Systemic osteoporosis is more pronounced in metamorphoses. Causes and treatment of systemic osteoporosis. How the disease manifests itself at different stages

Systemic osteoporosis

a disease belonging to the group of metabolic osteopathies. In the development of the disease, the leading role is assigned to the violation of the mechanisms of modeling and remodeling of bone tissue. O. s. can be both the result of exposure to adverse environmental factors and genetic defects. The latter is confirmed by cases of systemic osteoporosis, which are observed in several members of the same family. Active mutagenic factors are ionizing radiation, some chemical compounds, viruses. Risk factors for systemic osteoporosis may include early menopause, hyperfunction of the adrenal cortex, hyperthyroidism, hypogonadism, excess phosphorus intake, starvation (insufficient calcium intake), long-term use of drugs such as heparin, barbiturates, alcohol, smoking, excessive coffee consumption, physical inactivity and etc. In some cases, the disease develops during pregnancy and lactation, as well as in the pathology of the gastrointestinal tract. More often, several risk factors act simultaneously, so the disease is considered polyetiological multifactorial.

clinical picture. O.'s manifestations with. varied. One of its most persistent symptoms is pain in the lumbar region, sacrum, and hip joints. Patients usually note a feeling of heaviness between the shoulder blades, general muscle weakness and gait disturbance. In some forms, the first manifestation of the disease may be pain and deformity of the ankle joints or the appearance of swelling and pain in the area of ​​the feet with its gradual spread to the large joints of the lower and small upper extremities. Subsequently, pain in the pelvic bones, ribs, which increases with physical exertion, joins. Further progression of the process is accompanied by a persistent pain syndrome, which does not disappear at rest and often forces one to take analgesics for a long time. Sometimes the first manifestation of O. with. there is a pathological fracture of the bones of the lower third of the forearm. None of the symptoms are pathognomonic and can be seen in many other metabolic osteopathies, multiple myeloma.

The course of the disease is often slow, but progressive. Spontaneous regression has been described only in some patients with a transient form of systemic osteoporosis (for example, in young men with idiopathic juvenile osteoporosis, in women during pregnancy or during lactation). With the progression of the disease, the violation of bone mineralization increases every year, which is accompanied by a decrease in its mechanical strength. As a result, pathological fractures, secondary deformities are noted, which often lead to disability.

Diagnosis. The most important role in O.'s diagnosis with. X-ray examination is assigned, in which a decrease in bone shadow density (osteopenia), increased vertical striation of the vertebral bodies, sclerosis of the subchondral plates, numerous depressed fractures in the central sections of the subchondral plates, fractures of the vertebral bodies (Fig. 1), pelvic bones, femoral necks, other bones of the skeleton. Thinning of the cortical layer of long tubular bones, restructuring processes similar to Looser's zones in the necks of the femurs (Fig. 2) and pelvic bones are also characteristic. In some cases, granular foci of enlightenment are observed in long tubular bones, as well as in the bones of the skull and hands.

At some forms O. of page. X-ray features are possible. Thus, in the steroid form of the disease, in contrast to the postmenopausal one, the deformity of the vertebral bodies in the fish type is more common (Fig. 3). Wedge-shaped deformity of the vertebral bodies in patients with postmenopausal form occurs without visible trauma, and with O. s. in young and middle-aged people, such a deformation of the vertebral bodies can be detected after lifting weights or falling from a height of their height. Numerous compression fractures of the vertebral bodies, which were previously described as hormonal spondylopathy or osteoporotic spondylopathy, are more appropriately referred to as platyspondylia, given that such an x-ray picture can be observed not only in various forms of osteoporosis, but also in other diseases and metabolic osteopathies. As a rule, there is no connection between such a deformation of the vertebral bodies and endocrine disorders. Fractures of the necks of the femur are more common in patients with senile form O. s., and pelvic fractures - in young and middle-aged people. None of the radiological symptoms is pathognomonic, because similar changes can be noted in osteomalacia, osteoporotic form of myeloma, etc. In this regard, radiological changes, like clinical ones, should be considered only in conjunction with other data.

The results of laboratory tests are of great importance for establishing the diagnosis. With O. s. possible hypocalcemia, an increase in the level of phosphorus in the blood while maintaining its normal excretion and tubular reabsorption, a decrease or increase in the activity of alkaline phosphatase, transient hypercalciuria, increased urinary excretion of hydroxyproline. In cases where hypocalcemia is combined with an increased release of hydroxyproline and a slight increase in the level of alkaline phosphatase, it is necessary to carry out a differential diagnosis with osteomalacia (Osteomalacia).

Often, invasive and non-invasive methods for determining bone mass are used in the diagnosis of the disease. Non-invasive methods include X-ray densitometry, X-ray morphometry, gamma-photon absorptiometry. X-ray morphometric and X-ray densitometric methods are quite simple, take little time, however, they allow you to determine mainly the mass of the cortical part of the bone and measure only in the region of the phalanges or II metacarpal bone, which are affected in O. with. not in the first place. The spine and femoral neck are considered the most vulnerable parts of the skeleton in systemic osteoporosis, so data on the state of these parts of the skeleton are of the greatest value. They can be obtained by two-photon absorptiometry and computed tomography.

An invasive method for assessing bone mass is histomorphometry of the material obtained from a biopsy of the iliac wing. It allows to obtain a quantitative characteristic of such parameters of bone tissue as cancellous bone volume, trabecular width, cortical plate width and porosity.

In all cases when there are difficulties in O.'s diagnosis with. according to the clinical and radiological picture and biochemical data, the patient should be referred to a specialized orthopedic hospital.

Treatment. The use of calcium preparations alone does not stop the progression of the pathological process and does not increase bone mass. The use of anabolic hormones contributes to an increase mainly in muscle mass. Data regarding the therapeutic effect of estrogens are contradictory. Their use, undoubtedly, is pathogenetically justified at O. of page which developed against the background of the Hypogonadism at women. Calcitonin has a pronounced analgesic effect, but does not stop the progression of the process. In addition, long-term use of calcitonin can lead to secondary hyperparathyroidism and increased bone resorption.

Wide application for O.'s treatment of page. found fluorine preparations, tk. their introduction as a result of the substitution of hydroxyl ions in hydroxyapatite leads to an increase in bone volume, improves the structure of the crystal lattice. But the matrix newly formed under the influence of fluorides is poorly mineralized, therefore, treatment with fluoride preparations (ossin, correberon, tridine) must be combined with the appointment of active vitamin D metabolites and calcium preparations. Long-term fluoride treatment, at least 2 1/2 years. The daily dose of calcium gluconate is 1.5 g. Due to the fact that fluorine forms insoluble compounds with calcium, the intake of fluorine and calcium cannot be combined in time, and the interval between their intake should be several hours. With fluorine preparations, it is also impossible to simultaneously take dairy products, cereals cooked in milk. In cases where hypocalcemia is observed in systemic osteoporosis, treatment should be supplemented with oxydevit (an active metabolite of vitamin D), which improves calcium absorption in the intestine.

Treatment of various forms of systemic osteoporosis with only active vitamin D metabolites is based on evidence of calcium malabsorption in the intestine. There is evidence that the appointment of oksidevit for 1 year in patients with the postmenopausal form of the disease, with osteoporosis in young and middle-aged people, as well as with osteoporosis that has developed against the background of diabetes mellitus, stabilizes the x-ray picture, eliminates pain (already after 2 -5 months after the start of treatment), stops the loss of spongy bone, maintains the thickness of the trabeculae and the width of the cortical bone plate. In some patients, during treatment with oxidevit, a significant increase in the width of the trabeculae and cortical plate is noted, which indicates the effect of the drug on the processes of modeling and remodeling. In each case, an individual selection of the dose of the drug and the duration of the course of treatment is necessary. Just as in the treatment with fluoride preparations, biochemical control is necessary at least once every 6 months. Mandatory components of O.'s treatment with. are exercise therapy, massage. With muscle weakness, hydrokinesitherapy is recommended. The therapeutic motor regimen is determined individually, health paths, close tourism or walks are prescribed. The complex of therapeutic measures includes orthotics. Corsets are prescribed according to indications.

Violation of the processes of remodeling and modeling in patients with O. s. excludes the possibility of surgical treatment of fractures of the femoral neck or other fractures without prior and subsequent conservative treatment.

Bibliography: Kon R.M. and Roth K.S. Early diagnosis of metabolic diseases, trans. from English, p. 350, 398, M., 1986; Violation of calcium metabolism, ed. D. Heath and S.J. Marx, trans. from English, M., 1985.

Osteoporosis is a disease in which the leaching of calcium and other minerals from the bone tissue prevails over their accumulation, which causes its irreversible modification. The bones become brittle, and in the structure of their tissues there is a “restructuring”, which consists in reducing the number of plates that form it.

Voids and pores are formed, the size of which is sometimes comparable to the size of holes in hard cheeses.

Frequent fractures in osteoporosis

Loose bone tissue is easily destroyed. Fractures cannot be avoided, and they happen not only during winter walks on slippery ice or autumn slush. Sometimes, to break an arm, it is enough to lift a heavy bag, and tripping over a rug in the hallway is enough to earn a “bedridden” fracture of the femoral neck. Such metamorphoses are caused by a violation of phosphorus-calcium metabolism in the body. Where does calcium “leave” and why does osteoporosis occur, what are its symptoms and how successful is the treatment?

Prerequisites for the development of osteoporosis largely take into account its classification. Let's consider the most common of them.

Let's start with a topographic classification, in which two forms of the disease are distinguished - local and generalized.

With local form the bone substance of a particular bone loses its density due to fractures, displacements, bruises, burns, toxic effects, etc.

Depletion of bone tissue can take the form of round or oval foci of various sizes (spotted osteoporosis).

If the bone is evenly depleted, they speak of uniform local osteoporosis.

Osteoporosis of the hip can lead to severe fractures

Local rarefaction of the bone tissue structure often occurs in the bones that form large joints. A typical case and a common cause of severe, "immobilizing" fractures in the elderly is osteoporosis of the hip joint, in which the disease affects the neck of the femur.

There are also regional osteoporosis, covering an anatomical region consisting of several bones, more often a joint. This form of the disease threatens not only bone fractures.

Osteoporosis of the joints develops, in which the fragility of the surfaces of the articular bones is combined with degenerative processes in the cartilage tissue.

The most commonly affected are the hip and knee joints.

If the pathological process also affects the soft tissues of the joint, they talk about periarticular osteoporosis. Periarticular osteoporosis of the hands is a frequent consequence of a decrease in bone density and a violation of their structure, manifested by pain in the joint and its crunching at the time of movement.

Leads to severe consequences diffuse osteoporosis of the spine, in which there is a reduced density of tissue in its vertebrae.

Diffuse osteoporosis of the spine threatens to fracture the spinal column

In addition to stoop, strengthening the lumbar curve and the formation of a hump, this type of disease threatens with severe fractures of the spinal column.

Systemic osteoporosis affects all the bones of the skeleton.

Osteoporosis in children and adults

Also distinguished:

Gender injustice

Although osteoporosis of the bones is diagnosed in almost 100% of men who have crossed the 75-year mark, women still remain the first contenders for “bone porosity”.
Causes of osteoporosis in women:

• Disharmony of hormones caused by menopause. The metabolism of calcium ions is carried out mainly in the constantly renewing bone tissue. It is constantly undergoing metabolic processes. Special cells - osteoblasts - synthesize bone substance, while others - osteoclasts - "resorb" it. Responsibility for the balance in this system is the sex hormones - estrogens and progesterone in women, androgens - in men. Menopause, accompanied by a sharp decrease in the production of sex hormones, disrupts the exchange of "building material";
• Poor diet. A diet based on carbohydrates and refined foods, soda and coffee threatens with a deficiency of calcium, phosphorus and magnesium, proteins and unsaturated fatty acids, vitamin D, which does not at all contribute to strengthening bones;
• A dangerous "couple" - alcohol and nicotine, if they are not separated for a long time, lead to a loss of 25% of bone mass;
• Ovarian dysfunction or removal.

See the video for more details:

The beginning of the disease is very easy to miss - its first symptoms are very blurred.
In the early stages, signs of impaired salt metabolism will help to suspect osteoporosis:

• pain in the bones and neck;
• increased fatigue and low performance;
• tearfulness or apathy;
• sleep disturbance, feeling of fear;
• night cramps;
• periodontitis and excess plaque;
• delamination of the nail plate and early gray hair;
• gastrointestinal dysfunction and the onset of diabetes mellitus;
• tachycardia;
• allergy.

Progressive osteoporosis is irreversible, and its symptoms worsen in women. With a decrease in bone mass, painful sensations appear.

Pain in osteoporosis is aching in nature, often localized in the lower back and sacrum, pelvic bones, ankle and hip joints.

Squatting on tiptoe, pressure from above on outstretched arms, accompanied by pain in the spine. Often there is a "painful" sensation between the shoulder blades. Bone fractures are on the rise. A further decrease in bone density in some women causes a decrease in height, sometimes significant, up to 10-15 cm.
With similar symptoms, the disease declares itself to the representatives of the opposite sex.
In women who have not reached the menopausal period, the depletion of bone tissue can be the result of significant weight loss. So, rigid unbalanced diets, poor in calcium and minerals, in addition to reflecting a slender body in the mirror, can provoke osteoporosis of the knee joint, the first manifestations of which - prolonged aching pain in the knee after exercise - eventually result in a severe degree of bone demineralization, fraught with joint deformity.
For more information on the symptoms of osteoporosis, see the video:

It has been established that blond women with very fair skin are at risk of getting “porosity” of bones more than, for example, dark-skinned representatives of the Negroid race.

What are the complications of disability?

Poorly healed fractures and skeletal deformities associated with osteoporosis with a high degree of bone demineralization often render the patient unable to work and may even be bedridden.

The question is brewing - do they give disability in osteoporosis?

The decision of the special commission depends on the severity of the complications:

• Obtaining a disability of the 3rd group is likely with significant kyphoscoliosis, aggravated by a strong pain syndrome;
• Fracture of the femur or other bone, complicated by the development of the so-called "false joint" - a reason for establishing group 2 disability. The likelihood of getting it increases in the presence of cardiovascular or respiratory failure;
• Disability of the 1st group is established in the critical course of life-threatening and bedridden osteoporosis.

Osteoporosis threatens disability

Sick, come on!

The best way to determine how much bone mass has decreased is densitometry, which allows you to express in numbers the dynamics of changes in bone density.

Such a quantitative assessment will show that the patient has osteopenia or osteoporosis, the difference between which is in terms of the level of decrease in bone mineral density.

Among the auxiliary methods for diagnosing osteoporosis are radiography, the study of the levels of such markers of osteoporosis as osteocalcin, bone fraction of alkaline phosphatase, etc., biopsy and differential diagnosis.

Instead of a conclusion

The human skeleton is comparable to an architectural structure, the stability of which depends on the strength of its building blocks - the bones. But just as water wears away the strongest foundation, the disease destroys the bones from the inside, turning their strong homogeneous tissue into a fragile structure with gaping voids. Therefore, it is necessary to lay the “foundation” and strengthen the bones without waiting for fractures, starting from the moment of intensive growth, during pregnancy and lactation. How? Compensate for calcium deficiency, which is always accompanied by imperfections in the diet, with products containing mineral salts and vitamin D.

But do not forget at the same time that the body does not make “reserves” for the future, and therefore, taking the right portion of calcium from the tablet, it will hasten to get rid of the excess, removing them through the kidneys. Therefore, the presence of calcium, minerals and vitamin D in the diet is the most important point in the prevention and treatment of osteoporosis. And in order for the body to be able to use them “as intended” during menopause, women during this period often require estrogen replacement therapy, combined with calcium, vitamin D and bisphosphonates, drugs aimed at suppressing bone decay. Fluorine preparations are also effective.

Prevention of osteoporosis will help to avoid the disease

In some cases, the doctor prescribes the wearing of supporting corsets - you should not neglect such a recommendation, but it is better to take care of strengthening your own muscle corset. Therefore, do not neglect physical activity. However, in old age, physical activity should not only be dosed, but also “correct” - incorrect exercises can lead to fractures, so the nature of the sports load should be discussed with the doctor and exercised with an exercise therapy instructor.

We should not forget about the intrapersonal "underlying reason" of the disease. After all, the psychosomatics of osteoporosis, or its psychological causes, often indicates that a person has a feeling of lack of some kind of support. Therefore, follow the recommendations of the attending physicians - an endocrinologist and a rheumatologist, eat rationally, eradicate bad habits and be sure: you can protect yourself, because life can sometimes support you in the most unexpected way! Be healthy!

Table of contents [-]

Osteoporosis is an exchange-metabolic disease of bone tissue, during which there is a violation of its mineralization, structural restructuring and a decrease in density. There is a loss of balance between the processes of formation and destruction of bone.

The most common consequences of this are fractures, sometimes they can be the only manifestation of the disease.

In the vast majority of cases, the disease affects the elderly, but cases of juvenile osteoporosis in children are not uncommon. The prevalence of the disease is increasing every year, especially in countries with demographic problems, which is associated with the aging of the population.

The reasons

Osteoporosis is a multifactorial disease, its occurrence is mediated by a whole complex of adverse effects. Therefore, there are such causes of bone loss:

• Elderly age.
• Decrease in calcium and vitamin D in the diet.
• Hormonal disorders: thyroid disease, lack of estrogen in women.
• Diseases of the stomach and intestines.
• Systemic pathology of connective tissue.
• Diseases of the blood.
• Hypodynamia and prolonged immobilization.
• Drinking alcohol, smoking.
• Medications (corticosteroids, anticonvulsants).
• Bone injuries, inflammation, tumors.
• Heredity.

If, with a comprehensive examination, it is not possible to identify any factors, then they speak of idiopathic osteoporosis. In other words, such a diagnosis is made if the disease develops against the background of complete well-being and in the absence of apparent causes. In other situations, they suggest a different nature of the pathology. Further treatment tactics will depend on this, therefore, if a disease is suspected, it is strongly recommended to be examined by a specialist.

What is osteoporosis

According to the modern classification of osteoporosis, there are several varieties of the disease.

First of all, it is worth considering the primary nature of the disease, since such cases are the majority - up to 90%.

At the same time, a decrease in bone density occurs independently, without the influence of external adverse factors or other diseases. Pathology extends to many components of the skeleton - diffuse osteoporosis develops, which covers all the bones of the limbs.

Illness in the elderly

Involutive osteoporosis is one of the manifestations of the general aging of the body. Bone tissue acts as a certain indicator of the intensity of such changes, becoming more and more fragile with age. Mostly women in the postmenopausal period (after 50 years) are susceptible to the disease. This is due to a lack of estrogens in the body due to involutive processes in the ovaries. The development of senile osteoporosis is observed in old age - after 70 years. The mechanism of its occurrence is dominated by violations of the enzyme system of the kidneys, which leads to a decrease in the production of vitamin D and a deterioration in calcium absorption.

The disease in older people often leads to severe fractures (for example, of the femoral neck), which can later become a cause of disability.

Disease in childhood

Idiopathic juvenile osteoporosis is a rare phenomenon. In this case, boys are more likely to suffer in the period before puberty (7-14 years).

Since up to 90% of bone mass is formed in children and adolescents, with the development of pathological processes, persistent bone deformities and frequent fractures may occur.

In some cases, changes may disappear without a trace.

hereditary pathology

Often there are familial cases of the disease. This is associated with altered activity of certain genes responsible for the process of bone remodeling. There may be various variants of such disorders: gene polymorphism, increased expression of some genes and a decrease in others. In any case, the hereditary type of the disease can only be determined by the results of a medical genetic examination.

Disease of unknown etiology

If in middle-aged patients it is not possible to establish the cause of the disease, then the diagnosis of idiopathic osteoporosis is most likely. It occurs in women of reproductive age (before menopause), as well as in men under 50 years of age. Symptoms of the disease may disappear at some point even without treatment.

The development of secondary osteoporosis is mediated by various factors that can affect bone tissue, disrupting its development.

It is possible to say exactly what type of disease is present in a particular case only by the results of an in-depth examination.

Symptoms

The disease can be completely asymptomatic for a long time, forcing attention to itself only after the first fracture. However, there are certain signs, the presence of which may indicate the likelihood of the disease. These include:

• Back pain: aching or sharp if the nerve roots are infringed.
• Decrease in height due to a decrease in the height of the vertebrae.
• Deformities of the spine, chest.
• Convulsive contractions of the muscles in the legs at night.
• Periodontitis.
• Brittleness of nails and hair.
• Decreased work capacity, fatigue.

Many of these signs can be observed in diffuse osteoporosis of the spine, when the porosity of bone tissue in the vertebral bodies increases. In addition, pain can also occur in other parts of the body - this may be a sign of periarticular osteoporosis.

Often the lower limbs are affected, which already experience increased stress.

Diffuse osteoporosis of the foot is characterized by almost constant pain, which is aggravated by walking and lifting weights. Based on these symptoms, you can suspect the disease and conduct the necessary examination in a timely manner. If the diagnosis is confirmed, then treatment should be started immediately.
Symptoms of the disease may vary depending on the localization of the process and the degree of its development. Depending on the prevalence and nature of bone damage, there are:

1. Systemic osteoporosis - the disease covers all components of the skeleton.
2. Diffuse osteoporosis - all parts of the limb are affected.
3. Regional osteoporosis - a pathological process is noted in one or more skeletal zones.
4. Local osteoporosis - a decrease in mineral density in only one bone.
5. Periarticular osteoporosis - develops only around the joints.
6. Spotted osteoporosis - develops in the early stages of the disease and is characterized by uneven lesions, there are separate areas of loss of bone density.

The presence of any signs of illness is an indication for a medical examination. This should not be delayed, since the pathology will steadily progress.

Treatment

For the purpose of maximum efficiency, the treatment of the disease should be started as early as possible - even at the stage of patchy osteoporosis, when the pathological process is localized, and bone destruction has not reached its maximum severity. The following activities will help with this:

• Eating foods high in calcium: milk, hard cheeses, cottage cheese, fruits and vegetables.
• The use of calcium and vitamin D supplements.
• Estrogen replacement therapy for postmenopausal women.
• The use of drugs that slow down bone destruction and enhance osteosynthesis: bisphosphonates, calcitonin, strontium ranelate.
• Treatment of the underlying disease that led to a decrease in bone density.
• Dose reduction or replacement of certain drugs: glucocorticoids, anticonvulsants.
• Age-appropriate physical activity, fracture prevention.
• Walks in the fresh air with moderate insolation.

Drugs for the treatment of osteoporosis are prescribed only by a doctor. Independent use of medicines is unacceptable. Only timely detection of pathology and adequate therapy will get rid of the disease and improve the quality of life.

Important! Doctors in shock: “An effective and affordable remedy for joint pain exists ...” ...

1. Causes and risk factors
2. Pathogenesis
3. Diagnostics
4. Treatment
5. Basic therapy

A pathological condition called osteoporosis is a systemic progressive chronic pathology, which is formed as a result of a violation of calcium metabolism in the human body. This condition is characterized decrease in bone density, increased fragility and disruption of microarchitectonics. In medical terms, osteoporosis is a specific process in which catabolism (breakdown) processes predominate over bone metabolism. Those people who have experienced this disease know firsthand about the problems that arise with osteoporosis. This disease occurs more often in women in premenopausal and menopausal age. With the development of certain somatic diseases, osteoporosis occurs in men of different ages and even in children.

An urgent issue for medical specialists is how the disease is treated, the prevention of which should be carried out in a timely manner, before the appearance of irreversible processes in bone tissue.

Interesting fact! At least 40% of people who have experienced a fracture of the bones of the upper and lower extremities have progressive osteoporosis, which is caused by a violation of calcium metabolism in the body.

Referring to the data of world statistics, at least 77 million people in Japan, Europe and the US have osteoporosis. In addition, cases of hospitalization of women aged 45 to 55 years are more due to the complications that arise in them against the background of osteoporosis.

The process of diagnosis and subsequent treatment of this disease must be carried out in specialized conditions, under the supervision of a medical specialist. Correction of osteoporosis at home is carried out through medicinal medicines that contain calcium and vitamin D3.

Important! Attempts to treat this pathological condition with folk remedies without the use of pharmaceuticals can aggravate the general condition and lead to the formation of spontaneous fractures of the limbs. One of the most serious consequences of untreated osteoporosis is a hip fracture.

Causes and risk factors

Osteoporosis refers to polyetiological diseases that occur under the influence of both exogenous and endogenous factors. In medical practice, there is an extensive classification of factors that can provoke the destruction of bone tissue in the human body.

The endocrinological causes of osteoporosis formation include:

• Infertility by female and male type;
• Hormonal disorders in the body;
• Late onset of menarche;
• Early pathological menopause;
• Dysmenorrhea caused by functional and organic disorders in the female reproductive system.

As genetic factors for the destruction of bone tissue can be identified:

• Asthenic body type;
• High growth, both in women and in men;
• Low body weight. For Caucasian women, this figure is less than 55 kg;
• critical age. For women, the critical age range is from 45 to 55 years, when hormonal changes occur, provoked by the onset of menopause. If we talk about the representatives of the male part of the population, then osteoporosis is dangerous for them in old age, when involutive changes occur that affect calcium metabolism;
• The presence of spontaneous fractures or signs of osteoporosis in close relatives.

There are also exogenous factors that contribute to the start of the processes of destruction of bone tissue. These factors include:

• Excessive alcohol consumption;
• tobacco smoking;
• Insufficient intake of calcium and vitamin D from food;
• Prolonged stay on parenteral nutrition;
• Excessive emotional and physical stress;
• Conducting labor activity, which is associated with a long stay in a passive (sitting) position.

Concomitant diseases can provoke the development of osteoporosis in the human body. These pathologies include:

• Chronic renal failure;
• Organic and functional pathologies of the thyroid gland, primary hypogonadism, diabetes mellitus and Addison's disease;
• Systemic diseases (Bekhterev's disease, systemic lupus erythematosus and rheumatoid arthritis);
• Malabsorption syndrome;
• Pathologies of the hematopoietic organs (lymphomas, leukemia, as well as multiple fibroids).

In addition, long-term use of anticoagulants, tetracyclines, lithium preparations, thyroid hormones, anticonvulsants, and glucocorticosteroids can serve as the cause of the formation of osteoporosis.

Pathogenesis

Pathogenetic changes in osteoporosis do not have a single mechanism. Destructive processes in the bone tissue can be both sluggish and fleeting. There are such stages of bone destruction in this disease:

1. Dissociation between the process of destruction and renewal of bone tissue is formed;
2. There is a decrease in the density of the cortical layer of bones, resulting in a decrease in bone mass;
3. Damaged bones become less strong and vulnerable to various injuries. At the final stage of osteoporosis, frequent spontaneous fractures can be observed, as well as deforming changes in the limbs and the spinal column.

The decisive factor in the development of osteoporosis is the deficiency of elements such as phosphorus, calcium and vitamin D.

D Osteoporosis is characterized by a long asymptomatic course, as a result of which the patient may not be aware of the systematic destruction of bone tissue for several years. Most often, this disease affects the vertebral bodies. When the pathological process begins to gain momentum, a person is forced to turn to a medical specialist by daily aching pain in one of the sections of the spinal column.

Early signs of osteoporosis include:

• Daily episodes of tachycardia and fatigue;
• Such manifestations of meteosensitivity as aching pain and aches in the spine, upper and lower extremities in response to changing weather conditions;
• Premature appearance of gray hair;
• Fragility of nails, hair and peeling of the skin;
• Pathological changes in the oral cavity (periodontal disease);
• Episodes of convulsive contraction of the muscles of the thigh and lower leg. Women of young and middle age are most susceptible to this symptom.

Important! Despite the fact that osteoporosis affects the entire musculoskeletal system, the indicator of pathological changes is the spinal column. If destruction processes predominate in the vertebral bodies, then the result of such a process is a wedge-shaped deformity and spontaneous fractures of these anatomical formations. Some people may not be aware that such a catastrophe has occurred in their body.

Symptoms and treatment

Destructive disorders in the hip joint in osteoporosis are accompanied by discomfort and pain on the side of the lesion. This pathology is characterized by a gradual increase in pain, as well as its intensification after physical exertion. In the absence of proper treatment, pain begins to disturb a person at rest, mainly in the evening and at night. The next stage in the development of this disease is atrophy of the skeletal muscles and a sharp decrease in motor activity.

In addition to these symptoms, with osteoporosis of the hip joint, the following signs are observed:

• Deforming changes in the joint;
• Unilateral or bilateral shortening of the lower extremities;
• development of lameness.

Important! During progression, this disease affects not only the quality of human life, but also the state of other organs and systems. People with osteoporosis are characterized by emotional lability, increased irritability, apathy and sleep disturbance.

The most striking clinical picture can be observed in osteoporosis of the spine. If the processes of calcium and phosphorus metabolism are disturbed in the human body, then osteoporosis of the cervical spine, thoracic and lumbar spine can develop with equal probability. The lumbar region is a very vulnerable place, as it has a large axial load. If the density in the bodies of the lumbar vertebrae is reduced, then they are deformed and destroyed under the action of compression.

With the development of osteoporosis of the thoracic spine, a person feels pain in the interscapular region and all the way to the waist. When the knee joint is affected, a person feels not only discomfort and pain, but also difficulties while walking, as well as when climbing stairs. Those pathological changes that occur with osteoporosis of the knee are called degenerative arthritis. Along with degenerative processes in the bone tissue, the formation of bone growths is observed. The danger of this condition lies in the fact that its rapid progression is fraught with the development of neoplasms. The main symptoms of degenerative arthritis include:

• Crunch in the knee area when moving;
• Difficulty moving in the joint;
• Pain at rest and during exercise;
• Visual deformation of the knee joint and an increase in its size;
• Atrophy of the skeletal muscles surrounding this area;
• Reducing the height of the patient.

Along with the knee joints, the disease spreads to other areas of the lower extremities, including the ankle joint. In violation of the exchange of calcium and phosphorus in the body, osteoporosis affects the femur, tibia and fibula, as well as the feet.

Osteoporosis of the shoulder joint belongs to the regional type of this pathology. This disease proceeds in a limited format, affecting only the articular area. With osteoporosis of the shoulder joint, degenerative processes develop in the articular fossa of the scapula and the head of the humerus.

If this disease affects the area of ​​\u200b\u200bthe hands, then a person feels a number of such symptoms:

• Pain in the metatarsophalangeal joints at rest and during exercise;
• An increase in the heads of the metatarsal bones;
• Deformation of the small joints of the hand;
• Atrophy of small muscles and stiffness of movements.

Interesting fact! A pathological condition called osteoporosis covers not only the structures of the musculoskeletal system, but also human teeth. This phenomenon is due to the fact that human teeth have a bone component, which, in the absence of proper mineralization, becomes thinner and destroyed.

Osteoporosis of teeth is fraught with their rapid destruction, the spread of carious foci and subsequent loss.

Diagnostics

If a person has more than one predisposing factor to the development of osteoporosis, then he is recommended to undergo a comprehensive examination, which is aimed at identifying structural changes. The main and most effective methods for detecting osteoporosis will be described in the form of a table.

A complete list of laboratory tests for suspected osteoporosis includes the following tests:

• The study of quantitative indicators for ionizing calcium;
• Study of the level of 25-hydroxyvitamin D;
• Determination of the concentration of triiodothyronine, tetraiodothyronine and thyroid stimulating hormone;
• Examination of blood samples for the level of sex hormones (estrogen and testosterone);
• Analysis for the quantitative content of parathyroid hormone.

Based on the obtained data of laboratory and instrumental examination, the patient is given a final diagnosis and appropriate treatment is prescribed.

The general plan of therapeutic measures for diagnosed osteoporosis includes the following items:

1. Basic therapy, the purpose of which is to normalize metabolic processes in bone tissue and replenish the deficiency of such basic trace elements as phosphorus, calcium, magnesium and vitamin D;
2. Hormone Replacement Therapy. If the main reason for the development of this disease is a deficiency of thyroid and parathyroid hormones, then the patient is prescribed replacement therapy, which includes taking natural and synthetic analogues of hormones;
3. Symptomatic therapy. Since the main manifestations of osteoporosis are discomfort and pain in large and small joints, such patients are prescribed non-steroidal anti-inflammatory drugs, analgesics, topical agents with anti-inflammatory and warming effects, as well as multivitamin complexes.

Basic therapy

Medicinal medicines that are part of basic therapy stimulate the regenerative abilities of bone tissue and prevent its further destruction. The list of medicines for the main treatment includes the following groups of medicines:

1. Selective estrogen receptor modulators. The prominent representative of this group is Raloxifene, which suppresses the mechanisms of bone tissue destruction and reduces the risk of spontaneous bone fractures;
2. Bisphosphonates. This group has the largest evidence base, which gives it the right to be called the drugs of choice in the treatment of osteoporosis. Their action is based on a pronounced suppression of the process of destruction of bone tissue and increased deposition of mineral components in the bones. As features of the use of this group, it should be noted the ban on taking a horizontal position for 30-40 minutes from the moment of using one of the drugs from this group. For the treatment of osteoporosis, medicines such as Zoledronic acid, Fosavans, Risedronate Alendronate and Ibandronate are used;
3. Genetically engineered drug Denosumab, which blocks the activity of osteoclast cells responsible for the physiological and pathological destruction of bone tissue. The domestic pharmaceutical industry sells this drug in an injection form for subcutaneous administration. The dosage is 60 mg. Denosumab has been shown to be highly safe in clinical trials and is therefore used in patients with renal insufficiency;
4. Drugs that activate bone tissue regeneration. Such medicines include parathyroid hormone derivatives (Teriparatide), as well as medicines containing fluorine (Coreberon, Ossin). These medicines have proven to be highly effective. The only drawback of Teriparatide is the high cost (about 27,000 rubles).

Hormone Replacement Therapy

Osteoporosis, triggered by hormonal imbalance in the body, is not a rare problem. This type of treatment is especially relevant for women in the premenopausal and menopausal period. Such patients are increasingly being prescribed estrogen receptor modulators (Evista, Keoxifen, Raloxifene). These drugs inhibit the destruction of bone tissue and help reduce the risk of spontaneous fractures by 60%.

Another effective drug combination for osteoporosis in middle-aged women is calcium supplements in combination with estrogen derivatives (Femoston and Kliogest). The use of other drugs containing estrogens is highly undesirable, since these hormones have a proliferative effect, promoting the growth of benign and malignant neoplasms.

Important! In order to avoid negative consequences while taking estrogen-like drugs, women are recommended to perform hormone replacement therapy under regular monitoring of hormone levels in the body. In addition, for safety reasons, when a hormone-containing drug is discontinued, the dosage used is slowly reduced.

Therapy with calcium preparations and symptomatic treatment

Effective treatment of this condition does not make sense without the inclusion of drugs containing calcium in the list of medicines. In medical practice, combinations of calcium preparations are widely used, as well as those medicines that regulate its metabolism. Medicinal medicines containing this microelement include calcium lactate, calcium chloride and calcium glycerophosphate. Multivitamin complexes are very popular, such as Complivit, Elevit, Calcinova and Nutrimax. To improve the absorption of calcium, combined medicines are used, which include vitamin D (Natekal, Calcium D3 Nycomed, Orthocalcium).

Correction of the main manifestations of osteoporosis is carried out through the following methods:

• Surgical treatment of spontaneous fractures;
• Compliance with dietary recommendations, which include increased intake of foods rich in calcium, phosphorus and vitamin D;
• Taking non-steroidal anti-inflammatory drugs, muscle relaxants and analgesics;
• Therapeutic massage, hardware physiotherapy and physiotherapy sessions.

All of these methods are aimed at improving peripheral circulation, relieving pain and normalizing metabolic processes in the structures of the musculoskeletal system.

The timely start of combined therapy for osteoporosis gives great prospects for the elimination of catabolic processes in bone tissue.

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The site provides background information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious physician.

Osteoporosis

is a pathological condition characterized by the following features:

• destruction of bone tissue: decay processes begin to predominate in it over synthesis processes
• decrease in bone strength and, as a result, an increase in their fragility
• violation of the internal structure of the bones

Osteoporosis can be an independent disease or a symptom of other pathologies.

Osteoporosis is one of the most common diseases. Its prevalence is highest among older and older people. Currently, the problem of osteoporosis is very relevant, as in all countries of the world life expectancy is increasing.

Some interesting numbers:

• in about 80% of women over the age of 50, signs of osteoporosis can be detected, in men the disease is less common;
• in hospitals in Europe, the number of patients with osteoporosis after 45 years always exceeds the number of patients with myocardial infarction, diabetes, breast cancer;
• the most common complication of osteoporosis is a hip fracture (detected annually in 250,000 US residents);
• almost every woman after 65 years of age “has on her account” at least one fracture, and most often it is associated with osteoporosis;
• According to experts, if the prevalence of osteoporosis continues to increase at the rate it is now, then by 2050 it will turn into a massive epidemic.

Osteoporosis was quite common even in ancient times, which is clearly evidenced by the paintings of the times of Antiquity - they often depict people with a violation of posture characteristic of the disease.

European doctors began to actively deal with the problem of osteoporosis only from 1824, when the researcher Cooper first stated that a fracture of the femoral neck in old age is associated with pathological changes in bone tissue.

Bone Anatomy Bone tissue is a type of connective tissue.

The structure of bone tissue:

• collagen fibers (a special type of protein) are the basis of bone tissue
• mineral compounds (mainly calcium phosphate) surround and strengthen the protein base, together they form concentric platelets;
• bone tissue cells are located between the plates;
• vessels and nerves in the thickness of the bone tissue pass through special channels.

The bone is arranged in such a way that maximum strength is ensured with the minimum expenditure of building material. For example, the femur of an adult is capable of withstanding loads of up to 4 tons.

Depending on the internal structure, the bone substance can be compact or spongy (there are many cavities inside, like in a sponge).

Types of bones, depending on the structure:

• Long tubular. The main part of the body of such a bone is a long tube, the walls of which are represented by a compact substance, and in the center there is a cavity containing yellow bone marrow (adipose tissue). The ends of the bone - the epiphyses - consist of a spongy substance. It contains red bone marrow, which is responsible for blood formation.
• Short and flat bones. They consist only of a spongy substance, covered from the outside with a thin layer of compact. They contain red bone marrow.
• Combined dice are made up of parts with different structures. For example, vertebrae, skull bones can be attributed to this group.

Outside, each bone is covered with periosteum - a thin film of connective tissue.

Functions of the periosteum:

• bone growth in thickness - it is in the periosteum that growth cells are located
• fusion of bones after fractures
• blood supply and innervation of the bone
• all tendons are attached not to the bone tissue itself, but to the periosteum covering it

Causes of osteoporosis How does bone mineralization occur?

Bone tissue is in constant dynamic equilibrium. It is constantly undergoing the processes of creation and destruction.

The basis for the deposition of mineral compounds are collagen protein molecules. On them, as on a framework, calcium phosphate crystals form and grow, which then turn into hydroxyapatites.

The function of bone tissue mineralization belongs to special cells - osteoblasts. They secrete phosphates, which then combine with calcium. Another type of cells - osteoclasts - are responsible for the destruction of bone tissue and the leaching of mineral compounds from it.

At the moment, the processes of bone mineralization are not fully understood.

Factors affecting bone mineralization (factors that increase the risk of osteoporosis)

• Hormonal. Some hormones activate osteoblasts and the synthesis of bone tissue, while others, on the contrary, contribute to its destruction and leaching of calcium and phosphorus into the blood. The risk of osteoporosis increases significantly with hormonal imbalance, pathology of the thyroid gland, adrenal glands, parathyroid glands. In women, the disease often develops after menopause (the content of the sex hormones estrogen, which protect bones from destruction, decreases in the body).
• Hereditary. It is known that osteoporosis is much more common in people of Caucasian and Mongoloid races. The risk increases when the disease is detected in relatives.
• Lifestyle. Smoking, drinking alcohol, unhealthy diet, overweight, sedentary lifestyle - all this greatly increases the likelihood of osteoporosis.
• Other diseases. Many diseases of the blood, kidneys, digestive system, heart and blood vessels, autoimmune pathologies can contribute to the development of osteoporosis.
• Medications. The ability to increase the risk of developing osteoporosis is listed among the side effects of a number of drugs.

Most often, it is not possible to name the only reason that led to the development of the disease. Osteoporosis is caused by a combination of causes. They accumulate over time, overlap each other, and at some point changes in bone tissue reach a critical level. diagnosed with osteoporosis.

Types of osteoporosis Osteoporosis is divided into two large groups: primary and secondary. Primary osteoporosis is a consequence of the natural aging of the body. Secondary osteoporosis is a symptom of other diseases.

Types of primary osteoporosis:

• postmenopausal- develops in postmenopausal women
• senile- is a symptom of natural aging of the body
• idiopathic- develops at any age, its causes have not yet been established

Types of secondary osteoporosis :

• caused by diseases of the endocrine system(endocrine glands): thyroid gland, adrenal glands, pancreas, reduced production of sex hormones;
• conditioned rheumatic diseases: ankylosing spondylitis, systemic lupus erythematosus, rheumatoid arthritis, osteoarthritis;
• caused by diseases of the digestive system: with gastroduodenitis and other pathologies, the absorption of calcium and phosphorus is impaired;
• due to blood disorders: leukemia, lymphoma, thalassemia, multiple myeloma;
• caused by other diseases: There are many pathologies that can lead to the destruction of bone tissue, while osteoporosis is most often considered as part of a disease.

Symptoms of osteoporosis

Osteoporosis is dangerous because at first it does not manifest itself in any way or is accompanied by minimal symptoms. Often the diagnosis can be established already with the development of complications - pathological bone fractures (see below).

Common symptoms that may be characteristic of the initial stages of osteoporosis

• bone pain especially when the weather changes
• increased general fatigue
• early gray hair
• plaque formation
• periodontal disease- a disease that affects the tissues that surround the root of the tooth
• cardiopalmus

Pathological fractures are the most common complication of osteoporosis. A pathological fracture is a fracture that occurs with minimal impact on the bone.

Influences that can lead to pathological fractures:

• awkward movements
• weak blow, whose strength is clearly not enough to break the bone of a healthy person
• the fall(not from above)
• coughing, sneezing
• normal loads e.g. on leg bones while walking

A pathological fracture occurs because the patient's bones become brittle. Often the fragments grow together very poorly. This is also due to osteoporosis: bone tissue regeneration is impaired. Between the fragments, a false joint is formed - pseudoarthrosis. In this case, the function of the affected limb deteriorates sharply.

Symptoms of osteoporosis of the hands and feet.

General symptoms that may be observed at the initial stage of osteochondrosis of the upper and lower extremities :

• Pain in the bones that increase during weather changes. They are usually not very strong, have a aching character. The patient may not attach importance to them for a long time, considering them a manifestation of fatigue.
• Cramps in the muscles of the limbs at night.
• Nail changes. They begin to delaminate, become more fragile.
• Deformities of the limbs (most often the legs). They are noted with a sufficiently long course of the disease.

But most often the diagnosis is established not on the basis of the listed symptoms, but after complications of osteoporosis arise - pathological bone fractures.

Pathological fracture of the femoral neck The femoral neck is the narrowest part of the bone, with the help of which its body is connected to the head. It is she who is most susceptible to fractures in osteoporosis. Most often occurs in women aged 65 - 85 years. It is one of the most common causes of disability in adults.

Symptoms of a pathological fracture of the femoral neck in osteoporosis:

• Prolonged severe pain in the groin. Virtually no patient associates this symptom with hip problems. People often continue to endure pain without consulting a doctor. The very moment of the break goes unnoticed. Often with osteoporosis, this happens right while driving.
• Shortening of the diseased leg compared to the healthy one. This symptom also often goes unnoticed, since the difference is usually small, within 4 cm.
• Turning the leg outward around the longitudinal axis. If the patient lies on his back, then it is noticeable that the foot on the side of the lesion is turned outward more than on the healthy one.

A pathological fracture of the femoral neck in osteoporosis is usually treated for a long time and with great difficulty. The neck and head of the femur have some features of the blood supply. If blood vessels are damaged during a fracture, aseptic necrosis of the femoral head will occur: it dies and begins to dissolve.

Fracture of the radius Osteoporosis of the bones of the upper extremities is often diagnosed after a complication in the form of a pathological fracture of the radius. It breaks, as a rule, near the hand, when the patient leans on the hand, or during a blow.

The second most common complication of osteoporosis of the bones of the hands is a fracture of the neck of the humerus.

Since pathological fractures of the bones of the hands occur easily due to increased bone fragility, they are not accompanied by the same pronounced symptoms as ordinary traumatic fractures.

Symptoms of osteoporosis of the spine:

• Back pain. Depending on the localization of the pathological process, the patient is concerned about pain in the lower back or between the shoulder blades. Most often, they occur against the background of prolonged work in a monotonous position.
• Posture disorder. Patients with osteoarthritis of the spine are characterized by a pronounced stoop.
• Height reduction. Due to a decrease in the height of the patient's spinal column.
• Violation of the mobility of the spinal column. Occurs due to pain and deformation of the vertebrae.

Vertebral compression fractures in osteoporosis

Compression Vertebral fractures are one of the most common complications of osteoporosis. It is diagnosed annually in 700,000 people worldwide.

With a compression fracture, the vertebra is flattened, as if it is pressed into itself, as a result of which its height decreases. Most often, the anterior edge of the vertebral body is deformed, as a result of which it takes the form of a wedge.

A compression fracture of a vertebra is characterized by severe pain in the spine. Because of them, the patient is often unable to sit and stand for a long time.

In general, osteoporosis of the spinal column manifests itself in the form of symptoms that strongly resemble osteochondrosis. It is often difficult to distinguish one disease from another.

Symptoms of osteoporosis of the joints

Osteoporosis of the joints is a lesion of the heads of the bones that take part in the formation of the joint. This "neighborhood" always affects the general condition and mobility in the joint.

In its symptoms, osteoporosis of the joints strongly resembles arthrosis.

The main symptoms of osteoporosis of the joints:

• joint pain
• swelling of tissues in the joint area
• deformations
• crunchy sensation during movement
• mobility impairment

The most common localizations of osteoporosis of the joints :

• osteoporosis of the hip joint: its complications include the fracture of the femoral neck mentioned above
• osteoporosis of the knee
• osteoporosis of the wrist
• osteoporosis of the shoulder
• osteoporosis of small joints of the wrist, metacarpus, hand, metatarsus, tarsus, fingers and toes
• osteoporosis of the intervertebral joints

Diagnosis of osteoporosis The initial stage of diagnosis of osteoporosis: identification of risk factors

Before using laboratory and instrumental studies to diagnose osteoporosis, the doctor must identify the risk factors that contribute to the development of the disease. This happens during a personal examination and questioning.

Risk factors, the presence of which the doctor specifies in a patient with osteoporosis:

• food quality, the presence in the diet of a sufficient amount of products that are sources of calcium and phosphorus;
• detection of hypovitaminosis D;
• diseases of the digestive system: many of them are the cause of difficult absorption and absorption of calcium and phosphorus;
• hypodynamia- long periods when the patient was forced to be immobilized on the bed (for example, the treatment of injuries, other serious illnesses);
• menopause, in older women: how early did menopause occur?
• medicines, has the patient recently taken medications of hormones of the adrenal cortex, parathyroid gland?
• chronic diseases, the patient has chronic and severe diseases: liver, kidneys, adrenal glands;
• underweight: when the patient's body weight does not meet the standards for his height, when it is much lower, this indicates malnutrition, insufficient absorption of nutrients and creates an additional risk of developing osteoporosis;
• bad habits(smoking and drinking): Does the patient smoke? how often? Does the patient drink alcohol? how often? From what age? for how long? in what quantity?
• clarifies the nature of the patient's work, its connection with mental or physical activity, sports, gymnastics: reduced physical activity is one of the factors in the development of osteoporosis.

Instrumental diagnostic methods for osteoporosis

Laboratory diagnostic methods for osteoporosis

Normally, the rate of formation of new bone tissue and the rate of its destruction are approximately equal. Osteoporosis develops when destruction prevails over education. Substances that can be detected in a patient's blood can be divided into three groups:

• indicators that help assess the formation of new bone tissue
• indicators to assess the intensity of bone tissue decay
• indicators that allow in general to assess the state of metabolism in bone tissue

Indicators that help evaluate the formation of new bone tissue

*All figures are for informational purposes only. Only a specialist doctor can adequately interpret the results of laboratory tests.
Indicators to assess the exchange of calcium and phosphorus

Normally, calcium is present in the blood in an amount of 2.2-2.75 mmol / l.

Normal phosphorus content:

Indicators characterizing the processes of destruction of bone tissue

These indicators are studied mainly in order to evaluate the effectiveness of treatment in osteoporosis. With properly prescribed therapy, the content of these substances in the blood should decrease.
Treatment of osteoporosis Medical treatment of osteoporosis

To gently reduce the symptoms of menopause, non-hormonal herbal remedies are used, for example, the biologically active food supplement ESTROVEL® capsules - a complex of phytoestrogens, vitamins and microelements, the components of which act on the main manifestations of menopause. ESTROVEL® contains vitamin K1 and boron, which help reduce the risk of osteoporosis.

*** Treatment of osteoporosis should be carried out only on prescription and under the supervision of a physician.***** IU - International Units. A specific unit of measurement for medicinal substances.****** UNITS - Action Units, a specific measure of the activity of medicinal substances.

Which doctor treats osteoporosis? The causes of osteoporosis are manifold. Therefore, different specialists can deal with the treatment of the disease.

Physicians involved in the diagnosis and treatment of osteoporosis:

• traumatologist-orthopedist– specializes in injuries (in this case, pathological fractures) and various disorders of the skeletal system
• endocrinologist- a doctor dealing with diseases of the endocrine system (thyroid and parathyroid glands, adrenal glands, pancreas, etc.)
• rheumatologist– specialist in diseases of the joints and connective tissue

What diet to follow with osteoporosis?

The main tasks of therapeutic nutrition in osteoporosis :

• Enrich your diet with foods high in calcium
• enrich the diet with foods containing a large number of substances that contribute to improved absorption and assimilation of calcium by the body
• exclude foods that slow down and impair the absorption of calcium

For normal absorption of calcium and phosphates by bone tissue, the body must receive such useful substances as: magnesium, copper, vitamins K, B6, D, A. Osteoporosis requires a complete protein diet.

Foods rich in calcium and indicated for osteoporosis:

• milk and dairy products: cottage cheese, yoghurts, cheeses
• cereals, cereals
• dark green vegetables
• dried apricots and other dried fruits
• nuts
• wholemeal bread
• oily fish

If with the help of nutrition it is not possible to cover the body's need for calcium, then it is used as part of vitamins, various dietary supplements, in the form of medications (calcium chloride, calcium gluconate - see above).

Products that impair calcium absorption and are not recommended for patients with osteoporosis:

• strong tea
• chocolate
• alcohol
• pork, beef, liver - foods that contain a large amount of iron, which impairs calcium absorption

What calcium preparations are effective in the treatment of osteoporosis?

Three calcium preparations are used for osteoporosis: calcium chloride, calcium gluconate and calcium lactate (see table above).

What exercises should be done for osteoporosis?

A set of exercises for osteoporosis should be carried out as directed and under the supervision of a physician. The specialist will take into account the stage of the course of the disease and the severity of pathological changes in the bones, the age and physical capabilities of the patient, concomitant diseases.

If you still decide to do gymnastics on your own, at home, then first consult with your doctor.

An approximate set of exercises for osteoporosis (start with 4 - 5 repetitions of each exercise, then you can increase):

In the starting position, lying on the floor on your back:

• flexion and extension of the feet
• feet turning out and in
• flexion and extension of the arms (hands to the shoulders)
• raising straight arms up
• put a roller under your feet so that your knees are in a half-bent state, alternately extend your knees
• bend your knees and pull them to your chest, stay in this position for 5 seconds

In the starting position, lying on the floor on the stomach :

• raise your shoulders above the floor surface, stay in this position for 5 seconds;
• scissors exercise: crossing the legs in such a way that the right and left legs alternately on top
• raise the leg above the floor as far as you can, but so that there is no pain (ideally - by 90⁰), while the other leg and hands should be pressed to the floor; then change legs

What folk methods of treatment of osteoporosis exist?

In folk medicine, there is a fairly large arsenal of methods for the treatment of osteoporosis. But before using any of them, be sure to consult a doctor.

Treatment of osteoporosis with comfrey compresses: Take a small amount of dry comfrey leaves and insist for some time in a dimexide solution. Apply compresses to all places where pain is disturbing, 1-2 times a day.

Treatment of osteoporosis with mummy Take a small amount of mummy, about the size of a match head. Dissolve in a glass of water. Take three times a day, 20 minutes before meals. The course of treatment is 20 days, then you need to take a break.

Treating Osteoporosis with Eggshell and Lemon Juice Finely crush the eggshell. Mix with lemon juice. Take 1 tablespoon 1 time per day.

Treatment of osteoporosis with geranium compresses Take 1 tablespoon of the dried herb. Brew in a glass of boiling water, insist for an hour. Apply for compresses on the affected areas.

Prognosis: what to expect from osteoporosis treatment?

With the right treatment, you can significantly slow down or completely slow down the development of osteoporosis. However, the working capacity of many patients is reduced, they are advised to change jobs to simpler ones or to completely abandon physical labor.

If complications of the disease occur, the prognosis worsens. For example, a pathological fracture of the femoral neck often leads to the death of patients, usually within the first year.

For high-quality treatment of osteoporosis, it is important not only to take medications, but also to follow the doctor's recommendations regarding the correct lifestyle and nutrition.

Prevention of osteoporosis:

• proper nutrition
• sufficient physical activity
• taking multivitamin complexes, biologically active food supplements containing calcium
• timely treatment of all diseases that can cause osteoporosis
• giving up bad habits: smoking, alcohol abuse
• rational mode of work and rest
• fight against underweight
• adequate sun exposure (sun exposure produces vitamin D in the skin, which promotes the absorption of calcium by the bones)

Specialty: Pediatrician, pediatric surgeon

Updated: 26.5.2017

The disease occurs due to a decrease in the amount of calcium in the bones, as a result of which the bones become brittle. Causes of osteoporosis of the bones:

• hereditary factor;
• insufficient intake of calcium, vitamin D;
• excessive physical activity;
• consequences of an organ transplant operation;
• age-related changes;
• the use of corticosteroids, anticonvulsants;
• hormonal changes.

Symptoms

Typical symptoms of osteoporosis are:

• aching pain in the spine;
• slouch;
• gradual decline in growth;
• leg cramps at night;
• chest deformity;
• periodontal disease;
• fragility of nails;
• increased fatigue.

Diagnostics

To determine how to treat osteoporosis, an endocrinologist prescribes a number of studies:

• general, biochemical blood test
• spinal x-ray
• densitometry
• quantitative computed tomography of the femoral neck, spine

For the treatment of osteoporosis are prescribed:

• special diet;
• preparations containing calcium and vitamin D;
• hormone replacement therapy in menopausal women (bisphosphonates, estrogens).

During the period of treatment, patients must follow a diet, including in the diet:

• milk, dairy products;
• parsley, onion, lettuce;
• fish;
• nuts;
• citrus;
• broccoli, cauliflower;
• legumes.

It is necessary to limit foods containing phosphorus (red meat, carbonated drinks), which prevent the absorption of calcium. Complications

What happens if osteoporosis is not treated on time? Osteoporosis of the bones and spine can lead to the following complications:

• frequent poorly healing fractures
• kyphosis (curvature of the upper spine)
• external physical defects (posture disorders)
• obstruction of movement

At-risk groups

Osteoporosis - who is more at risk of getting sick:

• the elderly (especially women);
• people with low levels of sex hormones;
• people with a hereditary predisposition;
• people leading a sedentary lifestyle;
• underweight people;
• people with excessive sweating.

• do physical exercises regularly;
• Get enough calcium and vitamin D.

This article was compiled using reference medical publications and materials from open sources on the Internet. It is published for educational purposes only and is not scientific material or professional medical advice. Literature: Wikipedia: Search for the term “osteoporosis” in dictionaries and encyclopedias Do not self-medicate, the diagnosis and treatment of diseases should be performed by an experienced professional doctor!

Osteoporosis is a disease of bone tissue, increased fragility of bones due to a lack of calcium. For a patient with osteoporosis, even minor injuries can result in a fracture. The occurrence of osteoporosis, as a rule, occurs due to metabolic disorders. Suppose a person stumbled, unsuccessfully opened a heavy door, or dropped a heavy book on the floor. For a patient with osteoporosis, any situation that seems simple can end very badly - a fracture. Women are more susceptible to this disease, especially during the period of hormonal failure, with menopause, men suffer from this disease much less frequently. Most often it occurs in women who have experienced the onset of menopause and are in the menopause period. It is they who are in the “risk group” who should be especially attentive to their health and take into account all manifestations of the disease.

• Symptoms of osteoporosis
• Causes of osteoporosis
• Degrees of osteoporosis
• Osteoporosis of the hip joint
• Diagnosis of osteoporosis
• How to treat osteoporosis?
• Which doctor should I contact?

Symptoms of osteoporosis

Symptoms of osteoporosis most often do not appear, people can live for many years, not suspecting that such processes are taking place in their body. But still, as the main symptoms of osteoporosis, scientists note a decrease in bone tissue, aching pain in the lower back, and frequent fractures can sometimes disturb. Ordinary doctors most often cannot determine the cause of frequent fractures, only such narrow specialists as orthopedists or surgeons can suspect this disease, after which they are sent for bone x-rays, etc., women are sent to a gynecologist. With osteoporosis, the patient may decrease in size due to a decrease in bone tissue, even become 10–15 cm shorter in height. Symptoms of osteoporosis include:

significant fatigue (indicates a general weakening of the body, deterioration of metabolism and slower compensation of all functions);

cramps in the lower extremities, which appear mainly at night;

excess plaque on tooth enamel;

periodontitis;

pain in the bones or lower back;

obvious fragility and predisposition of nails to delamination;

premature graying (occurs quite rarely);

hernia of the intervertebral department;

problems associated with the functioning of the gastrointestinal tract (provoked by serious deformities of the spine, which literally presses on the internal organs of a woman, including the stomach);

the onset of diabetes mellitus (osteoporosis is also an endocrine disorder, so consultation of this specialist is necessary);

allergy;

other ailments that are associated with dysfunction of metabolism and salt metabolism.

excessive heartbeat.

It is impossible not to pay attention to such serious symptoms as:

bone fractures;

feeling of heaviness in the area between the shoulder blades;

general weakness in the muscles;

change in growth to a smaller side;

rachiocampsis.

They, in turn, are evidence that the disease is at a later stage. Often osteoporosis at this stage is already irreversible, it is only possible to stop its progression or slow down all its effects on the body.

Causes of osteoporosis

The cause of osteoporosis can be a long history of smoking, alcohol abuse, digestive problems, malfunctioning metabolism or the disease is inherited. In old age, osteoporosis often occurs due to poor absorption of calcium, as well as nutrients in the intestines. But the most common cause of osteoporosis is, as a rule, hormonal imbalance. Mostly osteoporosis occurs in women and is associated with menopause. The point is not at all a lack of calcium in the body, but a violation of the building cells of bone tissues. There are two types of cells in our body: building and destroying. During menopause, the work of building cells is disrupted. You need to go to a gynecologist or look for remedies that will restore the body during menopause. If you take drugs like synthetic corticosteroids for a very long time, then your body begins to suffer. The lack of hormones due to drugs can lead to a disease such as osteoporosis. With age, all people experience a decrease in the degree of bone density, their strength and tone are significantly reduced. These are quite understandable changes that occur in the body as a result of aging. But in certain categories of people, such changes are formed much earlier in time and proceed more intensively. A significant number of causes of this disease have been identified. There are also reasons that cannot be changed:

belonging to the female sex;

caucasoid or mongoloid race (it has been proven that African Americans have a virtually zero risk of osteoporosis. This is possible due to the fact that they are often and for a long time in the sun, which strengthens the bone structure);

weakened or thinned skeletal tissues;

genetic factor (in this case, the degree of closeness of kinship is not of particular importance).

There are also risk factors that can be influenced:

food unsaturated with calcium and vitamin D (you should consume as much calcium and a vitamin belonging to this group as possible);

the use of certain drugs, for example, corticosteroids and anticonvulsants (they should be minimized if possible. If this is not possible, then immediately after the end of their intake, it is recommended to contact a chiropractor and be aware of the risk of developing an ailment in the future);

frequent use of hormonal drugs;

hypodynamic lifestyle (it has been proven that the more active a woman leads, the less she is at risk of developing osteoporosis);

any form of smoking;

excessive consumption of alcoholic beverages (more than three groups per day with varying degrees of strength);

dysfunction of the digestive system, the work of the endocrine, as well as the pancreas;

hormonal changes that occur throughout menopause;

violation of the functioning of the ovaries or their removal (leads to hormonal imbalance or early onset of menopause. This, in turn, can become a catalyst for the development of osteoporosis);

problems in the work of the adrenal glands (in itself is not the cause of the formation of the disease, but taking medications may well provoke it);

all other diseases of the endocrine glands (they are most often directly related to hormonal imbalance).

Thus, the appearance of osteoporosis will be quite expected if you know all the reasons that will affect the formation of the presented disease. Osteoporosis of the senile type occurs due to calcium deficiency associated with age and the loss of balance between the rate of destruction of bone tissue, as well as the rate of formation of new bone-type tissue. "Senile" implies that the condition presented is formed at an older age, most often in people from 70 years of age or more. This disease is twice as common in women than in men. In women, it is almost always combined with the postmenopausal stage. It should be especially noted that in less than 5% of cases, the disease is due to some other ailment or the intake of certain medications. This is a form of osteoporosis known as secondary. It can be formed under the conditions that were indicated above. For example, problems with the kidneys or the endocrine gland. Excessive alcohol consumption and addiction to smoking only exacerbate the presented disease. There is also idiopathic "juvenile" osteoporosis. This is the rarest type of osteoporosis, the cause of which is currently unknown. It is formed in infants, children and young people who have quite normal levels of hormones and vitamins in the blood. In addition, they do not have any clear reason for the decrease in the degree of bone density.

Degrees of osteoporosis

Determine the severity of osteoporosis, such as:

the primary degree, which is revealed in a decrease in bone density. X-ray diagnostics reveals significant transparency of the X-ray shadow and striated silhouettes of the vertebrae. This degree of illness is determined exclusively during medical research;

osteoporosis of the secondary degree, or moderate - an obvious decrease in bone density. In this case, the vertebral bodies acquire a specific biconcave shape, a wedge-shaped deformation of one of the vertebrae is formed. This degree of illness is manifested in the strongest painful sensations;

pronounced osteoporosis, or tertiary degree - a sharp transparency of the vertebrae is detected during an x-ray examination. Otherwise, it is called glazing and the presence of a wedge-shaped deformity at the same time in several vertebrae. At this stage, osteoporosis is already evident.

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Osteoporosis of the hip joint

This form of this disease is known as osteoporosis of the hip joint. According to its genesis, it is no different from osteoporosis of other bones, except for localization in the area of ​​the same name. The most vulnerable place in this manifestation of the disease is the neck of the femur. A fracture of the presented area in older people quite often ends in death or the inability to move in the usual normal mode. In the vast majority, only endoprosthetics makes it possible to fully restore the functioning of the hip joint. Osteoporosis of the presented type can have the following three types of localization:

local - at the same time, there is a decrease in the degree of bone density and the tip of the femur at the initial stage of such ailments as specific necrosis of the tip of the femur and Perthes' disease;

regional - it is formed exclusively with arthrosis of the hip joint;

common - gets its development in connection with circulatory dysfunction in the lower extremities.

Osteoporosis of the hip joint can be formed as a result of systemic osteoporosis, which is much more typical for this disease. With the presented form of the disease, bone tissues lose the ability to maintain optimal physiological loads. The total defeat of the hip and knee joints in this case is provoked by the fact that it is mainly on them that the most significant load “falls” in the process of movement. Osteoporosis of the hip joint begins to develop for a whole list of reasons:

prolonged loss of motor functions of the lower extremities during the long-term treatment of fractures, dislocations and other injuries. This causes atrophy of motor functions, which is almost impossible to bring to a normal state;

a significant load on one limb in the event that the work of the second was removed or disrupted. This option also negatively affects the functioning of a particular limb, as a result of which it loses muscle memory;

complication of blood circulation in some specific conditions. We are talking about burns, frostbite, phlegmon (inflammatory or purulent decomposition of tissues) and others, which also become catalysts for muscle and tissue atrophy;

transient osteoporosis should be considered a special form of osteoporosis of the hip joints in women. It is formed in females in the later stages of pregnancy and in men aged 30 to 40 years.

It is possible to detect this form of the disease on an x-ray or on palpation (in some cases). Timely detection is very important, because this will make it possible to start adequate treatment as early as possible. Regardless of the causes of the manifestation of the presented disease, the mandatory components of the treatment process should be considered, first of all, physiotherapy exercises. It is it that makes it possible to bring metabolic processes in bone tissues “in shape”, to regulate the degree of joint mobility and muscle activity. Such recovery takes a very long time, and the older the person, the more complications it passes. A strict, well-balanced nutrition schedule and frequent exposure to passive and active sun are very important. The second makes it possible to make the production of vitamin D faster, and, accordingly, strengthen bone tissue. It is also allowed to take medications, but only as prescribed by a specialist. These can be both drugs containing calcium and vitamin D3 (or its other metabolites), and bisphosphonates. It is undesirable to take any hormonal preparations for those women who have reached the age of over 70 years. However, sometimes this is the only way to bring the structure of bone tissue back to normal.

Diagnosis of osteoporosis

A sufficient number of methods have been developed by which the diagnosis of osteoporosis is carried out. Radiography makes it possible to detect depletion of bone tissue only when their loss has reached more than 30%. Therefore, it makes sense to resort to this method only in the secondary degree of the disease. A more modern method, which is almost always carried out in osteoporosis, is the analysis of the height of the spine and the calculation of their relationship. Densitometry should be considered the optimal method. This is what makes it possible to accurately indicate the degree of bone density, the ratio of calcium in the human body, as well as the number of muscle and fat deposits. This method should be considered the safest, because only it does not use the so-called isotope methods of irradiation, which are clearly harmful to humans. It is based on the determination of skeletal density and reveals the mineral and other active components of bone tissue. Its advantage is the speed of obtaining results and perfect painlessness. Also, one should not underestimate the standard blood and urine tests, which make it possible to realistically assess the state of the phosphorus-calcium metabolism. This helps with information such as:

General analysis of calcium is one of the fundamental specific components of bone tissue, the most important trace element that takes part in the creation of the skeleton, the functioning of the heart muscle, nervous and muscular activity, as well as blood coagulation and all other processes. Variations in the form and stage of osteoporosis are manifested in various shifts in the degree of calcium concentration. The optimal indicators of calcium: are as follows: from 2.2 to 2.65 mmol per liter.

Inorganic phosphorus is a component of the mineral substance of bone tissue, which is present in the human body as salts (calcium and magnesium phosphates) and takes part in the process of bone tissue formation and cell-type energy metabolism. 85% of all phosphorus is located in the bones. Modifications in terms of the ratio of phosphorus in the blood can be noted in all kinds of changes in bone tissue, it is not only about osteoporosis. The optimal indicators of phosphorus should be considered from 0.85 to 1.45 micromoles per liter.

The substance parathyroid hormone, which is produced by the parathyroid glands and is responsible for the exchange of calcium and phosphorus type in the body. Identification of the concentration of parathyroid hormone can provide the most important information base for identifying various forms of osteoporosis. The optimal parameters of parathyroid hormone are from 9.5 to 75.0 pg per ml. This is between 0.7 and 5.6 pmol per litre.

Deoxypyridonolin, which is referred to as DPID, is a designation for the degree of destruction of bone tissue. It can be found in urine. Urinary expression increases with postmenopausal osteoporosis, osteomalacia, thyrotoxicosis, initial hyperparathyroidism. Optimal PIID values ​​vary by gender:

• for males, this is from 2.3 to 5.4 nmol;

  for a woman, from 3.0 to 7.4 nmol.

Osteocalcin is the main specific protein of bone tissue, which is actively involved in the process of bone repair and the development of a new tissue of this type. Excessively high levels of osteocalcin are present at the initial stage of hyperparathyroidism, in those who are sick with hyperthyroidism and acromegaly. With osteoporosis of the postmenopausal type, it is within the optimal range or increased. In osteomyelia and renal osteodystrophy, the ratio of osteocalcin decreases. The presented examination is necessary to detect osteoporosis and control treatment, with an increase in the ratio of calcium in human blood. The optimal indicators of osteocalcin are as follows:

• men - from 12.0 to 52.1 ng per ml;

  women in the premenopausal period - from 6.5 to 42.3 ng per ml;

  women in the postmenopausal period - from 5.4 to 59.1 ng per ml.

Thus, in the process of diagnosing osteoporosis in women, it is important to pay attention to any fluctuations in the data and to carry out all available studies. This will make it possible to make an accurate, timely diagnosis and, as a result, receive optimal treatment that will help in the shortest possible time.

How to treat osteoporosis?

Osteoporosis is treated with medication, people with endocrine disorders are prescribed drugs that will help restore hormonal levels. Elderly people are prescribed nutritional supplements rich in calcium and vitamin D. Women during menopause are prescribed hormone replacement therapy, as well as bisphosphonates. Also, patients can sometimes be prescribed physiotherapy exercises, massage, all this in small dosages - due to the fragility of the bones. They can, if necessary, write out the wearing of special supporting corsets. It is not possible to fully treat osteoporosis, but it is possible to learn to live with it and stop the further development of the disease. To do this, there is a need for walking, jogging, dancing. All this can provide the bones with the healthy “stress” they need and make them stronger. Such exercises will give you the opportunity to strengthen muscles and modify coordination and balance. Another ideal way to treat osteoporosis, which is recommended for all women, should be considered a "healthy" diet with an individually adjusted ratio of calcium and vitamin D. It is best to refer to a balanced diet, which is based on the postulates of the food pyramid. It is especially necessary in this case to make sure that the patient receives the amount he needs not only of calcium, but also of vitamin D. This can occur both in the process of eating food and when using nutritional supplements.

Treatment with bisphosphonates

One of the most modern methods of treating the presented disease in women are bisphosphonates. They are the most stable analogues of pyrophosphates, which are formed naturally. They function on the female body in this way: they are embedded in the structure of the bone tissue, remain in it for a long period of time and slow down the bone reservation by reducing the activity of osteoclasts. At the moment, bisphosphonates should be considered a recognized way to prevent and treat osteoporosis, not only in women, but also in men. Studies that have been successfully conducted on many thousands of patients have demonstrated that bisphosphonates:

absolutely not dangerous;

well tolerated by the human body;

have few side effects;

inhibit bone reservation;

positively affect the increase in bone mineral density (BMD);

reduce the likelihood of fractures.

To date, only a certain number of bisphosphonates are used in active practice, namely alendronate, risedronate, ibondronate, zoledronic acid. They are characterized by a variety of ways and methods of introduction into the body. The most famous and well-studied bisphosphonate is alindronate. Its degree of effectiveness has been proven in numerous surveys in those with osteoporosis. Studies were also carried out in the presence of fractures in the vertebral region. Also, this drug is effective in the process of preventing osteoporosis in postmenopausal women with osteopenia. On average, alindronate reduces the likelihood of fractures of various localizations by 50%, and the likelihood of more specific fractures in the vertebral region by 90%. This drug is prescribed in a dosage of 70 mg, that is, one tablet, once a week. In postmenopausal osteoporosis, risedronate is also used at a dosage of 30 mg per week.

The drug "Miacalcic"

In addition to the previously presented primary line methods, salmon calcitonins can be used in the treatment of osteoporosis in some cases. This remedy is a specific analogue of the hormone of the endocrine gland calcitonin, which takes an active part in the restoration of calcium homeostasis. A feature of the drug "Miacalcic", which contains salmon calcitonin, should be considered that it significantly reduces the risk of fractures while excluding the obvious dynamics of the disease. This became possible due to its positive impact on the quality of bone tissue (their micro and macroarchitectonics). The probability of formation of new fractures in the spine during the treatment with "Miacalcic" is reduced by 36%. At the same time, the drug is characterized by another parameter that is actively used in active medical practice: "Miacalcic" produces an obvious analgesic effect for those sensations that are provoked by fractures.

Hormone Replacement Therapy

Hormone replacement therapy (HRT) should also be noted. It is she who boasts a high degree of effectiveness in female representatives in the postmenopausal period. There is a serious side effect of the presented therapy, which is venous thrombosis. In this connection, in the process of prescribing this treatment, a woman must be informed about the possible complications without fail. But, despite this, it is HRT that remains the preventive measure of the fundamental series in female representatives with menopause up to 45 years old. In addition, this is such a remedy that really effectively removes all the vegetative symptoms of the clinical type that are characteristic of menopause. In each individual case, the problem of prescribing HRT to a woman needs a thorough gynecological and mammological examination and monitoring. With constant pain in the lumbar region, certain exercises that strengthen the back muscles can be quite effective. Lifting weights and falling can only make symptoms worse. Therefore, a constant physical load is recommended.

Prevention of osteoporosis

It is many times easier to prevent osteoporosis than to cure it. Preventive measures are to maintain or increase the degree of bone density through the application of the required ratio of calcium. There is also a need to exercise physical loads with weights and, for certain categories, to take active drugs. Special exercises with pressure on the bones, for example, walking and running up flights of stairs, also have a positive effect on increasing the degree of bone density. The same exercises that are not associated with such a load - swimming, do not have any effect on the degree of bone density. Therefore, it is very important to consult a specialist and in no case engage in self-treatment. This can be fraught with even greater complications in osteoporosis in women.

Which doctor should I contact for osteoporosis?

In order to examine for the presence of osteoporosis, it is advisable to contact such specialists as an endocrinologist, rheumatologist, gynecologist and orthopedic traumatologist. Such an impressive number of doctors is necessary because the female body is a single entity and osteoporosis can be caused by a variety of malfunctions in the body. This means that it will be necessary to treat not only the ailment presented, but also what provoked it. To detect deeper problems, it is necessary to be examined by a significant number of specialists. It is necessary to be examined by each of the presented doctors after the age of 40 at least once a year. This approach will make it possible to prevent the onset of the disease and help mitigate its manifestations, in particular, to prevent fractures. First of all, it is necessary to undergo examinations by an endocrinologist and a gynecologist, which will indicate the need for testing for groups of hormones and, if necessary, they will be sent to a rheumatologist or orthopedist. It is these specialists who determine the adequate treatment, and will help solve all the health problems that have arisen. Author of the article: Zubolenko Valentina Ivanovna, endocrinologist

Systemic osteoporosis is a pathological process of reduced bone mineralization, in which the strength and density of bone tissue decreases.

Systemic osteoporosis is also called diffuse osteoporosis because the process simultaneously affects all the bones of the skeleton.

There are several reasons for the development of the disease:

1. Decreased motor activity, lack of proteins and calcium, vitamin C, impaired absorption of calcium in the intestine.
2. Long-term use of glucocorticoids,
3. Osteoporosis due to pathology of endocrine proteins. This also includes hypogonadism. Due to thyrotoxicosis, an excessive increase in thyroid function, systemic osteoporosis can also appear. Diabetes and hyperparathyroidism (hyperactivity of the parathyroid glands), hypothyroidism, hypercortisolism (excessive secretion of hormones by the adrenal cortex) are recognized as factors influencing the onset of the disease.
4. Gastrointestinal disorders, such as ulcers, surgery to remove any part of the stomach, cirrhosis of the liver, impaired enzyme activity, alcohol abuse.

Separately, it is worth mentioning the consequences of drug treatment - long-term use of heparin or anticonvulsants can lead to the development of the disease.

In addition, the influence is exerted by:

• genetic defects,
• Adolescence or juvenile factor associated with rapid growth,
• Senile or senile osteoporosis (develops in people older than 70 years). It is characterized by a decrease in motor capabilities, insufficient intake of proteins and calcium, deterioration of calcium absorption in the gastrointestinal tract,
• Bone marrow disorders such as myeloma, lymphoma, or leukemia

A prolonged decrease in the load on the skeleton also leads to the development of the disease.

This can be when being in conditions of weightlessness or with paralysis, which are characterized by the inability to move the limbs or one of them.

Idiopathic osteoporosis. Such a diagnosis is made when the cause remains unclear.

Depending on the causes that caused osteoporosis, the symptoms may be different. This is due to the fact that complaints from other diseases that are not related to osteoporosis may come to the fore.

In most cases, you first have to eliminate the cause that has become the provocateur of osteoporosis, and only then make up for the deficiency of minerals in the bone tissue. Periarticular osteoporosis affects large joints, such as the shoulder, knee, or elbow. The disease affects the cartilage near the bone, reducing its elasticity.

It should be especially noted that bone osteoporosis is not a mandatory component of aging. Normally, bone density decreases, but the mechanical strength is sufficient to withstand physical stress.

Many clinical studies indicate that long-term use of calcium supplements, as well as active vitamin D metabolites (more than a year), leads to:

• slowing down the process of calcium leaching from the bone,
• stabilization of the x-ray picture,
• elimination of pain in the bones, which is caused by microfractures.

Thus, calcium and vitamin D3 preparations must be prescribed for the prophylactic purposes of osteoporosis or in the early stages of its development.

Bisphosphonates are increasingly used in osteoporosis. These are special synthetic substitutes for inorganic pyrophosphate, which is involved in the regulation of cellular calcium metabolism.

Long-term use of bisphosphonates in the development of osteoporosis, in most cases, increases bone density and thickness, causing a significant increase in cancellous bone.

Bisphosphonates are prescribed along with calcium and vitamin D3 supplements. The dosage of bisphosphonates and the duration of such treatment is selected on a strictly individual basis.

Systemic osteoporosis is a pathology associated with a violation of the structure of bone tissue.

Due to defects in mineral metabolism in the body, the absorption of calcium is disrupted, which leads to a change in tissue density - a smooth and homogeneous bone becomes loose and porous. Weakened and brittle bones are prone to injury, which means that a person with systemic osteoporosis is at a very high risk of a sudden fracture. Moreover, for this it is not necessary to fall or hit hard - a fracture can be caused by actions familiar to a healthy person, for example, lifting a heavy bag or sliding on ice.

According to the type of structure, the human bone is spongy and compact.

Compact view of bone tissue has a solid dense structure due to the small plates located in it. All external parts of the tubular bones in the human body (tibia, ulna, and shoulder joints) have a dense and solid structure.

Spongy bone tissue equipped with plates, which are located at an angle to each other, forming cells. Due to this structure, the bone has a porous structure.

If the bone tissue is healthy, then the angle between the plates is small, respectively, the pores between them are not large. In systemic osteoporosis, the spongy layer of bone tissue decreases, the plates gradually begin to thin (and some of them disappear completely over time), which leads to an increase in the size of the pores, and, consequently, the fragility and fragility of the bones.

Systemic osteoporosis is a violation of the structure of bone tissue, which gradually leads to its complete destruction. After bone density decreases, a person begins to show the first symptoms of a serious illness.

Clinical picture

The patient cannot independently determine the first signs of systemic osteoporosis. Since the disease does not have an inflammatory component, the patient is not bothered by pain, physical weakness and other general signs. Systemic osteoporosis is suspected when a person is diagnosed with a fracture due to injury or a fall.

• discomfort in the place of localization of the pathology;
• feeling of muscle weakness;
• pain syndrome of a different nature;
• a change in posture (a person begins to “lean” forward, stoop is observed);
• a tendency to frequent fractures of a non-traumatic nature (fractures of the elbow or shoulder are most often observed, but not due to a fall or bruise);
• decrease in growth (the reason is the destruction of the spinal column, as well as compression fractures);
• weight loss of the patient.

With systemic osteoporosis in the late stage, the patient has constant, but not intense pain, which is most often localized in the spine or neck.

Discomfort in the patient occurs after active movements, long walking (pain is localized in the area of ​​the hip joint, in the area of ​​the knee joint, and also in the foot). Against the background of systemic osteoporosis, telangiectasias, the so-called spider veins on the skin, can develop.

Expert opinion

Pain and crunching in the back and joints over time can lead to terrible consequences - local or complete restriction of movement in the joint and spine, up to disability. People, taught by bitter experience, use a natural remedy recommended by orthopedist Bubnovsky to cure joints ... Read more»

Causes

With osteoporosis, bone density decreases. The meaning of "systemic" is characterized by a process in which pathology does not affect a specific bone, but the entire skeleton.

Types of systemic osteoporosis

1. Primary - more common in older people. Women are characterized by postmenopausal osteoporosis, which develops as a result of hormonal disorders. The main reasons for the development of primary systemic osteoporosis are heredity, a sedentary lifestyle, poor and poor-quality nutrition, and unfavorable ecology.
2. Secondary osteoporosis. It develops against the background of the underlying disease. Most often, provoking factors for the development of pathology are disruption of the thyroid gland, the consequences of injuries, scleroderma, diabetes mellitus, as well as long-term use of highly effective drugs.

Forms of the disease

Diagnostics

An important role in the diagnosis is the collection of anamnesis. X-ray, biochemical blood test, computed tomography, densitometry are used to confirm the diagnosis.

Interestingly, densitometry is the most informative method for diagnosing osteoporosis. Does not require special training.

A little about secrets

Have you ever experienced constant back and joint pain? Judging by the fact that you are reading this article, you are already personally familiar with osteochondrosis, arthrosis and arthritis. Surely you have tried a bunch of medicines, creams, ointments, injections, doctors, and, apparently, none of the above has helped you ... And there is an explanation for this: it is simply not profitable for pharmacists to sell a working remedy, as they will lose customers! Nevertheless, Chinese medicine has known the recipe for getting rid of these diseases for thousands of years, and it is simple and understandable. Read more»

According to the international classification of diseases (ICB 10), systemic osteoporosis is designated by the code M 81.

Treatment

The process cannot be prevented, so the treatment of systemic osteoporosis is aimed at eliminating the main symptoms.

• anabolic steroid;
• non-steroidal anti-inflammatory drugs;
• hormonal agents (for postmenopausal osteoporosis);
• calcium preparations;
• vitamin D3.

Measures that contribute to the suspension of the pathological process are - proper nutrition, physiotherapy exercises.

About nutrition

It is a mistake to think that an increased intake of foods with calcium will quickly improve health. With impaired mineral metabolism, calcium cannot be absorbed without appropriate treatment. Also in the diet there are foods that destroy calcium.

For example, strong tea, coffee and others. Therefore, a balanced, calcium-rich diet is an important part of a comprehensive treatment.

When is disability granted?

• significant kyphoscoliosis aggravated by pain syndrome was diagnosed;
• a bone fracture is equipped with the development of a "false joint";
• a bone fracture is accompanied by diseases of the heart, blood vessels or respiratory system;
• systemic osteochondrosis is the cause of immobility and threatens his life.

How to forget about pain in the back and joints?

We all know what pain and discomfort are. Arthrosis, arthritis, osteochondrosis and back pain seriously spoil life, limiting normal activities - it is impossible to raise a hand, step on a foot, get out of bed.