Osteoporosis (porous bone) is an inveterate degenerative systemic bone disease or a sporadic clinical syndrome, which results in the decrease of mineral density and structural damage of bone tissue due to the impaired calcium metabolism and the ability of bones to retain it. As a result, the bones become brittle.
Nowadays, osteoporosis is rather widespread, especially among people of older age and mainly among women. Osteoporosis takes the 4th place after cardiovascular and oncological pathologies and diabetes mellitus in terms of population disability and mortality from disease complications. The most unfavorable osteoporosis complications are subcapital fracture and vertebral compression fractures.
The great difficulty of disease diagnostics is related with a long asymptomatic period of pathology development and the manifestation of “causeless” fractures, when the bones are already rather thinned.
Types, causes and symptoms of osteoporosis
According to its origin, osteoporosis is divided into two groups: primary (involutional, postmenopausal, senile) and secondary.
Postmenopausal primary osteoporosis is the most widespread group: it affects mainly women after 15-20 years of menopause due to the lack of estrogen hormones (for men – testosterone); it is characterized by rapidly progressive bone loss.
Senile osteoporosis affects women and men after 70-80 with the equal frequency, it develops slowly, is related with the aging changes, lack of calcium (in food), vitamin D (in body).
Idiopathic osteoporosis is diagnosed only when the disease causes are unknown. It affects middle-aged people and even adolescents (juvenile osteoporosis).
Secondary osteoporosis is not a spontaneous disease; it is a consequence of previous diseases (endocrine, rheumatic, tumor, kidney and gastrointestinal tract diseases).
Risk factors of primary osteoporosis
- elderly age;
- delicate constitution;
- small height;
- fractures in family medical history;
- late onset of menses (after 15);
- early ischomenia (before 50);
- scanty and infrequent menses;
- long-term lactation (more than 6 months).
Taking into account that the immediate cause of osteoporosis is an imbalance of the calcium intake to the body (bone) and its excretion (“depletion”), you should know what leads to the calcium metabolism disorder, as it is rather easier to prevent pathology than to cure it. Thus, calcium imbalance can occur in the following cases:
- inappropriate nutrition;
- excessive drinking, smoking, drinking a lot of coffee;
- intake of certain medications (steroid hormones);
- forced lack of physical activity;
- chronic renal insufficiency;
- diabetes mellitus;
- hypovaria (relevant for women);
- excessive activity of the suprarenal cortex.
Among disease causes are:
- hormone imbalance (decrease of estrogen level, which affects the retention of calcium reserves in your body);
- diseases of blood-vascular system, musculoskeletal system, thyroid gland, etc. of various nature;
- low physical activity (such conditions are favorable for osteoclasts activity – cells destroying bone tissue);
- age-related decrease of calcium level in the body;
- unbalanced nutrition, limiting the calcium intake to the body (diet, fasting, consumption of acidic food, table salt, tea, coffee, alcohol);
- impaired absorption of minerals and vitamins;
- long-term use of carbonated beverages (each of them contains substances actively depleting calcium out of the body);
- dysfunction of digestive or cardiovascular systems;
- long-term intake of certain groups of medications (diuretics)
As is has already been noted, the disease develops asymptomatically for a long period. However, you should pay attention to your health in case of:
- rapid fatigability;
- muscle twitching;
- aching or burning pain in bones;
- frequent fractures with minimal load or traumatic factors (for example, awkward movements, light shock, or even normal limb rotation).
Diagnosis and treatment of osteoporosis
Despite the fact that it is rather difficult to identify the disease at its early stages, you can prevent it if you pay attention to the occurring age-related changes and calcium loss. Nowadays, pathology is diagnosed with the help of computed tomography and ultrasound densitometry. These methods allow determining not only the presence of changes in osseous structures, as well as their level and stage. The disease causes are detected with the help of additional laboratory testing determining the calcium level as well as other components necessary for physiological bone tissue functioning, and evaluating the functionality of organs and systems.
Medical treatment, in its turn, allows not only jugulating pathological process, but also launching the mechanism of osseous structure restoration and balancing metabolic processes. The complex of medications for osteoporosis treatment includes the following groups:
- agents of symptomatic therapy: anti-inflammatory drugs, analgesics, neuromuscular blocking agent. These medications relieve pain and spasms;
- calcium medications (stop disease progression);
- hormone replacement agents (restore metabolic processes);
- medications for bone mass acquisition (increase bone density, stimulating its growth);
- agents preventing destruction of bones (bisphosphonates, calcitonin, etc.).
During osteoporosis treatment, it should be noted the versatility of drugs based on the bisphosphonate complex. The latter not only restores the calcium metabolism and bone structure, but also relieves pain and inflammation. The use of creams with bisphosphonates, such as KSI cream, which can be used for a long period, is rather effective for comprehensive treatment, as they have no side effects. In addition, in contrast to pills and injections, creams have a very affordable cost.
Professor of A.A. Bogomolets National Medical University L.V. Degtyareva