Osteoporosis: definition, synonyms, course
Definition: Osteoporosis is a generalized disease of the bone apparatus characterized by bone resorption, the decline of bone substance, deterioration of bone tissue and an increased risk of bone fracture. According to the WHO, osteoporosis is present when bone density is at least 2.5 standard deviation below the mean value of healthy young adults. Approximately 6 million people over 50 years of age are affected, women significantly more often than men due to the hormonal situation in the menopause.
Synonyms: Osteoporosis, bone loss, bone decalcification, increased bone fragility, reduction of bone mass, reduction of bone density: The WHO classifies osteoporosis into 4 stages. In the first stage (osteopenia), there is already a slight downward deviation in bone density without any fractures having already occurred. Stage 4 (advanced osteoporosis) is characterized by a severe loss of bone mineral content with multiple vertebral body fractures and fractures of the bones of the extremities.
There is an increased risk of primary osteoporosis especially for women from the age of 50 when menopause occurs (estrogen deficiency) or for men from the age of 60 (testosterone deficiency), and generally with increasing age (senile osteoporosis). Lack of physical activity, especially at a young age, a diet low in calcium and vitamin D, prolonged cortisone intake, rheumatic diseases, nicotine and underweight increase the risk of developing osteoporosis. Secondary osteoporosis develops due to certain hormonal and/or metabolic disorders, immobilization, and increased, prolonged cortisone intake.
Osteoporosis: diagnosis, symptoms, prevention, therapy
Diagnosis: Symptoms: Prevention: therapy:
- Anamnesis: Survey of the medical history with emphasis on the frequency of falls and fractures, genetic factors, prolonged cortisone intake, previous complaints, chronic back pain, prophylaxis taken? – Ask about current complaints: acute back pain or functional impairment, spontaneous bone fractures? – Physical examination
- Function test examples: Standing up from a chair, time-up-and-go test, walking speed, balance test, one-legged stand, ICF (International Classification of Function)
- Bone densitometry
- Laboratory
- X-ray
- Bone biopsy: removal and examination of bone tissue only in rare secondary forms
- Freedom from symptoms at the onset of the disease
- Acute or chronic back pain
- Reduction in height, hunched back due to wedge vertebrae formation in the case of fractures in the thoracic spine, fir-tree like folds on the back
- Spontaneous bone fractures, especially of the spine, hip joint fractures or extremities
- Deformation of vertebral bodies or bones of extremities
- Physical activity (beginning in youth)
- Vitamin D and calcium as food supplements, sunlight, vitamin D and calcium-rich diet (low animal fats)
- Avoidance of alcohol and nicotine
- Fall prevention as functional training and other preventive measures
- Wearing spinal or hip protectors to reduce the increased risk of fracture
- Drug therapy depending on the stage, especially biphosphonates and vitamin D, possibly estrogen/progestin
- Sports, increasing muscle strength and coordination, mobility and balance
- Calcium-rich and vitamin D-containing diet, alkaline diet
- Magnetic field therapy, Bemer therapy and vibration training
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