Two million people in our country suffer from osteoporosis. Most are women. 90 percent go untreated. – We have no influence on age, menopause, past diseases, but we can do a lot to minimize the risk – says Dr. Michał Drwięga, specialist in orthopedics and traumatology of the musculoskeletal system from the Carolina Medical Center. October 20 is World Osteoporosis Day. How to strengthen bones and protect them against fractures?
- Osteoporosis is a metabolic disease of the bone. It is characterized by low bone mass, impaired microarchitecture of bone tissue and, consequently, increased susceptibility to fractures
- This disease affects women more often due to the fact that they have more delicate bones, which are additionally weakened by hormonal changes – mainly after the menopause, when estrogen is depleted. Many of them also weaken the bone tissue with slimming diets – then they do not provide the body with, among others adequate amounts of protein, calcium and vitamin D.
- Prevention in osteoporosis is primarily: recreational sports, proper diet, or supplementation under the supervision of a doctor (most Poles have a deficiency of vitamin D. Only construction workers working outside, in the sun and without T-shirts have enough of it)
- Osteoporosis has no symptoms. We often learn about it when we break bones after a fall. Fractures of the femoral neck in the elderly are particularly common and dangerous. Post-operative complications (a blood clot that can travel to the vessels in the brain), prolonged immobilization that reduces the function of many organs, can be fatal
– Women should increase their vigilance and take care of the prevention of osteoporosis, especially when approaching the borderline, when they enter the risk group, i.e. in the period of menopause. It is worth testing bone mineral density in your XNUMXs. And if we have suffered an osteoporotic injury in the past, it is best to do it regularly – says Dr. Michał Drwięga, an orthopedist and traumatologist. – Then they very well illustrate how bone parameters change – he adds.
If you are a woman, especially if you are in the menopause, or if you have already had one and are over 60, smoke and avoid sports, you are at risk.
Unfortunately, osteoporosis has no specific symptoms, which makes it more dangerous. It’s becoming more common in today’s world – most of us are very inactive, spend little time outdoors, avoid the sun for fear of skin cancer, and our food is increasingly depleted of nutrients. The World Health Organization (WHO) has already recognized osteoporosis as a disease of the 2st century and entered it on the list of diseases of civilization. In Poland, according to the data of the National Institute of Geriatrics, Rheumatology and Rehabilitation, about 10 million people suffer from osteoporosis, and this tendency will grow with the aging society. Interestingly, in Poland only XNUMX percent of patients with osteoporosis are treated.
A simple fall can be dangerous for someone with osteoporosis. The most common then are:
– Fractures of the distal radius, the so-called «Loco typico» – this is a typical place of injury, when losing balance, we try to save ourselves from falling and lean on an outstretched arm.
– Fractures closer to the femur, i.e. the hip. Injury often found when slipping, when a man falls on the buttocks, sideways. This type of fracture is especially dangerous in the elderly. For this reason, it is often said that osteoporosis can be indirectly fatal because after such a serious fracture it is very difficult, sometimes even impossible, to recover. If such an injury is not treated immediately, the patient is immobilized in bed, which has a very bad effect on the functioning of internal organs and the overall condition of the body. It can lead to death. Therefore, in the elderly, such fractures are most often arthroplasty – the bones are not fused together because they are too weak, but they are replaced with a prosthesis.
– Fractures within the spine, in particular in the lumbar vertebrae, are also the domain of the elderly. The vertebrae affected by osteoporosis are very soft inside and sometimes not so much a fall causes a fracture, but even driving a car over a speed bump can cause serious injury – the severity of the injury does not have to be great. Fracture of one or more vertebrae causes significant pain and neurological symptoms, which can gradually lead to progressive deformation of the spine, reduced chest capacity, and deterioration of respiratory and circulatory performance. In old age, these are very dangerous changes.
– The proximal part of the humerus is also subject to osteoporotic fractures. Their cause is most often a fall on an outstretched hand. After such a fracture, patients experience a painful restriction of movement and a visible swelling of the shoulder.
Doctors emphasize that, for example, the first osteoporotic wrist fracture doubles the risk of the next one, while in the case of hip fractures, the risk increases even threefold, which is why proper prophylaxis and early detection of osteoporosis is so important.
Prevention is essential
Despite the fact that we have no influence on our age, hormone economy or past diseases, we can do a lot to minimize the risk of osteoporosis by implementing simple prevention principles:
1. Motion
Regular physical activity can work wonders – the body adjusts bone strength to its needs and strives to meet our lifestyle. Importantly, any physical activity requires high resistance from the bones, so no matter if we are skiing, jogging, or maybe taking long walks, the bones will be stimulated to bear the load during a given activity.
2. A diet rich in calcium
A diet rich in calcium is also the basis for the prevention of osteoporosis – therefore, do not avoid dairy products, including milk or lean curd, choose foods rich in vitamin D, especially fruits and vegetables, such as cabbage, broccoli, Brussels sprouts, kale and legumes. An ideal diet for bones is also rich in sea fish, nuts, almonds, sesame seeds, poppy seeds and sunflower seeds, buckwheat and millet, cereals, olive oil, linseed and rapeseed oil. At the same time, it is worth remembering about regular 4-5 meals a day.
3. Supplementation, if prescribed by a doctor
In addition to a properly selected diet, sometimes it is necessary to support the body pharmacologically. If recommended by a rheumatologist. Diet is always better because microelements, vitamins, etc. are usually much less absorbed from supplements than from food.
Therefore, pharmacological treatment is applied mainly to patients who have already suffered an osteoporotic fracture once. However, such therapy is recommended only after the fracture has healed completely, as some medications block bone fusion.
The result of a densitometry test can confirm concerns about the condition of our bones, or dispel them and calm us down. – Women should increase their vigilance and take care of the prevention of osteoporosis, especially when approaching the threshold, when they enter the risk group. Prophylactic examinations of bone mineral density after the age of 50 – especially among people who have already suffered an osteoporotic injury, should be performed regularly. How often will depend on the test results and the decision of the attending physician on the basis of specific indications. However, it is best to do them regularly, because they illustrate very well how parameters change. With large deficiencies of bone tissue, such a test should be performed even every year. – says Dr. Drwięga.
Unfortunately, osteoporosis cannot be completely cured or the changes that have occurred in the bone tissue cannot be completely undone. Only through appropriate pharmacology can the values be improved and a stable state can be brought, which will guarantee that the degeneration will not progress.
Densitometry – what does the examination look like?
Usually, the bones of the wrist, thigh, forearm and lumbar spine are usually densitometric, i.e. those that are most often injured. An X-ray machine is used for the examination, and the test results are interpreted on the basis of the number of X-rays that can penetrate the bones. The more porous the bones are, the more X-rays will penetrate them. These amounts are analyzed by an electronic detector and shown on the numerical data by which the doctor judges the bone density.
Prophylactically densitometry should be performed mainly by women over 50 and those with a history of osteoporosis in their family. Additional indications for the examination are: low body weight, a history of fractures, a diet low in calcium and vitamin D, low physical activity, late first menstruation, early menopause, short-term births, smoking and alcohol abuse.