Osteoporosis is a disease that reduces bone mass. As Dr. del Pino Montes, head of the Rheumatology Unit at the University Hospital of Salamanca, explains, this disease causes the bones to become more fragile and facilitates the appearance of fractures with minimal trauma or even without trauma.
The WHO and other health organizations have drawn attention to this problem which affects millions of women in the world and which is the cause of the serious health problem caused by the huge number of osteoporotic fractures, a high health and social cost. After an osteoporotic fracture, there is often a loss of quality of life, dependence of some people, and even a decrease in survival.
In healthy conditions, bones have a complex structure that allows us to resist the impacts of daily activity and common falls. However, with osteoporosis this structure suffers, deteriorates and loses the resistance of healthy bone. The consequence is increased fragility and ease of breakage and the appearance of fractures. Unfortunately, while osteoporosis is developing, there is no clinical manifestation. It is called the silent epidemic. Only the appearance of the fracture highlights the slow loss of bone mass that has been occurring for years.
The most frequent osteoporosis is that which appears in women after menopause. From that moment on, the ovaries stop producing estrogens. These are hormones that protect the bone and prevent bone loss. With the cessation of their production, the bone is subjected to increased bone resorption. This process is necessary to maintain the bone in the best conditions, but after menopause the process accelerates and acquires a great magnitude. After a few years of deterioration, fractures appear, mainly, but not exclusively, vertebral, wrist, shoulder and hip fractures.
What patient profile may be more susceptible to suffer this pathology (women or men, age groups…)?
This disease affects approximately 3 million people in Spain, especially prevalent in postmenopausal women. It is estimated that 35% of women suffer from the disease from the age of 50 onwards, with the percentage increasing to 52% from the age of 70 onwards. According to 2010 data, the total cost of osteoporosis is estimated at 2,864 million euros, including pharmacological treatment.
It can also affect men over 50 years of age, but the frequency is lower, approximately one male for every three females.
What are the causes of the disease?
In addition, there are secondary forms that can affect younger people. They are mainly due to inflammatory diseases, including rheumatic diseases such as rheumatoid arthritis. It may also be related to diseases of the digestive system, especially those with problems in absorbing calcium and other nutrients. Among endocrinological diseases, diabetes mellitus should be highlighted due to its frequency. It should be noted that extreme thinness is associated with increased chances of fracture, and diseases such as anorexia nervosa may be accompanied by osteoporosis. Some drugs have the ability to reduce bone mass, including corticosteroids, which are used in the treatment of many inflammatory diseases, tumors and in the case of transplants.
Can osteoporosis be prevented?
Fortunately, osteoporosis can be treated and prevented. Prevention is based on health education. The highest peak of bone mass is reached at around 30 years of age and therefore it is necessary to prevent it from childhood and youth when the skeleton is developing. Habits such as smoking, alcohol, lack of physical exercise, diets with little dairy products reduce the capacity to achieve maximum bone development. The diet should not only incorporate dairy products, but should be healthy and sufficient to cover the metabolic needs.
How is this disease treated?
Here we have good news. First of all, it is advisable for a specialist in Rheumatology to make a diagnosis before fractures develop. The diagnosis is made by measuring bone density by densitometry. This data will make it possible to know the person’s risk of fracture. When there is a risk of osteoporosis, it is essential to correct toxic habits and risk factors in order to change them for healthy habits. It has been well studied that in order to correct osteoporosis, it is necessary to have enough Vitamin D. In many patients it is necessary to administer it to achieve adequate levels since it is not easily found in the usual foods.
Physical exercise is very important for bone health. Walking for 1 hour a day is sufficient in most cases. Falls should be avoided by avoiding obstacles in the home and paying attention to those in the street. Avoiding falls will also prevent fractures.
In addition, there are effective drugs available to reduce the number of fractures. Up to 3 out of every 4 fractures can be avoided. The type of treatment should be chosen according to the risk of fracture of each person, looking for the one that, due to its efficacy, tolerability and comfort, fits each patient.