Osteoporosis has become a serious public health problem around the world. So how can we prevent osteoporosis? What do we need to do? This article aims to help more people understand osteoporosis and learn how to prevent it.
Normal sclerotin Osteoporosis (light) Osteoporosis (heavy)
What is osteoporosis?
Osteoporosis is a systemic skeletal disease caused by multiple factors, characterized primarily by a decrease in bone density and quality as well as impaired bone microarchitecture, leading to increased bone fragility and a predisposition to fractures. We can classify osteoporosis as primary or secondary, further dividing primary osteoporosis into postmenopausal osteoporosis (Type I), age-related osteoporosis (Type II), and idiopathic osteoporosis.
Classification of osteoporosis
Osteoporosis is a metabolic bone disease, primarily caused by a decrease in bone formation and an increase in bone resorption. Osteoporosis can be further classified as follows:
01.Postmenopausal osteoporosis
Estrogen can influence bone metabolism. After menopause, the decline in estrogen levels is unable to effectively suppress osteoclasts, leading to increased osteoclast activity, rapid bone cell decomposition and resorption, and a decrease in bone mass with accelerated loss. The increase in bone cavities results in osteoporosis. Postmenopausal osteoporosis is a common and intractable metabolic bone disease in women, characterized by pain, spinal deformities, fractures, and adverse psychological effects on patients.
02.Age-related osteoporosis
In the elderly, a decrease in sex hormones stimulates osteoclasts while suppressing osteoblasts, leading to a reduction in bone mass. Additionally, the aging process can cause a decline in nutrient absorption capacity and organ function, resulting in vitamin D deficiency and chronic negative calcium balance, which can also lead to a decrease in bone mass and quality.
03.Idiopathic osteoporosis
The causes of idiopathic osteoporosis remain unclear but may be related to abnormal bone metabolism, such as increased bone resorption, sudden increases in bone formation during puberty that disrupt the balance between bone formation and resorption, or abnormal calcium metabolism in children.
04.Secondary osteoporosis
This is primarily caused by diseases or medications that affect bone metabolism, such as endocrine disorders (e.g., hyperthyroidism, hyperparathyroidism, type 1 diabetes, Cushing’s syndrome), gastrointestinal diseases (e.g., gastrectomy, liver and biliary diseases, malabsorption syndromes), hematological diseases (e.g., leukemia, lymphoma, multiple myeloma), connective tissue diseases (e.g., rheumatoid arthritis, gout, systemic lupus erythematosus), and medications (e.g., glucocorticoids, heparin, methotrexate, cyclosporine).
Factors Contributing to Osteoporosis
We can thus understand the common risk factors for osteoporosis: smoking, alcohol abuse, excessive consumption of caffeinated beverages, a sedentary lifestyle and prolonged bed rest, reduced sun exposure, calcium and vitamin D deficiency, a high-sodium diet, and populations with a history of gastrectomy.
What are the symptoms of osteoporosis?
In mild cases, there may be no obvious symptoms. As the condition progresses, patients may feel fatigued, experience lower back and body pain, and even experience widespread bone pain. Patients are also more prone to falls and fractures. Severe osteoporosis can lead to physical deformities such as kyphosis (hunched back).
The primary symptoms include:
–Fatigue: Patients feel easily fatigued, with fatigue worsening with exertion. There is a decline in weight-bearing capacity, and patients may be unable to bear weight.
–Osteodynia: Pain is commonly felt in the lower back and spine but can also manifest as widespread bodily pain. The pain is typically diffuse, without a fixed point of origin. The pain often worsens with changes in posture, prolonged walking, at night, or with weight-bearing activities, and can even lead to limited mobility.
–Spinal deformities: Vertebral compression fractures caused by severe osteoporosis can lead to loss of height, kyphosis (hunched back), and even impaired cardiopulmonary function. Severe lumbar vertebral compression fractures can also affect the abdominal organs, causing constipation and abdominal distension.
–Fractures: Fragility fractures can occur with minor trauma or daily activities, commonly affecting the thoracic and lumbar spine, as well as the hips, distal forearms, ribs, phalanges, and pelvis. The risk of subsequent fractures is significantly increased after an initial fracture.
–Juvenile/adolescent-onset osteoporosis: In addition to the typical symptoms, sudden growth arrest and recurrent fractures may occur during the disease onset, followed by natural remission.
Other associated symptoms include thoracic deformities that can compress the heart and lungs, leading to palpitations, chest tightness, shortness of breath, and decreased lung capacity in patients with kyphosis. Skin folds caused by skeletal deformities can become moist and prone to bacterial infections, causing itching and even skin erosion. Prolonged immobilization can also lead to pressure sores.
In summary, starting in adolescence, strengthening exercise, ensuring adequate calcium intake, preventing and actively treating various diseases (especially chronic wasting diseases, malnutrition, malabsorption, gonadal dysfunction, and growth disorders), and avoiding long-term use of medications that affect bone metabolism can help achieve optimal peak bone mass and reduce the risk of future osteoporosis.
In adulthood, calcium supplementation is a basic preventive measure, but it should not be the sole treatment for osteoporosis. Prevention strategies include slowing the rate and extent of bone loss, especially with timely estrogen or estrogen-progestogen replacement in postmenopausal women, and preventing fractures by addressing risk factors.
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From the Chinese Association of Rehabilitation Medicine
Post time: Jun-07-2024