Osteoporosis types, prevention and treatment

  • What is osteoporosis?

  • Osteoporosis is the dominant metabolic disease of the bones and is a major health and social problem. Asymptomatic disease that does not appear symptoms, except perhaps decrease in patient height and develop the characteristic stooped (bent forward) posture.
  • It is a decrease in the bone density, which can lead to breakage (fractures) of the same, in the case of smaller  loads, even when performing day-to-day activities.
  • These include hip fracture in elderly people, fractures of the hand (radii loco typico-fracture on the radius), and compressive fractures of spinal vertebrae, which actually decrease the height of the vertebrae.

What is the function of the bones?

  • The bone is a mechanical support of the musculoskeletal structure of the body.
  • Bone tissue is very active tissue.For the bone to maintain her shape,the bone tissue is going under constant changes and renewals. About 20 % of total bone tissue is regenerate each year.
There are 2 type of cells:
  • Osteoclasts ,breaks down bone tissue,
  • Osteoblasts, that synthesize bone.
  • In bones, a process of modeling and remodeling occurs, during which the old bone is removed and replacement with new bone tissue.
  • Maximum adult bone mass is reached between 30 and 35 years.
  • Type of osteoporosis 

  • Primary:
  • Idiopathic - unknown origin,
  • In women before menopause,
  • In young men or juvenile,
  • In women after menopause,
  • Senile (in adults related to age).
  • Irregular  nutrition, bulimia, lack of vitamin C and vitamin D, calcium, deficiency, excess sodium intake, immobilization,
  • In endocrine disorders (Cushing's syndrome), diabetes, acromegaly, hyperparathyroidism,etc 
  • After surgical interventions ( removal of a stomach or part of the colon).
  • Etiology/causes of osteoporosis

  • Genetic factor,
  • Early menopause,
  • Immobilization -passive life -no physical activity,
  • Endocrine and hematological disease,
  • Low body weight (BMD) ,
  • People who have been taking steroid medication
  • Decreased calcium intake
  • people with an eating disorders
  • Bad life habits (alcohol, smoking, high sodium intake, caffeine, etc.).

Why are women have bigger risk for  osteoporosis than men?

  •  A woman's risk of osteoporosis rises sharply after menopause.
  • It's also especially true for women who have small, thin frames.And man are more physically active then women,
  • Vertebral fractures, they are more often in  women compering to  men is 7: 1,
  • Hip fractures, they are more often in  women compering to  men is 2:1,
  • Colle's fracture ,they are more often in  women compering to  men is 5:1.

How we can know if we have osteoporosis and how to diagnosed it ?

  • They may also refer you for a DXA sken  to measure your bone mineral density.
  • And laboratory test-marker to help evaluate and monitor the rate of bone resorption  and formation in osteoporosis;
  • A T score - standard deviation is a measure of variability based on an average or expected value.Compering to  30 years old.
  • Z-score is below -2, your bone density is lower than it should be for someone of your age.
  • A native X-ray can diagnose the presence of osteoporosis when bone loss is more than 25 to 30 %.

    How to treat osteoporosis and is it possible to be treat it?

  • Yes, and the susses depend from initial condition, osteoporosis can be treated. After 1 year of treatment for osteoporosis control DXA scen should be maid.

    What medications and modalities  of physical medicine can be used in the treatment of osteoporosis?

  • Calcium and vitamin D as supplements or in a natural way with nutrition and sunbathing.
  • Biphosphonates are medications that take calcium from the body and carry it to the bone in order to strengthen it. By using these drugs the mineral bone density is improved by 5 to 10%.
  • Exercises to strengthen the extensors (muscles) on the back.
  • In patients suffering from osteoporosis, 30 to 40 minutes of daily walking (walking) is needed with so-called quick walking, then swimming 2 times a week for muscle strengthening on the back, exercises without excessive tension, tennis, gymnastics and others. a minimum threshold of bone load is required to increase the level of minerals in the bone itself.
  • People with normal bone density can act preventive through aerobics exercise, jogging, weight lifting, skiing and more.
  • Anabolic steroids have an osteoblastic effect, which helps to form the bone.
  •  Low frequency magnetic field stimulate synthesize of new bone.

Treating of fracture.

  • Hip fractures are treated  by operation on the hip.
  • Vertebral fractures, depends of the fractures,you're doctor will decide the type of treatment, is it by operation or non operating way.
  • Inoperative treatment pacinet should rest, take therapy given by there doctor, orthoses that are strictly prescribed by a doctor, because if they carry on their own, they can actually cause a weakening of the musculature.

How much calcium should we take?

  • The concentration of calcium depends on the age and gender of the patient
  • In children aged 9 to 18, the daily dose is 1300 mg,
  • In women од 25 до 64 години, дневната доза изнесува 1000 mg,
  • In women over 65 years of age, the daily dose of 1500 mg,
  • In breastfeeding women and pregnant women, the daily dose is 1200 - 1500 mg,
  • In men under 65, the daily dose is 1000 mg,
  • In men over 65 years, the daily dose is 1500 mg.