Osteoporosis: Symptoms and treatment of women. How to treat osteoporosis

Osteoporosis - rarefaction of cortical and cancellous bone layer which occurs as a result of the partial dissolution of bone substance. diseases of the name comes from the Greek words: osteo - bone and poros - pore, hole, hole. The fragility of the bone caused by the decrease in the proportion of bone per unit volume due to a violation of metabolic processes in the body, responsible for the absorption of calcium trace element. Let us consider why there is osteoporosis, what is it and how to treat the disease by means of traditional and folk medicine?

The pathology is more common in women during menopause (up to 80% of cases). The plight of patients with osteoporosis is that even with minor injuries and compression loads they develop bone fractures. The process of bone loss progresses with each passing year, limiting the mobility of patients and reducing the quality of life. A number of activities helps to stop the process and prevent the occurrence of fractures and cracks.

What it is?

Osteoporosis - exchange chronically progressive systemic skeletal disease or clinical syndrome, which manifests itself in other The disease, which is characterized by decrease in bone density, a violation of their microarchitectonics and increased fragility due metabolic disorders of bone tissue with a predominance of catabolic processes of bone formation, decreased bone strength and increased the risk of fractures.

This definition of osteoporosis relates to diseases of the musculoskeletal and connective tissue disorders (ICD-10) and complementary to the term "metabolic disease or exchange".

Causes of

The development of osteoporosis is playing the role of an imbalance in bone remodeling. In the process of constant renewal of the bone involved cells - osteoclasts and osteoblasts. One osteoclast destroy as much bone mass as 100 forms of osteoblasts. For filling (mineralization) of bone gaps caused by osteoclasts for 10 days to 80 days it requires osteoblasts.

By increasing the activity of osteoclasts (for various reasons) destruction of bone occurs faster than its formation. Thinning and trabecular perforated plate, there is destruction of horizontal linkages, increased bone fragility, brittleness - which threatens to fracture.

Consider the detailed risk factors.

endocrinological:

• later menarche;
• any hormonal imbalance;
• early menopause (postovariektomicheskaya including);
• periods amenorrhea history until menopause;
• all kinds of infertility.

genetic:

• the elderly and old age (old age);
• female sex (risk of osteoporosis for men is three times less than for women);
• belong to the Caucasoid or Mongoloid race;
• osteoporosis, pathological fractures, and / or femoral neck fractures of the vertebrae and close relatives;
• low peak bone mass (calculated objectively);
• Figured brittle (subjectively);
• the great length of the femoral neck with respect to the diaphysis;
• low weight (56 kg Caucasoid women and Asians to 50 kg, 70 kg male both races);
• critical growth (for women above 172 cm for men - 183 cm);
• the absence of generalized osteoarthritis;

Lifestyle-related:

• smoking;
• excessive exercise;
• long-term parenteral nutrition;
• nutritional deficiency of calcium (mineral deficiency in food or breaking its suction);
• abuse of alcohol (alcoholism);
• adynamia, lack of physical activity (reducing muscle stimulation increase bone mass system);
• hypovitaminosis D (deficiency of vitamin in the food or living in northern regions).

Factors caused by prolonged use of medications:

• anticonvulsants (phenytoin et al.);
• lithium;
• for the treatment of tumors (cytotoxic agents, cytotoxins);
• methotrexate, cyclosporin A;
• glucocorticoids (prednisolone, based on the ≥ 7,5 mg per day for six months or more);
• thyroid hormone (L-thyroxine et al.);
• anticoagulants (direct, indirect);
• tetracycline antibiotics;
• phosphate-binding antacids;
• agonists and antagonists of gonadotropin releasing factor and its.

Factors caused by comorbidity:

• the digestive system (impaired absorption);
• chronic heart failure;
• chronic renal failure;
• condition after organ transplantation;
• endocrine (hyperparathyroidism, thyrotoxicosis, hyperprolactinemia, diabetes mellitus, Cushing's syndrome, primary hypogonadism, Addison's disease);
• blood and hemopoietic system (leukemia, multiple myeloma, lymphoma, pernicious anemia);
• autoallergens system (rheumatoid arthritis, ankylosing spondylitis, polymyositis, systemic lupus erythematosus, etc.).

Thus, the appearance of osteoporosis would be expected, if you know all the reasons, which have an impact on the formation of ideas illness.

Senile osteoporosis type arises due to calcium deficiency associated with aging and loss of balance Forcing between bone tissue destruction and speed the formation of new bone type. "Senile" implies that the present state is formed at an older age, most often in people of 70 years or more. This disease are twice as likely formed in females than in males. In women, it is almost always combined with postmenopausal stage.

It should be particularly noted that less than 5% of cases of the disease caused by any other illness or intake of some drugs. This form of osteoporosis, known as secondary. It can be formed in conditions that were identified above. Suppose, kidney problems, or endocrine glands. Needless active alcohol and addiction to smoking only exacerbate the disease presented.

There is also an idiopathic "youth" osteoporosis. This is a rare form of osteoporosis, the cause of which currently remains unknown. It is formed in infants, children and young people who have completely normal levels of hormones and vitamins in the blood. In addition, they have not seen any clear reasons for reducing the degree of bone density.

Classification

Depending on the reasons it is divided into the primary as a result of natural aging, and the secondary.

Types of primary osteoporosis:

• osteoporosis adults
• Idiopathic (undetermined). It can develop at any age
• Postmenopausal (for women)
• Juvenile (adolescence)
• Senile (senile)

Types of secondary osteoporosis - is due to:

• Diseases of the blood.
• Diseases of the digestive tract, contributing to the disruption of calcium absorption.
• kidney disease (Fanconi's syndrome, chronic renal failure).
• Endocrine diseases (reduction of the synthesis of sex hormones, thyroid dysfunction, parathyroid, pancreas, adrenal gland).
• Connective tissue diseases (rheumatism, systemic lupus erythematosus, osteoarthritis, rheumatoid arthritis).
• Other diseases that lead to bone destruction.

What happens with a bone in osteoporosis?

Bone in their structure can be of two types: compact and cancellous. Compact fabric is very dense, has a uniform structure and consists of concentrically arranged bone plates. It is a compact substance covers all the bones from the outside. Total layer thickness of the compact substances in the middle of the long, so-called long bones: it e.g., thigh, shin bone (tibia and fibula), shoulder, elbow, beam bone. This is clearly shown in the picture below.

bone head, as well as flat and short bones have a very thin layer of compact material, under which is located a spongy bone substance. Spongy substance itself has a porous structure due to the fact that is made up of bony plates, which are located to each other at an angle, forming a kind of cell.

Cancellous bone health is well defined bony plates and small pores. Plates spongy tissue are not arranged randomly but according to the direction in which the bone experiencing the greatest load (for example, by muscle contraction).

In osteoporosis, bone mineral loses its component, whereby the bone plate thinner or disappear altogether. This leads to a decrease in thickness and compact cancellous and rarefaction.

As a result of changes, not only the bone mineral density, but also, importantly, the structure of the bone tissue. Plates longer line up along the lines of the compression-tension, which significantly reduces resistance to stress bone.

The first signs

Early symptoms of osteoporosis in women after 50 years:

• ache, aching pain in the bones, particularly when changing weather;
• periodontal disease development and change of nails;
• fatigue, palpitation episodes;
• the early appearance of gray hair;
• muscle twitching legs at night, especially in women.

osteoporosis symptoms

The danger associated with clinical or asymptomatic oligosymptomatic onset of osteoporosis, masquerading as osteochondrosis and arthrosis. The disease is often diagnosed already in the presence of a fracture. A fractures can occur with minimal trauma picked gravity.

Notice the woman the symptoms of osteoporosis is difficult enough in the early stages, although there are a few signs. For example, changes in posture, bone pain during changing weather, brittle hair and nails, tooth decay. The most susceptible to diseases of the spine, femoral neck, bones of the hands and wrist. The first symptoms of osteoporosis can be pain in the lumbar and thoracic during prolonged static load of the spine (e.g., sedentary work), night leg cramps, brittle nails, senile stoop, reducing growth (by reducing the height of the vertebrae), the phenomenon periodontal disease.

Persistent back pain, back pain, interscapular area can be symptoms of osteoporosis. If there is pain, loss of height, change in posture is necessary to consult a doctor, be screened for osteoporosis.

Diagnostics

Establish an accurate diagnosis only on the basis of complaints of the patient is not possible. Indeed, under the signs of osteoporosis may be masked by other diseases of the musculoskeletal system, requiring a different approach to treatment.

Modern diagnostic capabilities allow us to solve several problems at once: to identify the presence of osteoporosis and its consequences, evaluate the degree of osteopenia, and to determine the possible cause of this pathology.

osteoporosis diagnosis techniques:

1. MRI and CT scans.
2. Examination by a podiatrist (a surgeon, a neurologist).
3. Isotope absorptiometry.
4. General and biochemical analysis of urine.
5. A study of hormonal status.
6. X-ray or ultrasound bone densitometry (measured bone mineral density).
7. General and biochemical analysis of blood (indicating the concentration of calcium, phosphorus, magnesium and other indicators).
8. Determination of daily calcium release by the kidneys (estimated extent of absorption of trace elements in the digestive tract structures).
9. skeletal radiography (a multi-view for a clearer picture, the method is effective in case of loss of bone mass over a third).

The leading method of assessment of bone loss in the diagnosis of osteoporosis is bone densitometry. This method allows one to accurately measure the bone mass, to assess the structural density and bone tissue to determine the extent of osteopenia. In most European countries densitometry is recommended every two years for all women older than 45 years and for men - 50 years. If you have any risk factors for development of osteoporosis begins to conduct this survey should be used.

How to treat osteoporosis?

Modern treatment of osteoporosis in women and is a complex event inseparable from nutrition, consumption of vitamin D, preparations containing phosphorus - calcium supplements. The following treatments are the most known:

1. The use of bisphosphonates, e.g., alindronata. This drug inhibits the destruction of bone and almost twice reduces the risk of pathological fractures;
2. The use of "Miakaltsik" drug, which is a natural analog of calcitonin improves phosphorus - calcium metabolism;
3. An effective method of treatment of osteoporosis in women has hormone replacement therapy, which is performed after the menopause. Estrogen therapy should be undertaken only after careful examination of the gynecologist, and accounting mammologist severity of side effects, the most common of which is venous thrombosis.

In addition to these therapies, patients with osteoporosis is a special Stand-LFK, as well as a mild massage.

Bisphosphonates for osteoporosis

At the moment, bisphosphonates should be considered as a recognized method of prevention and treatment of osteoporosis is not only for women but also for men. Studies that have been carried out successfully on many thousands of patients, have demonstrated that bisphosphonates:

• inhibit bone booking;
• positive effect on the increase in bone mineral density (BMD);
• absolutely not dangerous;
• well tolerated by the human body;
• have few side effects;
• reduce the risk of fractures.

To date, the active practice applicable only a certain amount of bisphosphonate, namely, alendronate, risedronate, ibondronat, zoledrinovaya acid. They are characterized by a variety of means and methods of introduction into the body.

The most well-known and well-studied bisphosphonate should be considered alindronat. Its degree of effectiveness is proven in numerous surveys of those who are afflicted by osteoporosis. Research carried out in the presence of fractures in the vertebrae.

Also, this drug is effective in the prevention of osteoporosis in postmenopausal women with osteopenia. On average alindronat reduces the likelihood of forming a wide variety of localization of fractures by 50%, while the probability of a specific fractures in the vertebrae - at 90%.

This drug is prescribed at a dosage of 70 mg, i.e. one pill, once per week. In postmenopausal osteoporosis risedronate type is also used in a dosage of 30 mg per week.

Diet and Nutrition rules

Basic Principles power osteoporosis stacked in a very simple scheme: food should provide the necessary amount of calcium and vitamin D. The latter is necessary for proper calcium absorption. In addition, it improves the absorption of calcium and potassium, phosphorus and magnesium.

Patients diagnosed with osteoporosis should be excluded from the diet:

• any products from cocoa beans and coffee;
• alcoholic beverages;
• sugar - it can be replaced with honey;
• confectionery;
• carbonated drinks, which in its composition contain caffeine - such as the well-known energy;
• margarine, mayonnaise and any fatty sauces - it is better to replace them with sour cream or olive oil / balsamic vinegar and mustard sauce;
• mutton and beef fats - in the use of these types of meat have to choose lean pieces.

Permitted products for osteoporosis include:

• Green and leafy vegetables species.
• Fruits, berries, absolutely all kinds.
• All kinds of nuts and seeds.
• All kinds of fungi. According to the research the highest content of calcium found in white mushrooms.
• Legumes.
• Pasta.
• refined vegetable oil.
• Seafood. Shrimp, mussels, octopus, squid - the representatives of the marine world in its chemical composition have a sufficiently high amount of calcium. In extreme cases, you should regularly eat sea cabbage - it is still rich and iodine.
• Fish. It is necessary to enter into the diet, and river and sea fish, as they have different compositions. Not worth it to fry, better boil, steamed or stew.
• Eggs. It can be eaten and the chicken and quail eggs - they will be equally useful for people with osteoporosis.
• Vegetables. To use allowed absolutely all kinds of vegetables, including tomatoes, zucchini, pumpkin. If you love fried vegetables, use the grill for this, and prepare stews of vegetables is better to use the minimum amount of vegetable oil.
• Meat of all kinds. It is very useful to introduce into the diet of patients with osteoporosis rabbit and turkey.
• Milk products. Here doubts and should not be - yogurt and cottage cheese, sour cream and cream, whey and fermented baked different high content of calcium. But should pay attention to the fat content of the products - it must be low.

Terms of use of food as part of a diet for osteoporosis:

• better to eat food prepared at home;
• per day should be at least 5 meals;
• break between the food must be not more than 3, 5 hours;
• snack in the cafe, replace the yogurt and fresh fruit (apple, banana);
• can not be combined in one dish of meat and cereals;
• you can safely eat meat with vegetables;
• it is impossible to organize mono-diet - for example, the whole day there is only dairy products or vegetables

Exceptionally diet does not give good results - it should be only one component in the treatment of osteoporosis.

Lifestyle modification

Treatment and prevention of osteoporosis are impossible without lifestyle changes and getting rid of the risk factors for this disease and its complications. Medications or other treatments for osteoporosis is important and necessary complement modifying their lifestyle.

The main recommendations of the World Health Organization for patients at risk for osteoporotic fractures:

• maintaining constant active lifestyle;
• sufficient exposure to the sun and the fresh air;
• refusal of smoking and excessive alcohol use;
• compliance with individual rates of calcium and vitamin D in food, and if necessary, to make up the deficit drugs;
• maintain body mass index of not less than 19 kg / m2, as low weight - it is a serious risk of fractures;
• observe a healthy sleep;
• visit regularly seaside resorts and sanatoriums.

When prepared correctly treatment program, which will take into account all the individual characteristics of the patient, the cause mineralization disorders bones and risk factors, as well as adequate preventive measures for osteoporosis progress can dramatically slow, and sometimes stop.

Forecast

The forecast for recovery depends on the extent and timeliness of detection of osteopenia and accuracy correction of the pathological condition.

Since osteoporosis is considered a disease of older people, unfortunately, avoid this disease is not always possible. The main danger for osteoporosis - a trauma and its consequences. But doctors are inclined to say that not all cases of osteoporosis is an "accompaniment" of old age. That the disease is not touched, it should comply with preventive measures and carefully monitor their health.

It is also important to consider the presence of background diseases or conditions leading to the development of this disease and in the treatment of osteoporosis, bone produce them adequate correction. While eliminating risk factors such forecast becomes more favorable.

prevention

How to prevent osteoporosis or stop its further progression? You must adhere to these rules:

1. It is necessary to limit the consumption of coffee, tea, alcoholic beverages.
2. It is essential that every day present certain physical activity.
3. It is recommended to engage in sports, but avoid too intense exercise.
4. Limit the consumption of foods containing phosphorus. This is red meat, any sweet drinks with gas.
5. Nutrition, which implies the use of products containing large amounts of calcium. These include milk, yogurt, cheese, cottage cheese, broccoli.

Also do not forget about preventive examination of the body, which will allow time to identify problems with the operation of the propulsion system and prevent life-threatening consequences.