Epidemiological studies in China show that the number of people suffering from osteoporosis will be about 90 million in 2021, and about 30% of women and 20% of men over the age of 50 will suffer from osteoporotic fractures, making osteoporosis a serious public health problem in China. So what should we do to prevent osteoporosis? What do we need to do? The purpose of this article is to help more people to recognize osteoporosis, to help people grasp how to prevent osteoporosis, in order to reduce the incidence of osteoporosis in China.
What is osteoporosis?
Osteoporosis is a systemic bone disease triggered by a variety of causes, and is mainly characterized by a decrease in bone density and bone quality, and damage to bone microstructure, which increases bone brittleness and creates a fracture-prone state. Osteoporosis is mainly categorized into primary and secondary, and primary is further divided into postmenopausal osteoporosis (type I), senile osteoporosis (type II) and idiopathic osteoporosis.
Classification of osteoporosis
Osteoporosis is a metabolic bone disease, which is mainly caused by decreased bone formation and increased bone resorption. Osteoporosis is also categorized as follows:
01. Postmenopausal osteoporosis
Estrogen can affect bone metabolism. The decrease in estrogen level after menopause cannot effectively inhibit osteoclasts, resulting in active osteoclasts, rapid decomposition and resorption of osteoblasts, decrease in bone mass and accelerated bone loss, and increase in empty space in the bones, resulting in osteoporosis. Postmenopausal osteoporosis is a common and intractable metabolic bone disease in women due to accelerated bone loss after menopause caused by the interruption of estrogen. It is characterized by pain, spinal deformity, fracture, and an adverse psychological state for the patient.
02.Geriatric osteoporosis
Decreased sex hormones in the elderly stimulate osteoclasts while inhibiting osteoblasts, resulting in decreased bone mass. Secondly, the aging process, there will be a decline in nutrient absorption capacity, organ function decline and other phenomena, resulting in vitamin D deficiency, chronic negative calcium balance, etc., will also lead to a decline in bone mass and bone quality.
03. Idiopathic osteoporosis
The etiology of idiopathic osteoporosis is still unclear. It may be related to abnormal regulation of bone metabolism, such as increased bone resorption, or a sudden increase in puberty growth, a sudden increase in bone mass, a disruption of the balance between bone formation and resorption, or an abnormal calcium metabolism in children.
04.Secondary osteoporosis
It is mainly caused by diseases or drugs affecting bone metabolism, and the common influencing factors are: endocrine diseases (e.g. hyperthyroidism, hyperparathyroidism, type 1 diabetes mellitus, Cushing's syndrome), digestive disorders (post-gastrectomy, hepatobiliary diseases, malabsorption syndromes), hematological disorders (leukemia, lymphoma, plasma cell disorders), connective tissue disorders (rheumatoid arthritis, gout, systemic lupus erythematosus), drug effects (glucocorticosteroids, hepatic hormones), and other drugs (glucocorticosteroids, hepatocellular carcinogens). Effects (glucocorticoids, heparin, methotrexate, cyclosporine), etc.
Predisposing factors of osteoporosis
So we can know what are the common predisposing factors of osteoporosis: smoking, alcoholism, drinking too much caffeinated beverages; low physical activity, prolonged bed rest; reduced sun exposure, calcium deficiency, vitamin D deficiency, high sodium diet, etc.; and post-gastric resection people.
What are the symptoms after osteoporosis?
In mild cases, there may be no obvious symptoms. As the disease progresses, patients feel weak, easy to have pain in the back and back, and even generalized bone pain. Fractures are more likely to occur when falling or dropping. Severe osteoporosis can also lead to deformation of the body such as hunchback. The first and foremost are
Weakness: easy to fatigue, aggravated by exertion, reduced weight-bearing capacity or even inability to bear weight.
Bone pain: pain in the lower back is common, and generalized bone pain can also occur. The pain is mostly diffuse and has no fixed pain point. The pain is usually aggravated when the posture changes, after walking for a long period of time, at night or during weight-bearing activities, or even with limited activities.
Spinal deformity: For example, spinal deformity, vertebral compression fracture caused by severe osteoporosis can make height shorter, hunchback and other spinal deformities, and even affect the cardiopulmonary function. Compression fracture of the lumbar vertebrae in severe cases can also involve the abdominal organs, resulting in constipation and bloating.
Fracture: i.e. fragility fracture, easy to fracture during minor trauma or daily activities, occurring in the thoracolumbar spine, followed by the hip, distal forearm, other parts such as ribs, metatarsals, pelvis and other parts of the body. After a fracture has occurred, the chance of another fracture is significantly elevated.
Idiopathic adolescent type: In addition to the more typical symptoms, there is a sudden growth arrest during the onset of the disease and a tendency to multiple fractures, after which the disease resolves naturally.
At the same time there will be some other symptoms such as osteoporosis can lead to deformation of the thoracic vertebrae in severe cases, and in severe cases, it can compress the heart and lungs, resulting in abnormal function of the circulatory and respiratory systems, such as hunchback patients, often accompanied by palpitations, chest tightness and shortness of breath, dyspnea, decreased lung capacity and other cardiorespiratory symptoms. Skeletal deformities lead to forced folds in the surrounding skin, and the folds are sweaty and moist, which is very likely to harbor bacteria, itching and even erosion. Long-term bedridden people are also prone to bedsores.
In conclusion, from adolescence onwards, strengthening exercise, ensuring sufficient calcium intake, preventing and actively treating various diseases, especially chronic wasting disease and malnutrition, malabsorption, etc., preventing various gonadal dysfunctions and growth diseases; avoiding long-term use of drugs affecting bone metabolism, etc., can try to obtain the ideal peak bone mass and reduce the risk of osteoporosis in the future. Calcium supplementation in adulthood is a basic measure for the prevention of osteoporosis and cannot be used alone as an osteoporosis treatment drug, but only as a basic adjunct. Prevention in adulthood consists of two main aspects. One is to try to slow down the rate and degree of bone loss. For postmenopausal women, the recognized measure is early supplementation with estrogen or estrogen-progestin combination. The second is to prevent fractures in osteoporotic patients; avoidance of fracture risk factors can significantly reduce the incidence of fractures.
References
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[7] Han Xiangli, Lou Zhijie, Shao Yan. Recent research on Chinese medicine disease name and mechanism, clinical experiment and internal and external diagnosis and treatment of osteoporosis. Medical Theory and Practice, 2017
Author(s): Tianhao Meng (Therapy Major, Inner Mongolia Medical University, Class of 2020)
Reviewed by Yan Jinyu (Director of Chinese Society of Rehabilitation Medicine, Vice Chairman of Rehabilitation Therapy Specialty Committee, Standing Member of Critical Illness Rehabilitation Specialty Committee)
Post time: Aug-12-2024