Osteoporosis treatment in older men. Problems of osteoporosis in men. Osteoporosis in men: exercise
A disease such as osteoporosis in men is 2 times less common than in women, due to the peculiarities of the hormonal background. But at the same time, an unhealthy lifestyle, malnutrition and concomitant pathologies provoke the development of the disease even in young, able-bodied men, which often leads to disability.
Reasons for the development of the disease
Osteoporosis refers to chronic pathologies characterized by a decrease in bone density. Because of this, the bones become brittle and less elastic, increasing the risk of fracture. The structure of bone tissue depends on the degree of mineralization. The main components that ensure the integrity of bones are phosphorus and calcium. Their deficiency in the body makes the bones porous, while the cells lose their ability to normal regeneration.
There are two forms of the disease: primary and secondary. Primary osteoporosis develops as a result of natural age-related changes, in which there is a slowdown in biological and chemical processes in the body. The secondary form is more characteristic of men, as it is the result of concomitant pathologies or taking certain medications. The following factors can provoke the development of the disease:
- malignant tumors;
- chronic pathologies of the kidneys and liver;
- violations of metabolic processes;
- diseases of the endocrine system;
- dysfunction of the small intestine, which leads to impaired absorption of useful elements;
- violation of phosphorus-calcium metabolism;
- rickets;
- taking corticosteroids and barbiturates;
- hormone therapy;
- long-term use of anticonvulsants;
- abuse of alcohol and caffeine;
- smoking;
- poor nutrition;
- physical inactivity.
What else provokes the disease in men?
Lack of testosterone can provoke the development of the disease. There are others. A special role is played by the genetic factor, which leads to a violation of the synthesis of vitamin D and collagen, which are responsible for bone density. Hormonal disorders are among the main causes of osteoporosis in men. With a deficiency of a hormone such as testosterone and an excess of estrogen, the process of regeneration of bone tissue cells is disrupted, which slows down the recovery functions. And also the pathology becomes a consequence of taking medications that are aimed at combating rheumatoid arthritis.
Main symptoms
At the first stages of development, the disease is almost asymptomatic, while complex degenerative-dystrophic processes occur in the bone tissue. As a rule, signs of pathology appear after a fracture. Patients have pain and a feeling of stiffness in the lumbar region, spine and chest. Gradually, the disease spreads to large articular joints and the pelvis. Initially, the pain syndrome is short-lived, as the disease develops, the pain becomes permanent and increases in intensity. There is a curvature of posture, which is expressed in various forms of scoliosis and kyphosis. As the pathology progresses, bone density is catastrophically reduced, which leads to a decrease in height by several centimeters. In men, symptoms such as early gray hair and slow growth of the nail plate are noted.
If hormonal disorders are considered the root cause of the development of the disease, then signs of sexual impotence and a decrease in testicles appear.
With such a disease, men can develop hand tremors. The disease affects not only the bones, but also closely lying muscles, which leads to muscle weakness and fatigue. In the later stages of the pathology, deformational changes in the structure of the fingers and toes are noted, which are accompanied by the formation of bone growths. Because of this, habitual mobility is disturbed in the limbs. The patient has gait changes and lameness. When the fingers of the upper extremities are affected, an uncontrolled tremor appears.
Diagnosis of osteoporosis in men
To diagnose osteoporosis, the doctor collects a complete history of complaints, comorbidities, and previous fractures. Next, an external examination of all structural units of the musculoskeletal system is carried out. If you suspect a decrease in testosterone levels, a man takes an analysis for hormones. A number of clinical trials are scheduled:
- Radiography. Determines the severity of degenerative-dystrophic disorders in bone tissue. Sets the degree of deformation changes.
- General and biochemical analysis of blood. Contribute to the determination of the quantitative ratio of vital elements.
- MRI and CT. Diagnose structural changes in the bones, even in the early stages of the disease.
- biochemical marker. Used to determine the level of bone mineralization.
The prevalence of osteoporosis is alarming. It turns out that this disease, identified in 1941 by the World Health Organization as an independent nosological form, is currently included in the group of major diseases that lead a person to disability or death. It includes cardiovascular, oncological pathologies and diabetes mellitus. The fourth position in the series is occupied by osteoporosis, literally meaning porous bones. The danger of this disease lies in the fact that it does not make itself felt for too long. Then the question is appropriate, which characteristic symptoms of osteoporosis must be paid attention to.
What is osteoporosis
The human bone according to the type of structure is compact and spongy. Compact bone tissue has a dense solid structure due to small plates concentrated on it. The outer side of all long tubular bones, such as the tibia and fibula, as well as the bones of the ulna and shoulder joint, are covered with the thickest layer of bone plates.
The tissue of the spongy structure consists of bone plates located at an angle to each other and forming cells. It is due to this structure that it has a porous structure.
In healthy bone, the angle of the cancellous tissue plates is small, so the pores have a small diameter. With osteoporosis, the thickness of spongy bone tissue decreases, the bone plates gradually become thinner, and over time may completely disappear. And since, thanks to the spongy substance, the bone can withstand physical stress, its thinning leads to bone fragility.
Thus, due to a decrease in density and a violation of the structure of the bone tissue, its gradual destruction occurs, and a person shows signs of the disease.
Signs and symptoms
What are the first signs of the disease that a person should pay attention to in order to prevent a critical decrease in bone density?
It should be noted that the disease does not have an inflammatory nature, therefore, the initial stage passes without pain, and a person first learns about osteoporosis in a medical institution after the first non-traumatic fracture, that is, without a cause in the form of an injury or fall.
Signs of osteoporosis include:
- frequent non-traumatic bone fractures (for example, shoulder or elbow joints without falls and injuries);
- deterioration in posture (stoop and tilt of the body forward);
- reduced growth (due to destruction of the spine and compression fractures);
- significant weight loss of the patient.
In the later stages of the disease, pain appears, not intense, but prolonged with localization in the lumbar or cervical spine. Also, discomfort occurs after a long walk in the area of the foot, hip and knee joint.
Systemic osteoporosis
Depending on the cause of osteoporosis, in women and men there are two types of osteoporosis - primary and secondary.
Primary
Systemic primary osteoporosis is common in the elderly. However, this group also includes women who have entered the postmenopausal period due to hormonal imbalance.
In general, systemic primary osteoporosis has four forms. This classification is based on the causes of the development of the disease, the main of which is age.
Forms of osteoporosis:
- up to 25 years - juvenile;
- 25-50 years - idiopathic;
- postmenopausal (in women during menopause);
- over 75 years - senial.
The main causes of primary osteoporosis are a genetic factor, lack of physical activity, unhealthy diet or poor environment.
Secondary
Systemic secondary osteoporosis is all forms of the disease that are detected against the background of any other diseases. The reasons for its appearance are mainly associated with disruption of the thyroid gland or diabetes mellitus and long-term medication.
Severe trauma is also considered as a cause of secondary osteoporosis. Systemic osteoporosis can occur without fractures, but often the course of the disease is complicated by pathological fractures.
Treatment according to the degree of the disease
Prior to the onset of clinical signs of primary or secondary osteoporosis, a person has disturbing symptoms, such as discomfort in the shoulder blades (possibly the shoulder joint), weakness in the body (feeling of muscle weakness), or severe pain in the cervical spine (possibly in the limbs and at the elbow joint).
As the disease progresses, bone density decreases, and the examination of the patient reveals the degree of osteoporosis: mild, moderate, and severe.
Each of them manifests itself in the form of symptoms:
- mild degree (first). It is characterized by a slight decrease in bone density. A person's legs hurt, and there is pain in the spine;
- moderate degree (second). The structure and density of the bone changes. A person experiences constant pain, stoop develops;
- severe degree. The bone tissue is partially or completely destroyed. The patient's posture is disturbed, there is a decrease in growth and ongoing back pain.
As doctors often say, the most effective treatment for osteoporosis is prevention. But in the case of this disease, a person notes his symptoms are far from being in the initial stage. Therefore, it is extremely important for him to know which doctor can determine the degree of the disease, and what methods of treatment will help.
Which doctor treats osteoporosis
The treatment of bone disease is always complex, so the patient may not be treated by one doctor, but by specialists of different profiles. For example, a traumatologist specializing in diseases of the musculoskeletal system. He can advise and treat the sick. And if a person has a metabolic disorder, then an endocrinologist is needed. In case of joint damage - a rheumatologist.
In the clinic where you should go for help, the patient will be seen by a general practitioner. After the initial examination, he writes out a referral for a consultation with specialists. And only after finding out the cause of the disease, the doctor decides which specialist will continue to treat the patient.
As practice shows, a doctor can deal with bone pathology: a neurologist, an osteopath or a chiropractor.
The need to involve such specialists is usually associated with compression fractures (due to the peculiarities of their localization sites).
Osteoporosis in older women
Osteoporosis in older women is associated with a decrease in the amount of the hormone estrogen, which is affected by the natural aging of the body. As a result, the bones become brittle, and the risk of fractures of the femoral neck, wrist and ulna, or microfractures and fractures of the spine increases.
Symptoms of bone disease in older women are stoop, kyphosis, a decrease in height by 10-15 cm, gait disturbance, back pain (due to developing spinal deformity).
Symptoms of postmenopausal osteoporosis
In a healthy body, old cells are constantly dying and new ones are being formed. The same processes take place in bone tissues. In women who have entered the postmenopausal period, loss of bone mass of a spongy structure inevitably occurs. And, as a result, obvious symptoms of osteoporosis can appear - fractures (often of the shoulder or elbow joint). The most dangerous for women of this age is a hip fracture.
Between the onset of the disease and the first symptoms that characterize postmenopausal osteoporosis in women, it can take 10 years.
Its manifestations in women are expressed in pain in the lumbar and thoracic region, deterioration in posture and limitation in the movement of the vertebrae.
Osteoporosis in men
Osteoporosis in men is less common than in the female half of the population. And the reasons for its occurrence in men are not so obvious. It is likely that the hormone testosterone, produced in them until old age, allows you to maintain bone mass. That is, the bones in men remain healthy.
Although the risk of the disease remains, especially when the hormone is not produced enough. In 50% of men, a decrease in its level is caused by reasons associated with alcohol abuse.
The manifestation of the disease in men is expressed by common symptoms: pain in the back and cervical area, kyphosis (stoop), compression fractures of the spine (in men there is a decrease in height), bone fractures in the leg, ribs, as well as shoulder, elbow, hip joints (in men less frequently than women).
To conduct an examination, the patient is sent for hardware diagnostics, and necessarily for a blood test. In the presence of osteoporosis in men, a change in the level of androgens in the blood is noted.
It is very sad, but the disease destroys the bones of not only older people, but also children. The fact is that in adolescents or children, the growth of bones in length is due to cartilage tissue, and the growth in width is due to the development of bone tissue.
Symptoms of the initial stage of the disease in children are often absent. But as it develops, they may complain of pain in the spine. In addition, children experience rapid fatigue (when sitting or standing).
The first manifestations of osteoporosis in children: dry skin, muscle cramps (at night), deterioration of hair, nails, pain in the knee, hip or shoulder joint.
Symptoms of the disease in children may subside or worsen, as their emotional state is not yet stable. Often, children have aching pain in the thoracic region, which usually disappears if the child sits down or lies down.
Most often, this disease is diagnosed in children in the first year of life, from 2.5 to 3.5 years, in the period from 6 to 7 years, and another stage is children from 12 years of age.
If children have fractures, especially for no reason, in the places of the shoulder, elbow joint or femoral neck, then this is a reason to consult a doctor for the treatment of osteoporosis.
Treatment of osteoporosis of the joints
Bones are made up of osteoblasts (bone-forming cells). If 30% of them are affected by osteoporosis, a person begins to feel pain.
Symptoms that accompany osteoporosis of the hip joint: aching back pain (for no reason), changes in posture, scoliosis, stoop, decreased height.
The defeat of the disease of the hip joint requires thoughtful, diverse treatment from specialists. Often, physicians of different profiles are involved in the treatment of a patient with osteoporosis of the hip joint.
The treatment process should include the therapy of the disease that caused osteoporosis of the hip joint, a symptomatic method (used to prevent the development of primary and secondary osteoporosis) and a pathogenetic complex.
Drug treatment of the hip joint is aimed at eliminating the symptoms and stopping the development of the disease.
The patient should take antiresorptive, anabolic (possibly hormonal) drugs. It is also necessary to take calcium supplements with vitamin D (for better absorption).
elbow joint
The disease gradually destroys the bones of the elbow joint, causing them to become brittle.
Symptoms of osteoporosis of the elbow joint: acute or chronic bone pain, numbness and impaired motor functions. With the development of the disease, there is a significant decrease in the thickness of the elbow or shoulder joint, which increases the risk of fractures.
The regeneration of the bone of the joint usually requires a long period, so a person can lose his ability to work for a long time.
Knee
Due to osteoporosis of the knee joint, its large cartilage and tissues wear out and deform. As a result, a person experiences pain in the knee area during any physical activity. Although the main cause of the disease is associated with natural aging, and more often knee diseases occur in older people, osteoporosis of the knee is diagnosed even in children.
The main symptoms of osteoporosis of the knee joint:
At stage I:
- discomfort in the knee (after walking or standing);
- stiffness of movement due to pain;
- narrowing of the joint space.
At stage II:
- severe pain (morning or evening);
- crunch in the joint;
- visible deformity of the knee joint;
- the appearance of complications articular mouse.
At stage III:
- an increase in the size of the joint;
- pain (constant, excruciating);
- the shape of the legs is bent;
- muscles atrophy;
- audible crunch in the knee when moving;
- decrease in growth.
Traditional methods of treatment of the knee joint recommend that patients take painkillers, anti-inflammatory and hormonal drugs, as well as chondoprotectors. It is also necessary to use intra-articular injections. The use of plaster (pressure) bandages and massage, acupuncture, and therapeutic exercises will also help a quick recovery.
Osteoporosis of the spine
Osteoporosis of the lumbar or thoracic region is manifested by symptoms not only in the spine. It can hook on any organs. This is reflected in his characteristic signs, such as the fact that the bones hurt, a tendency to fractures has appeared. Feeling of pain in the lumbar region of the back (from chest osteoporosis, the pain is aggravated by coughing), brittleness of nails, teeth and hair loss. Impaired sensation of the extremities and stoop.
Before treating a bone disease of the lumbar spine, the patient is given an X-ray examination, and bone density is also measured.
The vertebrae of the cervical spine are more massive and denser than those of its other departments, such as the thoracic and lumbar.
The manifestation of the pathology of the cervical bone tissue for different stages of the development of the disease:
- with a mild degree of damage, patients note the appearance of pain in the neck, accompanying a static position (in a car, at a computer), weakness and cramps in the limbs, tachycardia (palpitations, possibly due to osteoporosis of the thoracic spine), as well as early gray hair, bad teeth and nails;
- a moderate degree is manifested by constant pain (dull) in the cervical region and headaches (due to increased blood pressure);
- in a severe stage, growth decreases and pain is felt when palpating the cervical vertebrae.
Osteoporosis of the ribs and feet
The discomfort that is felt in the chest, or rather, its paired arcuate bones, is the pain in the ribs.
Symptoms of osteoporosis of the ribs
Soreness of the ribs can be caused by: cartilaginous and bone tissue, muscles and fascia (around the ribs), nerve endings (between the ribs).
It should be noted that pain in the ribs is so similar to heart pain (acute, aching or pulling) that only a specialist neurologist, surgeon, traumatologist or orthopedist can make an accurate diagnosis.
Pain in the ribs due to osteoporosis is associated with a change in the structure of bone tissue. If the nature of the pain is strong and sharp, this may indicate a pathological fracture of the ribs. Since the bone tissue affected by osteoporosis becomes very fragile, even a sharp turn of the body can lead to fractures of the ribs. When the bones of the ribs are destroyed, the integrity of the spine and the entire skeletal system of a person is violated.
Treatment of osteoporosis of the foot
The normal performance of a person depends on how healthy his ankle joint is. Due to the heavy loads on the feet, there is always a risk of ankle injuries, and with osteoporosis, the likelihood of foot fractures increases several times.
Determining when the bones of the foot began to thin is very difficult. But the first suspicion of osteoporosis of the foot may occur if the fracture occurred with a slight load on the ankle joint.
If the bones of the foot hurt when you press them, then these are also signs of the development of pathology. Over time, the patient notices swelling of the foot, redness, it becomes difficult for him to put on shoes. A severe form of the disease is characterized by joint deformity.
It will take a long time to treat damage to the bones of the foot with osteoporosis, following all the doctor's instructions.
With severe pain, the patient is prescribed drugs - analgesics. To prevent loss of bone density in the foot, the patient should take bisphosphonates and calcium and vitamin D supplements. Doctors recommend wearing orthopedic shoes to relieve excess stress on the foot.
During the treatment of foot disease, physical exertion on the ankle joint should be avoided.
Folk medicine
Many people know the beneficial effect of mumiyo on bones. And the choice of it for treatment at home justifies itself. Such a medicine should be taken in courses: before taking, a mumiyo ball (the size of a match head) is dissolved in water (70 ml), 20 minutes before meals (breakfast and dinner). Course treatment with folk remedies can be repeated. In the case of mumiyo, it is taken for 20 days with a break of 5-7 days. Then you can resume the reception.
Effective folk remedies that help restore the level of calcium in bone tissue are home-made preparations based on eggshells: peel the eggs from the film and boil. Then crush the shell to a powder state. Take the powder on the tip of a knife, add 2-3 drops of lemon juice. Calcium supplements should be taken in the evening, as this is the time when calcium is best absorbed.
Clay is a source of silicon. Prevention and treatment with such folk remedies always brings results. To prepare clay water, you need to dilute a spoonful of clay (dessert) in 150 ml of water. You need to drink the remedy on an empty stomach, 1/3 cup 2-3 times a day. The patient should be treated for 3 weeks, then take a break for 7 days and repeat the course.
Conclusion
It is impossible to cure osteoporosis with today's medical methods. A patient with such a diagnosis will have a long process of complex therapy, which includes drug treatment, exercise therapy and diet. These measures will help stop the destruction of bones, and enable a person to learn to live with this disease.
2015-12-18
How to treat osteoporosis of the bones
Osteoporosis of bones is a very common chronic systemic metabolic disease of the skeleton, which is characterized by a decrease in bone mass and its pathological restructuring. This leads to increased bone fragility and the development of pathological fractures in patients with osteoporosis. The most common osteoporotic compression fractures of the vertebrae and femoral neck.
Osteoporosis is called a silent epidemic, as pathology does not make itself felt for a long time. The first symptoms are often fractures, very rarely patients complain of bone pain. Osteoporosis of the joints and bones mainly affects the elderly and is the 4th leading cause of disability and death. Therefore, the treatment of osteoporosis and the prevention of its consequences is a priority task of modern gerontology and geriatrics.
Health food
Can osteoporosis be cured without a special diet? Definitely not! The main goal of therapeutic nutrition is to ensure that the necessary amount of calcium and vitamin D is supplied to the body with food.
- It is necessary to increase the amount of foods fortified with calcium and vitamin D in the diet (leafy vegetables, broccoli, sardines, nuts, salmon, oats, legumes, dairy products, dried fruits, seafood).
- Include in the diet foods rich in sulfur (onions, garlic, eggs), which is also essential for bone strength.
- Enrich your diet with foods with a high content of such useful trace elements as magnesium, silicon, zinc, phosphorus, copper, vitamins A, E, C, K.
- Limit the use of foods that interfere with the absorption and absorption of calcium (citrus fruits, tomatoes, alcoholic beverages, table salt, sweets, animal proteins).
Dietary nutrition in osteoporosis refers not only to methods of treatment, but also to prevention. Therefore, the described principles of the diet are suitable for everyone who is at risk and wants to avoid such a fate.
Therapeutic exercises for osteoporosis
Constant and adequate motor activity is shown to every person, regardless of age, and in patients with osteoporosis, physiotherapy exercises should become a mandatory habit. Regular physical activity at a young age helps to strengthen bones and increase their mineral density, in adulthood, training helps maintain the desired level of bone mass, and in old age, physical exercise, along with adequate intake of calcium and vitamin D, can slow down the development of osteoporosis and avoid its consequences.
Physical activity should not last less than 30 minutes and 5 times a week. Only then will they be effective. The best types of exercise are walking, aerobics, dancing, gymnastics.
Medical treatment of osteoporosis
What doctor treats osteoporosis? Several specialists can deal with this problem: a rheumatologist, a therapist, a gynecologist, an endocrinologist, an orthopedic traumatologist, a family doctor. Unfortunately, but often effective treatment of osteoporosis without drugs is not possible. Modern drug therapy is based on the principles of evidence-based medicine, that is, priority is given to those drugs that have proven their effectiveness in large-scale clinical trials.
All drugs for the treatment of osteoporosis can be divided into three groups:
- Drugs that affect both the process of bone formation and the resorption of bone tissue.
- Medications that interfere with bone resorption.
- Medicines that promote bone formation.
First group
These include calcium preparations, vitamin D and its active metabolites. These are the basic drugs that are used to treat osteoporosis in men and women in every case, regardless of the use of other medications.
The most effective combination is 1200 mg of calcium and 800 IU of vitamin D3 per day. It is important to say that such therapy is recommended for all people over the age of 60 years.
Also in this group of medicines are flavone compounds (Osteokhin). They are prescribed in long courses of 200 mg 3 times a day. They inhibit bone resorption, promote its mineralization, have an analgesic effect, and therefore are well suited to patients with bone pain. They are prescribed in addition to calcium and vitamin D preparations. Osteokhin is also effective in combination with calcitonin and estrogen, but the result of treatment develops slowly.
The first group of medicines also includes the ossein-hydroxyapatite complex, which is a substance of natural origin (ossein is a protein, and hydroxyapatite is a mineral complex of calcium and phosphorus). The drug has practically no contraindications and can be used even in pregnant and lactating mothers.
Second group
Treatment for osteoporosis often requires the use of more complex drugs, especially in the case of menopausal forms of the disease. It is then that anti-resorbents are prescribed - drugs that inhibit the resorption of bone tissue.
This includes hormone replacement therapy with estrogen in menopausal women, and the earlier such therapy is started, the better the protective effect it will have. How to treat osteoporosis with estrogens, such a specialist as an endocrinologist-gynecologist will tell in detail. Substitution therapy has many contraindications and side effects, so the decision on its need is made only by an experienced specialist after a detailed examination of the woman.
The second group includes calcitonin. It is a hormone secreted by the thyroid gland. Its main function is to inhibit bone resorption and thus lower the concentration of calcium in the blood. Today, there are synthetic analogues of calcitonin, which are used as drugs. It is often prescribed to women who are contraindicated in hormone replacement therapy.
Bisphosphonates inhibit the cells that resorb bone, the osteoclasts. Thus, they cause a decrease in the rate of bone tissue demineralization and can be used in osteoporosis.
Strontium preparations. The metabolism of strontium in the human body is very similar to that of calcium. This microelement accumulates in the bones, increasing their strength, and also prevents demineralization, therefore it is used to treat osteoporosis.
Third group
In search of how to cure osteoporosis with medicines, specialists began to use drugs that can activate the process of forming new bone tissue. This group includes:
- fluorine salts,
- growth hormone,
- parathyroid hormone.
It is important to emphasize that today the use of drugs from the group is somewhat limited, since the therapy is associated with a large number of side effects. Apply such treatment only in cases of severe course and forms of osteoporosis resistant to all other drugs.
Often people use a variety of homeopathy and folk remedies to treat osteoporosis at home. It should be said that this, in most cases, will not harm, but there is no evidence of the effectiveness of such techniques. Therefore, alternative therapies can be used, but only as an addition to the main treatment, diet and proper lifestyle.
Lifestyle Modification
Treatment and prevention of osteoporosis is impossible without lifestyle changes and getting rid of risk factors for this disease and its complications. Medication or other treatments for osteoporosis are important and should be complemented by lifestyle modifications. Key recommendations from the World Health Organization for patients at risk of osteoporotic fractures:
- maintaining an active lifestyle;
- sufficient exposure to the sun and fresh air;
- quitting smoking and excessive alcohol consumption;
- compliance with individual norms for the content of calcium and vitamin D in food, and, if necessary, to compensate for the deficiency with medicines;
- maintain a body mass index of at least 19 kg / m2, since low body weight is a serious risk of fractures;
- maintain a healthy sleep pattern;
- regularly visit sea resorts and sanatoriums.
With a well-designed treatment program that will take into account all the individual characteristics of the patient, the cause of impaired bone mineralization and risk factors, as well as with adequate preventive measures, the progress of osteoporosis can be significantly slowed down, and sometimes even stopped.
It is important to remember that, despite a long asymptomatic course, osteoporosis ranks 4th among all causes of disability and death in the world. Therefore, you need to be attentive to your health and seek medical help in time.
Bone densitometry: what is this study, how is it performed and where can it be done
Bone densitometry is a modern diagnostic method, the purpose of which is to determine the density of bone tissues and their structure.
Changes in these two characteristics make it possible to identify osteoporosis - a common and dangerous disease - at various stages of its development and take timely measures to treat the disease.
What is the procedure
Carrying out a densitometric study is an assessment of the condition of the bones according to several parameters:
The procedure does not require any traumatic intervention (injections, skin incisions, etc.): an accurate assessment of the state of the bone tissue can be obtained using analyzing equipment and special programs that process the obtained images.
How is Densitometry Performed?
In modern medical practice, two types of densitometric studies are used:
- X-ray densitometry of bones. In this case, bone density is assessed after obtaining x-rays of the bones (radial, femoral neck, lumbar vertebrae, etc.). A plain radiograph can also detect bone loss, but only if it is more than 20%. X-ray densitometry uses computer equipment to process the image and obtain information about the presence of osteoporosis even at the initial stage of the disease.
- Ultrasonic bone densitometry (echodensitometry). When it is carried out, the ability of ultrasound to pass through bone tissue at a speed that varies depending on their density is used. During the study, an ultrasonic wave is sent to any part of the skeleton, which returns to a special sensor and is analyzed by ultrasound equipment.
Bone densitometry is absolutely painless and, depending on the chosen diagnostic method, takes from 10 to 30 minutes.
The results obtained during densitometry are compared with the "gold standard" of bone density in several indices. The difference between the standard tissue characteristics and the obtained data determines the presence of osteoporosis and its degree.
When is densitometry performed?
A densitometric study is recommended in any situation that directly or indirectly indicates a possible decrease in bone density. The presence of one or more of the following factors puts a person at increased risk for developing osteoporosis and requires regular monitoring of the condition of the bones:
Special attention to bone density is required in cases where a person has fractures that are not associated with serious injuries (fracture of the toes when accidentally hitting furniture, compression fractures of the spine when lifting minor weights, etc.).
Weight loss while maintaining the usual diet can also be indirect evidence of a decrease in bone tissue density.
X-ray examination refers to more accurate methods for assessing the state of bone tissue, as it allows you to determine not only the mineralization of bones, but also their structure. At the same time, the regularity of the procedure should not exceed 1-2 times a year, which significantly reduces the possibilities of X-ray densitometry in monitoring the effectiveness of treatment.
Ultrasound densitometry is recommended as a preliminary study method when the patient has indirect signs of osteoporosis or is at risk. The advantage of this method is its complete harmlessness, which allows examination of the most vulnerable groups of the population - children and pregnant women.
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Echodensitometry is also indicated to control the treatment process in cases where the X-ray method of examination is contraindicated or unavailable for any reason.
Study preparation
No special measures are required to prepare for densitometry. But still, you need to follow some recommendations:
Before the densitometry, the doctor will ask you to remove all jewelry and accessories (watches, belts, etc.) that are in the study area and take a comfortable position on the couch or on a special podium.
Contraindications
In all young people, bone mass reaches its maximum by the age of twenty. Their density and quality characteristics will depend on nutrition, heredity, lifestyle, and the work of the endocrine glands. Malnutrition and low calcium intake during childhood and adolescence, and low testosterone levels in adults are the main cause of low bone density in men.
Rheumatoid arthritis contributes to the development of osteoporosis due to the nature of the therapy used.
The main content of bone tissue is calcium and phosphorus. They give the bones hardness and density. Violation of metabolic processes and diseases of the endocrine system lead to insufficient absorption of minerals from the intestines. This cause leads to the development of osteoporosis. The lack of calcium and phosphorus can be associated with any pathologies that develop in the body.
Osteoporosis is a decrease in bone density, which leads to a decrease in their strength, which increases the likelihood of fractures. The disease proceeds almost imperceptibly, so you need to know all the factors that lead to its development. Prevention and timely treatment of osteoporosis will help strengthen bones and stop the course of the disease. The development of osteoporosis in men occurs due to a lack of calcium in the body. There are many reasons that contribute to a decrease in bone mineralization.
When can men develop osteoporosis?
Most often, the disease affects people with unfavorable heredity. Osteoporosis can be primary and secondary. Primary osteoporosis most often develops in the elderly and senile age due to the general extinction of all biochemical processes in the human body.
In men, secondary osteoporosis is most often observed, the development of which is associated with the course of some kind of disease and the use of drugs that wash calcium out of the body or block its absorption from the intestines. This can be facilitated by:
- chronic renal and hepatic insufficiency;
- hyperthyroidism;
- rickets;
- malabsorption;
- development of malignant neoplasms;
- rheumatoid arthritis;
- hormonal disorders;
- taking corticosteroids;
- abuse of barbiturates;
- the use of anticonvulsants;
- continuous use of thyroid hormone preparations;
- coffee abuse;
- excessive alcohol consumption and smoking.
Genetic factors play an important role in the development of the disease. They determine bone density, the synthesis of vitamin D and some types of collagen in the body. All these processes are important for the proper formation of the bone structure. Genetic disorders lead to a deficiency of estrogen receptors and leptins.
Osteoporosis and hypogonadism are linked by a cause-and-effect relationship. An excess of estrogens and a deficiency of testosterone leads to a negative impact on the process of natural bone tissue renewal. Restriction of testosterone production due to any reason leads to accelerated destruction of the bone structure with delayed restoration.
Rheumatoid arthritis and osteoporosis are also inseparable. Decalcification begins to develop following treatment with glucocorticoids. In this disease, all men have low bone mineral density and permanent bone loss. Its rarefaction affects both spongy and compact bone, and this does not depend on the age of the patient. The longer a person has rheumatoid arthritis, the more severe the symptoms of osteoporosis become.
Symptoms of osteoporosis
Symptoms of osteoporosis include changes in gait, reduced height, and curvature of the thoracic spine. With hormonal causes, the development of osteoporosis may indicate sexual dysfunction and a change in the size of the testicles.
Symptoms that should alert a man are the appearance of heaviness in the interscapular region and general muscle weakness. After that, pain appears in the lumbar, sacral spine and ankle. At first, the pain is not strong and is periodic. Then it intensifies. This is due to the deformation of several adjacent vertebrae, which compress the nerve fibers. Then the pain becomes strong and constant.
Osteoporosis in men is constantly progressing, and the bone tissue becomes more and more porous. There is severe back pain, which is of a long-term nature. This sign indicates the deformation of several adjacent vertebrae, which compress the nerve fibers.
Pain and bone deformity are symptoms that appear at that stage of the disease, when the bones of the skeleton begin to break from the slightest load, which had previously been commonplace. Men ignore the manifestation of these symptoms until a fracture occurs, which leads to disability. Rheumatoid arthritis has similar pain symptoms, and patients attribute them to the underlying disease.
Diagnosis of osteoporosis in men
Rheumatologists conduct early diagnostics in their patients, identifying systemic disorders of bone mineral density. Diagnostic studies are carried out to study the state of the spongy and compact bone substance. When diagnosing osteoporosis, the doctor excludes osteoarticular tuberculosis and the development of oncological diseases that make the bones brittle.
For this, a study of bone tissue is carried out, which is taken for analysis using the trepanobiopsy method. The general and biochemical analysis of blood with osteoporosis remains normal, and with tuberculosis in the general analysis of blood there is an increased number of leukocytes. The erythrocyte sedimentation rate increases. In a biochemical blood test, an increase in C-reactive protein is observed.
Examination of the patient with the help of scintigraphy, computed or magnetic resonance imaging, X-ray examination allows to determine the development of osteoporosis with a sufficiently high accuracy and distinguish it from other diseases.
Often in men, the development of osteoporosis is diagnosed after a fracture of the spine or hip. Osteoporosis should be diagnosed if a man has:
- age over 70;
- fractures not associated with trauma;
- long-term use of glucocorticoids;
- manifestation of signs of osteopenia during x-ray examination;
- hypogonadism;
- hyperparathyroidism;
- rheumatoid arthritis;
- the presence of other factors that can lead to impaired bone metabolism.
Treatment of osteoporosis
Treat this disease with medications that improve bone mineral density. These include calcium and phosphorus preparations, vitamins A, B, C, E, D. A diet rich in organic calcium and phosphorus helps maintain bone health at the right level.
The choice of therapy for osteoporosis depends on what symptoms are observed, and treatment depends on the reasons for which it began to develop. If there is a history of diseases of the endocrine system or rheumatoid arthritis, glucocorticoid therapy is prescribed. To it is added therapy aimed at the treatment of osteoporosis. The use of calcium and vitamin D supplements in combination with bisphosphonates prevents the development of symptoms of osteoporosis in the presence of these diseases.
If a person takes anticonvulsants, then in addition to calcium and vitamin D, he is prescribed bisphosphonates.
Low testosterone levels are treated with hormonal preparations that contain this androgen.
The use of hormone replacement therapy in men improves bone mass and strengthens it. Stopping smoking and alcohol, especially beer, reduces the risk of osteoporosis, because these substances strongly affect the endocrine system and disrupt its work.
Prevention of osteoporosis is very important for men, since the consequences of the resulting fractures of the femur in men are much more severe than in women. Hospital mortality after hip fractures in men is 2 times higher. Fatal cases during the first year after a fracture of large bones and the spine occur in half of the men, while women die from it in two cases out of ten. Mortality from osteoporosis is due to the appearance of concomitant diseases: bedsores, gangrene, sepsis. More than half of men who have suffered hip fractures become disabled. They cannot move independently and are in severe pain.
In order for bones to be dense, it is necessary to ensure the intake of a sufficient amount of easily digestible calcium with vitamin D. at other times of the year. This can achieve the regulation of the mineral content in the bones and their normal density. Timely visits to the doctor and preventive examinations will help to recognize the disease in time and prevent its development.
According to the World Health Organization, about 35% of fractures in women and 20% in men are due to osteoporosis. In old age, it is the leading cause of such injuries.
Among all diseases leading to disability and death, osteoporosis ranks fourth (after cancer, cardiovascular diseases, etc.). Statistical data speaks about its social significance:
- 10% of the total population suffers from osteoporosis;
- characteristic fractures were found in 6% of people;
- 3 million compression fractures of the vertebral bodies are recorded annually, including 2 million in women and 1 in men;
- among people older than 50 years, the incidence of osteoporosis is 28%;
- Every minute in Russia, 17 fractures of the bones of the lower extremities, 5 fractures of the vertebral bodies are recorded, and every 5 minutes - of the femoral neck.
What is osteoporosis?
Osteoporosis (lat. osteoporosis)- a disease that is manifested by reduced plasticity and strength of bones.
It is based on the predominance of destruction processes over the formation of bone tissue.
Osteoporosis in men is a dangerous disease that leads to changes in bone density. Pathology refers to age-related diseases and is diagnosed in people older than 50-60 years. Osteoporosis is dangerous complications, which include fracture of the femoral neck. Why osteoporosis occurs in men, how to recognize it and what methods will help to cope with the disease - more on that.
Osteoporosis is quite widespread among the stronger sex; in Russia, among men over 50 years old, about a quarter have signs of a decrease in bone strength
According to statistics, women experience osteoporosis three times more often than men. The reason for this selectivity of the disease is that the bone tissue of the female skeleton itself is much less dense. However, this does not mean that men are completely immune from pathologies such as osteoporosis.
The risk group for the development of this pathology includes representatives of the stronger sex with overweight and a sedentary lifestyle. Risk factors:
- age over 65;
- bad habits;
- hormonal disorders;
- metabolic disorders.
Age changes
Osteoporosis is an age-related disease. Its development is due to changes that occur in the body as we age. First of all, this refers to the metabolic rate. With age, all processes occurring in the body gradually slow down. As a result, the rate of regeneration worsens, it takes more time to restore bones than at a young age. Against this background, the risk of developing osteoporosis increases many times, especially under the influence of predisposing factors.
Hormonal disorders
One of the first factors causing the development of senile changes in the structure of bone tissue is the cessation of the production of sex hormones. In men, this is less pronounced than in women, but androgen deficiency, the development of which is associated with the presence of chronic diseases of the genital organs, increases the risk of osteoporosis.
The cause of osteoporosis in men 40 years old can be a violation of testosterone production. This hormone has an important function in the formation of muscle and bone tissue, so its deficiency leads to a number of changes in the body in addition to reproductive health.
After 50 years, the lack of testosterone appears more clearly. If a man has any chronic diseases, as well as a lack of calcium, the risk of developing osteoporosis is very high.
Other reasons
With age, the absorption of nutrients that enter the body with food is disturbed. This can lead to calcium and phosphorus deficiencies. The lack of these elements entails demineralization of bones and a change in their density.
The development of osteoporosis in older men may be due to the presence of chronic diseases such as diabetes, gout, heart failure. Causes of osteoporosis in men at a young age are hypocalcemia, metabolic disorders and hypogonadism.
The causes of osteoporosis are made up of heredity and adverse environmental conditions.
Symptoms of the disease
Symptoms and treatment of osteoporosis in men depend on several factors:
- the severity of changes in bone tissue;
- localization of the lesion;
- the prevalence of the pathological process;
- age.
Despite the fact that osteoporosis is systemic, due to the nature of the load, some bones and joints are involved in the pathological process to a greater extent. As a rule, the localization of severe lesions is often due to the professional activity of a person. If a man lifts weights daily, the symptoms of osteoporosis will spread to a greater extent to the lower spine. With constant running and load on the knees, the pathological process will be expressed in the area of the knee joints.
Symptoms of osteoporosis in men depend on the severity of changes in bone density. In the initial stages of the pathological process, osteoporosis in young and elderly men has practically no symptoms. Perhaps the periodic appearance of moderate pain in the joints of the lower extremities with a strong load.
With severe osteoporosis in men, the following changes are observed:
- decrease in growth;
- curvature of the spine (scoliosis, kyphosis, stoop);
- pain in the lumbar region;
- foot and ankle pain;
- knee discomfort.
Features of osteoporosis in men - a moderately severe pain syndrome. Discomfort is aching episodic and goes away on its own. This complicates the treatment, since the patient simply does not see the point in going to the doctor, correlating periodic aching pains with fatigue due to stress.
Frequent fractures with minor injuries are a typical symptom of osteoporosis in old age and in men at a young age.
Manifestations and signs of osteoporosis are especially noticeable in injuries and bruises. Any damage to the joints takes a very long time. In the case of fractures, it may be necessary to take special drugs to accelerate the restoration of bone tissue, since regeneration against the background of osteoporosis is greatly slowed down.
As a rule, the older the man, the more pronounced the changes that occur against the background of pathology. While young patients complain only of minor pain during exertion, older patients notice a deterioration in posture and changes in gait due to bone pain.
Why is osteoporosis dangerous?
This is a dangerous disease with slow progression, which must be treated in a timely manner. Otherwise, the disease can cause the following changes and complications:
- curvature of the spinal column;
- frequent fractures;
- injuries of the intervertebral discs and vertebrae;
- hip fracture;
- deterioration of the blood supply to the brain;
- disruption of the internal organs.
Due to changes in bone density, there is a violation of posture. The development of kyphosis is potentially dangerous, there is a malfunction of the internal organs due to their displacement.
A hip fracture is especially dangerous for older patients. Such an injury leads to disability.
Diagnostics
The following methods are used to make a diagnosis:
- radiography (informative with a decrease in bone density by 25% or more);
- Ultrasound (reveals changes with a decrease in density by 5% or more);
- densitometry (the method is informative at the initial stages of the disease).
The problem is that few men go to the doctor when they feel discomfort. In the vast majority of cases, osteoporosis is detected incidentally, during examination due to injuries or fractures.
Treatment
Alternative treatment of osteoporosis, perhaps, is one of the most ancient, but by no means forgotten healing areas.
In the treatment of osteoporosis in men, the following methods are followed:
- medicines to restore bone density;
- Exercise therapy and physiotherapy to normalize metabolic processes and improve regeneration;
- diet to replenish calcium losses;
- massage to prevent further progression of the disease;
- folk remedies as an auxiliary method.
First, it is necessary to identify the causes of the development and occurrence of osteoporosis in men. In the case when the disease develops against the background of existing chronic diseases, one should undergo a comprehensive treatment of the pathology that led to the development of osteoporosis.
Drug therapy is carried out using the following groups of drugs and medicines:
- calcium and vitamin D;
- bisphosphonates;
- non-steroidal anti-inflammatory drugs;
- hormones.
Calcium supplements are the mainstream in the treatment of osteoporosis. Such drugs can increase bone density and strengthen bones to prevent fractures. Bisphosphonates reduce the rate of spread of the pathological process. The drugs of this group allow men to maintain their working capacity and reduce the risk of fractures.
Non-steroidal anti-inflammatory drugs (Diclofenac, Ibuprofen) are used to relieve pain. Hormones are used only when indicated (androgen deficiency).
Radon baths, mud therapy, magnetotherapy and ozone therapy are shown to improve bone tissue regeneration. Therapeutic exercise and massage allow you to normalize the distribution of the load on the spine to reduce pain when walking.
Folk remedies for osteoporosis are ineffective. A decoction of comfrey is used in addition to drug therapy in order to improve the absorption of calcium.
For hip fractures or severe knee injuries, joint replacement surgery may be indicated. The intervention is associated with a number of risks, therefore, it is carried out only in exceptional cases.
How best to treat osteoporosis in men, you need to ask your doctor, as in each case, different drugs may be required, depending on the causes of the disease.
Preventive measures
Knowing why men after 40 years old can develop osteoporosis, you should figure out how to prevent the appearance of this pathology.
The main methods of preventing osteoporosis in men:
- balanced diet;
- rejection of bad habits;
- regular moderate physical activity;
- annual survey;
- timely treatment of chronic diseases.
Men over 40 years of age should definitely be examined by a urologist every year. This is because a sharp decrease in testosterone levels can adversely affect bone density, so everything should be identified and corrected in a timely manner.
