Therapy of osteoporosis

Synonyms in the broader sense

Bone decalcification, bone loss, bone fragility, descaling of the bone, calcium, calcium, vertebral body fracture

definition

Osteoporosis, also called bone atrophy, is a skeletal system disorder in which bone substances and structures are lost or greatly diminished. This reduction in bone mass deteriorates the tissue structure of the bone and loses stability and elasticity. As a result, the bones become more susceptible to breakage, in extreme cases a break can even occur without a fall.

Due to the increased risk of fracture, the bone may collapse (sinter). This manifests itself especially in the area of ​​the vertebral body by visible changes. An example is the so-called "widow's hump", which can be particularly evident in older women and may lead to great mobility restrictions.

therapy

Osteoporosis of the lumbar spine

drugs
Calcium / calcium:
For a healthy bone, a sufficient calcium intake is absolutely essential. Various studies have shown that a person with average nutrition consumes only half of the recommended daily calcium / calcium intake. A deficiency can be eliminated by means of calcium-rich diet in the rule.
An increased calcium requirement can be observed during pregnancy, lactation, but also during menopause. Since this is in addition to the usually borderline calcium supply, this strong need should be additionally covered by calcium supplements. The recommended calcium dose is at least 1000 mg calcium / calcium per day.
Vitamin D:
A shortage of vitamins always leads to deficiency symptoms. Since vitamin D regulates the uptake of calcium from food and is formed under sunlight in the body, vitamin D deficiency usually sets in during winter months or when the patient is outdoors too little. If you increase the supply of vitamin D with so-called vitamin D preparations, it should be noted that these should be given only in low sunshine and at a low dose. This is useful, for example, in bedridden patients. The recommended dose will then be 800 IU (international units) of vitamin D per day.
bisphosphonates:
Osteoblasts are cells that perform bone-building or bone-degrading functions. The administration of bisphosphonates inhibits the activity of bone-degrading osteoblasts, but the activity of bone-building osteoblasts remains active. As a result, bisphosphonate therapy increases bone mass. The supporting structure (trabecular structure) is retained, so that the newly formed bone mass corresponds to the natural bone substance. Such a process can only succeed if bisphosphonates, such as Fosamax, are administered uninterrupted for an extended period of time (≥3 years). How long the treatment has to be continued in a particular case, decides the doctor.

A drug from the group of bisphosphonates is Fosamax with the active ingredient alendronate. Fosamax is taken as a tablet either once a week 70 mg or 10 mg daily.
Estrogen:
Numerous studies have shown that the use of estrogen can reduce the risk of bone loss in postmenopausal women. In order to achieve an effect, however, such preparations must be taken over a period of at least five years. It should be mentioned at this point that hormone preparations may increase the risk of cancer, in particular the risk of breast cancer. Menopausal symptoms, however, are reduced by the administration of estrogen.
Selective estrogen receptor modulators (SERMs), as well as estrogens, affect the bone structure. You may also attribute them a protective function for the heart and circulation. On the negative side, unlike the hormones, SERMs are unlikely to have a positive effect on the typical menopausal symptoms.
calcitonin:
Calcitonins counteract bone resorption, are anti-resorptive, so to speak, and additionally have an analgesic (= analgesic) effect. Unfortunately, they are not free of side effects. In some cases skin redness and / or nausea with vomiting may occur.
Fluoride:
In contrast to the so-called bisphosphonates, fluorides stimulate the activity of those osteoblasts responsible for bone formation (= osteoanabolic activity). The dosage is very important: too high a dosage reduces bone quality and stability. Through the addition of fluorides, the newly formed bone material no longer matches the natural substance.
It is important to note that fluorides must always be given in combination with calcium so that the newly formed bone can be sufficiently mineralized again.
In the context of this therapy, a concomitant phenomenon is the occurrence of bone and joint pain, which, however, usually disappear quickly when the treatment is interrupted.
Fluoride therapy should not be continued for more than two to three years without interruption.

Vibration training:
By means of vibration training it has now been proven that regular vibration training improved osteoporosis.
Read more about our topics:

  • vibration training
  • Vibration training in osteoporosis

prevention

Prevention:

Each person can and should counteract prophylactic diseases, especially of course the bone loss, the O. by a balanced and healthy diet, in conjunction with regular exercise. These are the measures that anyone can implement without any side effects themselves.

Move:
Scientific studies prove the close connection between physical activity and bone density. A sufficient amount of exercise also has a positive effect if osteoporosis has already started, ie the patient is already suffering from the consequences of osteoporosis. Due to movement, bone resorption can slow down, under

Not all movements have a positive effect, in case of already existing osteoporosis, an increased amount of exercise may even be dangerous, so you should generally consult with your doctor before increasing your range of motion.

Calcium - Metabolism:
An elevated level of phosphate in the body may prevent calcium from being incorporated into the body. Calcium and phosphate metabolism are closely related.
In the diet, you should therefore always make sure that phosphates are not absorbed too high. Many phosphates are included, for example, in caffeinated soft drinks. Since coffee boosts urine production and thus deprives the body of calcium, too much coffee is not recommended. Too much calcium excretion is also caused by the consumption of alcohol. There is also a negative effect on increased consumption of meat, in particular the consumption of pork, and sausage is often considered negative.

All medications listed in the therapy can also be used in the context of prevention in a modified dosage.

If the cause of osteoporosis in an eating disorder such as anorexia or bulimia is due, at the same time a psychotherapy should be initiated to treat the cause.

forecast

Untreated osteoporosis progresses incessantly. This can - as already shown above - possibly lead to permanent physical changes. The text has already referred to various accompanying phenomena. The most important are mentioned here again:

  • Decrease in height
  • hunchback
  • strongest bone pain
  • multiple fractures.

These examples show that severe forms of osteoporosis are associated with constant pain and sometimes severe movement restrictions. Not infrequently is then an early disability with a strong Hilfsbedürtig- and dependence the consequence.
Because osteoporosis usually affects the elderly, in many cases life in a nursing home sometimes seems inevitable.

Once you consciously look at these risks and consequences, it should be clear to everyone why prophylaxis, early diagnosis and possibly early treatment of osteoporosis are so important. Only in this way can the development of the disease be counteracted, on the one hand, and the progression and complications, on the other hand.

-> Back to main topic Osteoporosis

Additional information

You might also be interested in these topics:

  • Osteoporosis in underweight
  • Osteoporosis forms
  • Osteoporosis diagnosis
  • Prevent osteoporosis


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