Osteoporosis of the joints is a systemic disease in which a decrease in bone density develops and fragility of the articular surfaces of the bone appears. Due to osteoporosis, degenerative processes occur in the tissue and the cartilage itself.
Calcium is washed out of the tissues. Bone tissues are at risk for fractures.
Most often affects the large joints – knee, hip – those joints that account for the maximum physical activity.
Less common is an ankle, shoulder, elbow joint.
Osteoporosis affects not only the joints, but also the spine.
Two mechanisms can lead to osteoporosis:
The most common is a violation of calcium metabolism in various pathologies.
The second, relatively rare, is a violation of the processes of bone tissue regeneration – the activity of osteoblasts and osteoclasts (cells that promote the formation and destruction of bone tissue) is disrupted. In the absence of a disease with their help, the bone tissue of the joints is updated.
It is accepted to distinguish the following types of osteoporosis:
- Senile – in the elderly, there is a violation of the processes of renewal of the bone tissue of the joints.
- Postmenopausal – typical for women in menopause.
- Secondary – develops as a result of other pathological conditions.
- Combined – a combination of several types of osteoporosis.
Typical causes of secondary osteoporosis:
- malignant smoking (active or even passive);
- insufficient body weight;
- chronic alcoholism;
- abuse of caffeine-rich beverages;
- genetic predisposition;
- long-term hormone therapy – hormonal drugs for the treatment of diseases of the thyroid gland; corticosteroid therapy;
- lack of calcium intake with food;
- menopause in women;
- joint dysplasia;
- violation of calcium absorption in chronic diseases of the digestive system;
- the presence of endocrine diseases (diabetes mellitus, thyrotoxicosis, Cushing’s disease);
- frequent and prolonged excessive exercise;
- hypodynamia (reduced physical activity);
A long period of the disease proceeds unnoticed by the patient. There are no signs of the disease, then general indirect signs of osteoporosis (calcium deficiency) may appear:
- fragility, fragility of nails;
- night cramps in the calf muscles;
- the patient complains of fatigue, general weakness;
- early appearance of gray hair;
- frequent dental diseases;
- weakness in the legs;
- weight loss;
- decrease in growth (due to “subsidence” of the spinal column due to a decrease in bone density).
With the progression of osteoporosis, the patient appears painful sensations in the area of large joints. At the beginning, painful sensations arise on awakening and at the beginning of movement.
The patient notes that the pain goes away after it “diverges.”
Also, pain occurs after exercise, if they are more intense than usual.
As osteoporosis progresses, pain in the joints becomes long-lasting and later permanent. Also increases the severity of pain.
- In osteoporosis of the hip joint, pain may spread to the groin area.
- In osteoporosis of the knee joint, the pain spreads to the entire leg.
Often the disease is diagnosed after the patient has frequent fractures in the joints. Fracture occurs with minor injuries, there is increased bone fragility.
If signs of disease appear, you should consult a general practitioner, a rheumatologist or a traumatologist.
On examination, it is possible to reveal a shortening of the limb with an injured joint.
The doctor will conduct an examination and prescribe a complex of examinations:
- Bone densitometry to assess its density. This method allows, and to evaluate the effectiveness of therapy.
- Radiography of the joints in two projections. When osteoporosis on the
radiograph there are the following signs:
- increased bone transparency;
- the presence of outgrowths of bone tissue in the form of spines on the articular surfaces of bones;
- bone fractures near the joints.
- Ultrasound examination of the joints.
- If necessary, it is possible to conduct magnetic resonance and computed tomographic studies.
It is also necessary to pass a blood test for
- determine the level of calcium in the blood;
- determine the level of female hormones (estrogen), thyroid hormones.
If the secondary nature of the disease is suspected, a full examination is performed to rule out diseases that lead to osteoporosis.
Treatment of osteoporosis begins only after a full examination and determination of the cause of the disease.
Therapy of osteoporosis occurs over a long time (from several months).
In determining the primary disease, the treatment of both the underlying disease and osteoporosis is mandatory.
The main tasks of treatment include:
- correction of calcium metabolism;
- increased bone density;
- elimination of pain;
- prevention of complications.
Non-drug treatment includes:
- elimination of caffeine-containing beverages;
- avoiding alcohol and nicotine;
- regular physical therapy classes. thanks to physical exercise improves blood circulation in the joints. good activities are in the pool.
- can be fortifying massage.
Proper nutrition in osteoporosis of the joints plays an important role. Diet includes the obligatory use of food rich in calcium (dairy products, fatty fish).
For more information about nutrition in osteoporosis, see our separate article.
Physical therapy also has a positive effect:
- ultrasound with hydrocortisone;
- electrophoresis with novocaine;
- paraffin therapy;
- magnetic therapy;
- mud therapy
To relieve pain, anesthetic therapy is indicated for patients from the group of nonsteroidal anti-inflammatory analgesics:
- calcium gluconate;
To improve calcium absorption, vitamin D supplementation is recommended:
- an aqueous solution of vitamin D;
Drugs that slow down the destruction of bone tissue:
Drugs that promote bone formation:
- a growth hormone.
The last 2 groups of drugs are necessarily selected and prescribed by a doctor on the basis of diagnostic results.
The consequences of osteoporosis of the bone tissue of the joints are fractures in the joints.
Especially often there are fractures of the femoral neck, which lead to the immobilization of the patient. This is most dangerous in old age, when bone tissue regeneration is slow. Sometimes at fractures surgical treatment is carried out. The rehabilitation period can sometimes last up to a year or more.
Very often a hip fracture leads to disability, the patient is bedridden.
In order to prevent the development of complications, patients are recommended:
- avoid pronounced physical exertion;
- avoid a variety of traumatic effects;
- use thigh protectors, knee pads, elbow pads.
Since the period of treatment of the disease is very long, it is better to engage in the prevention of the development of this pathology.
Diagnosing osteoporosis in its early stages helps to prevent the development of severe consequences, and the duration of treatment is noticeably reduced.
The following measures are recommended to prevent osteoporosis of the joints:
- adequate calcium intake with food;
- alcohol rejection;
- restriction of the use of caffeine-containing beverages;
- regular gymnastics;
- achievement of normal body weight;
- menopausal women and males over 55 need to annually monitor the level of calcium in the blood, bone densitometry;
- in the presence of pain in the joints, it is necessary to undergo a radiographic examination;
- during therapy with hormonal drugs, it is imperative to control the level of calcium in the blood.