracture, which can occur with minimal load or lifting a fairly small severity.

At an early stage, it is difficult to notice the presence of this disease, but there are several signs that can help in diagnosis. This pain in the bones with changes in weather conditions, tooth decay, fragile hair and nails, irregularities in posture. Wrists, bones of the hands, spine and neck of the thigh, are the most sensitive to the disease.

The main symptoms of osteoporosis are the compression fractures of the head of the femur and the body of the vertebrae. Due to compression fractures of the vertebrae, painful sensations in the back can be observed, which after a while spontaneously disappear. In cases of repeated vertebral fractures, pain is often permanent. Sometimes, in severe cases of osteoporosis, even such minor movements as a torso of the body forward can cause a compression fracture of the spine (most often in older women). As a result of such fractures, kyphosis develops (pronounced inclination of the spine forward).

If there is any pain in the back, especially for elderly women, it is mandatory to seek medical help for advice and possible timely prescription of treatment or prevention of osteoporosis стадии остеопороза

Diagnosis of Osteoporosis

To date, the most informative method used to diagnose this disease is X-ray densitometry. It is prescribed only if there is a suspicion of osteoporosis, and the earlier the densitometry is done, the more effective the treatment will be. However, in order to prescribe adequate full-fledged treatment of osteoporosis, one x-ray densitometry is not enough. A general analysis of urine and blood, as well as a complete complex of biochemical (protein, calcium, phosphate) blood tests is carried out. Elderly, to exclude myeloma, X-ray examination of bone tissue is performed. If there are suspicions of fractures, all patients are assigned radiography. Computer tomography is prescribed for suspected metastatic lesions

Osteoporosis treatment

Treatment of osteoporosis is a rather complex problem, which is seriously handled by endocrinologists, neurologists, immunologists and rheumatologists. It is necessary to slow down the loss of bone mass, prevent the appearance of fractures, achieve stabilization of bone metabolism, reduce pain syndrome, and expand motor activity. To treat the underlying disease that led to osteoporosis, etiological therapy is used, and symptomatic therapy is used to relieve the pain syndrome. In addition, pathogenetic (pharmacotherapy) therapy of osteoporosis is used.

: Used in the treatment of osteoporosis drugs :

- Preparations stimulating bone formation: bioflavonoids, vitamin D3; salts of strontium, calcium and fluorine

- Preparations for suppression of bone resorption: bisphosphonates (zoledronic acid, risedronate, ibandronate, alendronate, pamidronate), calcitonin, natural estrogens

Unfortunately, to date, it is impossible to completely cure osteoporosis, but with the help of drugs influencing the absorption and subsequent absorption of calcium, the bone system can be significantly improved.

Therapeutic physical training in osteoporosis includes walking, which gives a load on the bones.

The diet for osteoporosis consists in the correct selection of food. They should contain vitamin D and calcium, these are: various dairy products, nuts, cabbage, greens, fish, broccoli. In addition, vitamin D is in sufficient quantity in fish, yolk and fish oil

Prevention of osteoporosis

The primary goal of prevention of osteoporosis is to consume enough calcium, which is in the required concentration in such foods as: low-fat dairy products, salmon, cauliflower, cheese, broccoli. At the same time, it is necessary to significantly reduce the consumption of products containing phosphorus, and this: sweet fizzy drinks, red meat, etc. It is necessary to significantly limit the use of caffeine and alcohol. The recommended daily dose of calcium to 60 years is 1000 mg, after 65 years - 1500 mg.

In case of ineffectiveness or impossibility of carrying out usual preventive measures of this disease, reception of means of medicamental prophylaxis is shown. In the period of menopause (menopause), for the prevention of osteoporosis, estrogens are used (in the form of subcutaneous implants or inside), as well as regular physical exercises. All women without exception, overdoing the forty-year boundary, it is necessary to check the functioning of the thyroid gland and, if necessary, to conduct timely adequate treatment.