Osteoporosis or bone loss is one of the most common bone diseases in our country. In this case, there is a sharp decrease in bone mass, which in the course leads to damage to the bone mass and bone structure. These disorders then affect bone function, so that bone fractures often occur. Osteoporosis or bone loss can be prevented relatively well by a balanced and calcium-rich diet. Likewise, sports and plenty of exercise help against this disease.
What is osteoporosis?
Osteoporosis, or bone loss, causes the bones of the sufferer to become porous and decrease in size faster than is normally the case. Compared to healthy people, the ratio between bone formation and bone loss is no longer correct in those affected by osteoporosis. At the beginning of the disease, patients hardly feel any suffering, as there are almost no symptoms. Only when the bone mass continues to decrease can bone fractures suddenly occur without cause, which are naturally associated with further pain. As a result of the fractures, poor posture is often assumed to protect the patient, and muscular tension develops. As osteoporosis progresses, those affected are no longer able to manage their daily lives on their own and thus often require assistance.
Causes
As with many other diseases, there is no one fundamental cause for osteoporosis; rather, there are many factors that can lead to the onset of the disease. In general, it can be said that in this disease there is a disorder in the metabolism of the bones, so that the structure of the bones is no longer guaranteed until the age of 40, as is common in healthy people. Risks that can lead to osteoporosis are, for example, underweight or vitamin deficiency. Too little exercise and an unhealthy lifestyle, such as smoking or taking various medications, can also promote the disease. Pre-existing conditions such as diabetes or kidney dysfunction are also frequently found in those affected. It is now proven that women are more at risk than men, which is mainly due to a lack of estrogen. In part, osteoporosis is also genetically hereditary.
Typical symptoms and signs
Schematic diagram of healthy bones and bones with osteoporosis. Click to enlarge. Osteoporosis develops insidiously, so that at the beginning of the disease there are hardly any symptoms. Only as the disease progresses do diffuse symptoms develop, which those affected often do not associate with bone loss. For example, osteoporosis may first become apparent in the form of back pain or pain in the knee joints. Similarly, bone fractures without apparent cause, so-called spontaneous fractures, are among the first symptoms of osteoporosis. In the advanced stage of bone loss, spontaneous fractures become more frequent. Characteristically, the femoral neck, the vertebral bodies and the upper and lower arm are particularly frequently affected by a fracture. Malposition of the corresponding extremities as well as severe pain may indicate a fracture. The vertebral body fracture in particular, however, often occurs as a gradual fracture. Those affected do not notice the fracture of the vertebral body, as it causes little or no pain. If there are several fractures in the spine, a hunchback may develop. This is also known as a widow’s hump in colloquial language. People with advanced osteoporosis can even lose several centimeters in height due to the vertebral fractures. Basically, persistent back pain, a decrease in height and a tendency to fracture are considered indications of osteoporosis.
Disease progression
Osteoporosis runs a chronic course, but it can be reduced if the disease is treated in time. However, if it is detected too late or if the wrong treatment is given, serious consequences can occur. Frequent bone fractures and pain occur as well as a curvature of the back. In most cases, the height of the body also decreases. Out of fear of renewed pain, many patients try to take it easy, but this only leads to further poor posture and causes further pain due to tension.The symptoms can lead to the affected person being considerably restricted in his or her everyday life and no longer being able to cope without the help of relatives or caregivers. Timely diagnosis and proper treatment of osteoporosis is therefore all the more important.
Complications
Among the most common complications associated with osteoporosis are dangerous bone fractures in advanced age. Fractures of the neck of the femur can be expected to have particularly serious consequences. In patients older than 70, this fracture leads to death in almost one third of all cases. About half of all those affected do not recover fully and remain in need of care for the rest of their lives. Postural damage is also a common complication of osteoporosis. The so-called “widow’s hump” is particularly characteristic. Patients usually suffer greatly from this because of their deformed external appearance. However, physical impairments are usually added to this. Due to the strong curvature of the spine, the chest space is reduced, which is regularly accompanied by respiratory dysfunction, which in turn causes shortness of breath, and in severe cases, serious lung diseases. If osteoporosis is not treated in time and progresses far, a number of other complications can be expected in addition to respiratory impairment. The poor posture often causes chronic pain and severely limits mobility, making it difficult to cope with everyday life and participate in social life. The reduction in quality of life can also cause depression. To prevent this negative spiral, treatment for osteoporosis should begin as early as possible.
When should you see a doctor?
If osteoporosis is present, an appropriate physician should always be consulted so that bone loss can be counteracted. Osteoporosis causes bone density to decrease faster than usual. To counteract this effect, medical and drug treatment should be sought as soon as possible. Those who opt for such treatment at an early stage can expect a rapid and effective improvement. However, osteoporosis cannot be completely cured. Bone density can be delayed with dietary supplements and other preparations, so that the life of the affected person can be made much more comfortable. If the visit to the doctor is delayed when osteoporosis occurs, serious complications can occur. The bones become weaker and more fragile from day to day, so that even the slightest stress can lead to a fracture. Therefore, the following applies: At the first signs of osteoporosis, an appropriate doctor should be consulted as soon as possible. Only in this way can treatment be initiated to counteract and significantly slow down bone loss. If medical and drug treatment is dispensed with entirely, it may even lead to life-threatening complications.
Treatment and therapy
Depending on the stage at which osteoporosis is diagnosed and how it progresses, treatment is also provided. The goal of therapy is mainly to improve the metabolism of the bones. In addition, drugs are mainly used to try to make the pain bearable for those affected. If osteoporosis is detected in a staidum, in which bone loss has not yet progressed so far, there is a great chance that this process can at least be slowed down. Treatment also includes a change in diet. The calcium contained in many foods, for example, strengthens the bones and should therefore be taken in larger quantities. Vitamin D also helps to reduce the symptoms of osteoporosis.
Aftercare
After treatment and rehabilitation, the patient receives therapy and aftercare recommendations for the attending primary care physician. Priority is given to the continuation of osteoporosis drug therapy and physiotherapeutic measures. An individual aftercare program is put together for the patient. This also includes physiotherapeutic and occupational therapy prescriptions. The use of aids is checked and constantly adapted to the patient’s changed circumstances. In the case of osteoporosis, follow-up care is necessary and useful in every case.On the one hand, this means that treatment is individually adapted to the patient’s current pain symptomatology. On the other hand, therapeutic measures for physical exercise are appropriately designed. Within the framework of the follow-up examinations, a continuously adapted, medicinal therapy is carried out. By means of continuous follow-up examinations, the bone mass of the patient with osteoporosis is measured and determined. Estrogen treatment, which is given until the end of life, is monitored by the physician. Appropriate follow-up care can prevent spontaneous fractures as far as possible by making the patient’s daily life safe. This includes, for example, sturdy, comfortable shoes and non-slip floors, as well as aids such as glasses in the event of vision problems. Another therapeutic approach in follow-up care is an adapted, balanced diet. Patients with osteoporosis should always have an adequate supply of vitamin D and calcium. This should be done either through appropriate foods or by taking dietary supplements.
Outlook and prognosis
Because osteoporosis is an irreversible process, there is no prospect of complete recovery from damage that has already occurred. The primary goal is to halt bone loss and generally stop the tendency for the skeleton to become brittle and prone to pain. Because of the highly variable nature of symptoms and long-term treatment, strict adherence to therapeutic measures remains necessary for a good prognosis. Patients must therefore attend regular check-ups and take prescribed medications, even if their symptoms are mild. If treatment is not given properly, there is a risk of continuous deterioration of the bone substance. Patients lose height, exhibit postural deformities and suffer from sometimes severe bone pain in later life. Without consistent therapy, bone fractures at an advanced age in particular pose a great danger to those affected. Consequential diseases and an increased risk of further injuries to the already affected regions lead, in the worst case, to the need for care or to death. In general, the probability of a manifesting movement restriction increases despite surgical interventions. Postoperative bleeding and a reduced ability to heal wounds often occur with new fractures. For patients, this also means a sharp increase in personal surgical risk. The lethality rate for a femoral neck fracture, for example, is 20 percent at age 70 and older. Conscientious prevention prevents the development of pronounced bone loss. If osteoporosis is already present, its course can be specifically influenced. Later occurring complications as well as pain remain absent with timely treatment.
What you can do yourself
A calcium-rich diet prevents osteoporosis and can favorably influence already existing bone loss. In addition, a sufficient supply of vitamin D is important so that the important mineral can be stored in the bones. Magnesium and vitamins K, C and B6 also contribute to bone health. A balanced diet with plenty of fresh fruit, vegetables, whole grains and dairy products usually provides the body with sufficient vital substances; occasionally, the intake of dietary supplements may be indicated. Osteoporosis patients should refrain from excessive consumption of foods and beverages rich in “calcium predators” such as phosphate and oxalic acid: These include cola, preserved sausage and meat products, spinach, beet, chard and rhubarb. Excessive consumption of caffeine and alcohol also has a negative effect on calcium metabolism. Exercise is an important part of osteoporosis therapy. Sports with a low risk of injury, such as walking, jogging or swimming, are well suited; team sports and martial arts are not recommended. In addition, the muscles can be strengthened with the help of special gymnastic exercises and the entire musculoskeletal system can be stabilized. In everyday life, it is important to avoid falls: In the living area, all tripping hazards should therefore be eliminated, and in the bathroom, rubber mats reduce the risk of slipping. At night, good lighting ensures greater safety.
