What is osteoporosis (bone loss)?

Osteoporosis, often also known as bone loss, is one of the most common age-related diseases. It is a metabolic disease of the skeleton where the bones lose their strength. They become porous. Bone fractures can occur as a result of the illness – especially in the vertebrae, femoral neck and forearm.

Woman suffers from bone loss due to osteoporosis

A quick look at the topic:

Chronic bone illness: It is possible to cure osteoporosis?

People’s life expectancy is also increasing steadily in Germany. This is precisely why healthcare and early detection are crucial. Although the cause of osteoporosis cannot be cured, the symptoms are very treatable. The earlier the diagnosis is known, the better the prognosis of a good quality of life into old age.

Various measures such as exercise and a healthy diet also help to prevent osteoporosis. 

Osteoporosis causes and risk factors – how does bone loss develop?

We see bones as rigid, solid structures that hardly change. In fact, however, a healthy body is constantly converting bone substance. Hormones, minerals, vitamins and messenger substances such as hormones significantly control these “conversion measures”. Up to approximately the age of 30 the bone mass is predominantly building up. If more bone mass is broken down than is newly formed, bones lose density and thus strength.

This is the point where the gradual process of osteoporosis can begin. The consequences over the course of the illness: The bones become more susceptible to fractures. Osteoporosis is generally divided into two different forms, primary and secondary osteoporosis.

Primary osteoporosis

Approximately 95 percent of all bone loss disorders are primary osteoporosis, which is once again divided into two types.

  • Type I osteoporosis: Type I osteoporosis often occurs in postmenopausal women (postmenopausal osteoporosis). The vertebrae are particularly susceptible to fractures.
  • Type II osteoporosis: In the case of type II osteoporosis, the first bone fracture typically occurs after the age of 70 (senile osteoporosis). In addition to the vertebrae, long bones of the thigh and arm are also affected.

Risk factors for the development of primary osteoporosis include, among others:

 

  • Age
  • Hereditary disposition
  • Female gender, hormones (late first and early last menstrual period)
  • Inactivity
  • Long periods of bed rest
  • Being underweight
  • Low-calcium or high-phosphate diet (e.g. fast food, soft drinks)
  • Consumption of things such as alcohol, coffee and cigarettes

Secondary osteoporosis

Secondary osteoporosis occurs as a result of certain pre-existing conditions or as an undesirable side effect of certain medication.

Risk factors for the development of secondary osteoporosis include, among others:

 

  • Anti-inflammatory drugs for the treatment of asthma or rheumatism (cortisone)
  • Hyperthyroidism
  • Tumour diseases

Osteoporosis symptoms and signs

How can we detect osteoporosis? Early diagnosis is crucial in order to start therapy promptly. This can have a favourable influence on prognosis. It is also advisable to undergo preventative care examinations. The elderly in particular should be aware of their body’s signals and consult a doctor if bone loss is suspected.

The illness initially begins without any identifiable signs. The precursor of osteoporosis is called osteopenia (reduction of bone density). Osteopenia can be kept at a constant level with regular medical check-ups and treatment.

If osteoporosis does then develop, a decrease in physical height and signs of hunchback can occur accompanied by severe, chronic pain in the area of the spine or sternum. Bone fractures without recognisable causes, e.g., vertebral fractures caused by one’s own body weight, also indicate osteoporosis. If you have these symptoms, please consult your doctor as they may indicate bone loss.

Bone density measurement provides information for the diagnosis

If osteoporosis is suspected, the doctor can carry out a bone density measurement (osteodensitometry). It provides information about the condition of the bones. A DXA measurement (dual-energy X-ray absorptiometry) measurement is usually performed. During this, X-rays are used to assess the structure of the bones. The intensity of radiation is absorbed differently, according to the bone density.  The values measured during this examination can provide information about bone density:

Other methods that are available for measuring bone density include quantitative computed tomography and quantitative ultrasound.

Prophylaxis: How can osteoporosis be prevented?

There are various ways to prevent bone loss and preserve bone structure and bone mass for as long as possible. Preventive measures should also be taken by young people to minimise the risk of osteoporosis later on in life.

Important factors for healthy bones are:

  • Exercise and moderate muscle training. Specific exercises help to strengthen the various muscle groups and limit bone loss.
  • A healthy and balanced diet with sufficient vitamins, calcium and proteins.

The combination of physical activity and appropriate nutrition supports the health of bones and muscles.

Osteoporosis therapy

Alongside a calcium-rich diet (read our dietary tips for osteoporosis here) and vitamin D, the guidelines of the umbrella organisation of the Deutschsprachige Wissenschaftliche Osteologische Gesellschaften e.V. [German-speaking Scientific Osteological Associations e.V.] (DVO) also recommend: Medication to increase bone mass, regular exercise and the use of spine-straightening orthoses.4

Medication and dietary supplements for the treatment of osteoporosis

Calcium is the main constituent of the mineral bone substance. Vitamin D promotes the absorption of calcium from food and supports its incorporation into the bones. Medication such as bisphosphonates, SERMs (selective oestrogen receptor modulators) and parathyroid hormones and teriparatides can also be used. The use of painkillers can be helpful to treat pain caused by osteoporosis, which can, for instance, occur in connection with vertebral body fractures.

Sport, strength training and exercises for osteoporosis – exercises to strengthen the muscles and promote mobility

Exercise is an important part of the treatment of osteoporosis. Exercise therapy – especially strengthening the back and abdominal musculature – should be conducted consistently. 

In addition to physiotherapy exercises, some sports are particularly beneficial for patients suffering from osteoporosis:

  • Hiking
  • Nordic walking
  • Cross-country skiing
  • Swimming
  • Dancing

Strength training also trains the muscles and thus releases positive stimuli for the build-up of bone mass.

The ideal approach is to combine different kinds of sport to improve strength and endurance. More muscle mass means a better prognosis for the quality of the bone. Outdoor exercises are especially effective: As sunlight stimulates the formation of vitamin D in the skin. 

Important: Osteoporosis patients should discuss all measures in advance with their doctor.

Which doctors treat osteoporosis?

First consult your family doctor. They will refer you to an osteoporosis specialist: An orthopaedist is a specialist doctor who focuses on diagnosing and treating illnesses of the musculoskeletal system.

Therapy with medi back orthoses for osteoporosis

In the past, patients with fractures of the spine caused by osteoporosis were often immobilised by a rigid corset. This resulted in further muscle loss. It is now known that, in addition to medicinal treatment, muscle activity plays a crucial role in bone formation.

Existing fractures of the spine should be treated not only with medication, but also with aids: Back braces actively straighten up the spine using the biofeedback system.

The Spinomed back brace and the body versions Spinomed active and Spinomed active men from medi can be used when treating osteoporotic vertebral body fractures. 

The DVO recommends the use of spine-straightening orthoses.1 The explicit recommendation is based on the high quality of the clinical studies. The two studies on Spinomed and Spinomed active2, 3

 

  • show that the back and abdominal musculature are strengthened by up to 73 and 56 percent respectively,
  • a reduction of the kyphosis angle by up to 11 percent,
  • a reduction of the tendency to fluctuate by up to 25 percent,
  • a reduction of pain by up to 47 percent,
  • improved physical comfort by up to 18 percent and
  • improved pulmonary function by up to 19 percent.

The osteoporosis specialist Professor Dr Helmut W. Minne and medi have jointly developed the Spinomed orthoses (back brace). This is designed like a backpack. Ergonomically moulded, flexible shoulder straps in the strap version and soft materials ensure an optimum fit and high user comfort. The body versions Spinomed active for women and Spinomed active men for men can be worn inconspicuously under clothing. All Spinomed back braces are based on the principle of biofeedback.

Greater lung volume as the upper body is held erect

The belt system and the back splint exert pulling forces on the pelvic and shoulder area. This allows users to unconsciously tighten their muscles and straighten their upper body. The more erect posture improves lung function.

 

Sources:

1 DVO. Prophylaxe, Diagnostik und Therapie der Osteoporose bei postmenopausalen Frauen und bei Männern. 2017. Published online: http://dv-osteologie.org/osteoporose-leitlinien (Last accessed 23.09.2021).

2 Pfeifer M et al. Die Wirkungen einer neu entwickelten Rückenorthese auf Körperhaltung, Rumpfmuskelkraft und Lebensqualität bei Frauen mit postmenopausaler Osteoporose. Eine randomisierte Studie. Am J Phys Med Rehabil 2004;83(3):177-186.

3 Pfeifer M et al. Die Wirkungen von zwei neu entwickelten Rückenorthesen auf Rumpfmuskelkraft, Körperhaltung und Lebensqualität bei Frauen mit postmenopausaler Osteoporose. Eine randomisierte Studie. Am J Phys Med Rehabil 2011;90(5):805-815.

Health personnel will make the diagnosis and can prescribe medical aids, e.g. from medi if necessary.

Your medical retailer will fit them individually for you.