By definition, osteoporosis is a disease of the
skeleton in which the body breaks down more bone than it builds
up. As a result, the bone density gradually decreases and the bones become
porous and brittle. The risk of a bone fracture is
significantly higher in osteoporosis patients - a slight fall or wrong movement
often leads to a fracture.
Doctors differentiate between "senile osteoporosis" in older people
and "postmenopausal osteoporosis" in women, in
which bone density decreases faster and due to hormonal changes during the
menopause. In men, bone loss also occurs; they suffer from
"senile osteoporosis". Much more often, however, are women in
whom the estrogen deficiency after menopause leads to increased bone loss.
More than every third woman over
60 is affected and around seven million people in Germany suffer from
osteoporosis. Due to demographic change, the disease is one of the most
common bone diseases in industrialized countries today.
Often, and especially in women, the dreaded bone
loss is noticeable on the spine. If vertebral fractures occur as a result
of the reduced bone density, a noticeable hunchback develops over time,
which is colloquially known as the " widow's hump" .
There is no therapy to cure osteoporosis. However,
it is possible to curb the disease with the right treatment and to keep the
impending restricted mobility within limits.
Osteoporosis:
The Symptoms
People with osteoporosis do not have pain at the
beginning of the disease, because the bone loss itself does not hurt. In
the advanced stages, however, back pain or knee pain can
occur. In addition, of course, the broken bones hurt, which often occur
for no apparent reason and are an important warning sign of the
disease. Often, fractures of the spine are caused by a break in a
vertebral body. A femoral neck fracture is also typical for osteoporosis
patients.
Doctors refer to the external appearance of the
back in advanced osteoporosis as the "fir tree phenomenon " or "fir tree effect": because the
vertebrae move closer together, the whole person shrinks. The skin does
not shrink with it, which means that folds form on the back that start in the
middle and run downwards on both sides - like the branches of a fir tree.
Osteoporosis:
The Causes
Up to the age of 35 - compared to bone resorption -
the development of bone substance predominates. After that, the body
steadily breaks down more bone mass than it builds , so that in old age there is an annual loss of up to
one percent - in healthy people. Anyone who suffers from osteoporosis will
degrade faster: up to six percent of the bone mass is then lost every
year. Reasons are, for example, a lack of calcium -
the most important building block of our bones - or hormonal changes during
menopause.
In addition to smoking, too little exercise and
sedentary work are among the risk factors that favor osteoporosis, because the
bone metabolism regularly needs stimuli to keep going. There are also
drugs that have a side effect on bone density - such as those for epilepsy.
Osteoporosis is not a “hereditary disease” in the
strict sense of the word, but genetic variants that are likely to be associated
with reduced bone density can be inherited. In cases in the family, there
is an increased risk of developing osteoporosis as well. Slim, graceful
women seem to be more prone to bone loss than strong ones. However, the
greatest risk factor for osteoporosis is and remains age.
Can
you prevent osteoporosis?
Osteoporosis can be prevented for a
lifetime. Sports activity and a balanced diet from
childhood are the best prophylaxis. Because movement,
especially when the skeleton is still growing, ensures good bone
stability. The following applies: the stronger the bones are before the
breakdown begins to outweigh the build-up, the better someone is protected
against osteoporosis.
Just like regular exercise, a diet rich in calcium and an adequate supply of vitamin D contribute to prevention. Vitamin
D, which the body can produces itself when exposed to sunlight, enables calcium
to be built into the bones. Well-trained muscles are helpful in
stabilizing the skeleton as well as possible into old age.
Doctor's
test: do I have osteoporosis?
In the doctor's office, the diagnosis of osteoporosis
consists of various examinations and measurements. First of all, the
doctor asks about risk factors, previous bone fractures, illnesses in the
family and pain. He controls mobility and examines the spine. If he
suspects that there is osteoporosis, a bone density measurement is
carried out, during which he determines the so-called T-value.
The examination is carried out using "Dual
Energy X-Ray Absorptiometry" (DXA), a double X-ray absorption measurement on the spine and
hips, which is also called "Osteodensitometry". The T-Score, which results from this measurement and can
be compared with the normal values using a table, indicates how much the
patient's bone density differs from the average value in people of the same
age. Values from -2.5 indicate insufficient bone density. If there
are also fractures, there is clearly an osteoporosis.
An X-ray examination of the
back makes existing vertebral fractures visible, and the doctor also has the
patient's blood examined in the laboratory, for example to check the calcium
level and rule out other diseases.
The
right therapy for osteoporosis
There is no cure for osteoporosis. But the
disease can be slowed down. The type of treatment depend on the severity
and fitness of the patient. To correct osteoporosis therapy include:
- sufficient exercise
- a healthy diet containing calcium and vitamin
D.
- Medication, e.g. B. bisphosphonates in
the form of tablets or syringes
- Painkiller
- the prevention of falls, e.g. B. through
living changes and safe shoes
- physical therapy measures for pain relief,
e.g. B. cold or heat
The doctor should decide on an individual
basis which drugs complement the therapy for
osteoporosis. Bisphosphonates, which strengthen the bone mass and at the
same time inhibit the breakdown, are the classics. However, there are
other active ingredients that either slow down bone loss or support bone
building. An antibody that has a positive effect on bone metabolism is now
also on the market. Hormone preparations with estrogens can counteract
postmenopausal osteoporosis.
After the diagnosis of osteoporosis, the doctor
should critically review those medications that a patient already takes
regularly: some medications promote bone loss and should be replaced by others
if possible.
Surgery is
sometimes required for severe and advanced forms of
osteoporosis . Surgeons then fix broken bones in the operating room,
surgically straighten the spine or insert artificial joints.