Spinal osteoporosis is a disease in which there is a decrease in bone density of the vertebrae. As a result, the fragility of the vertebrae increases, which can lead to the development of spinal fractures.
The occurrence of osteoporosis is more susceptible to women.
The disease develops as a result of pathologies associated with impaired calcium metabolism. These include the following states:
- thyroid disease ( hypothyroidism ; diffuse toxic goiter );
- metabolic disorders (obesity, diabetes);
- adrenal pathology (Itsenko-Cushing disease);
- systemic joint diseases (rheumatoid arthritis );
- diseases of the gastrointestinal tract (as calcium absorption is impaired).
There are also a number of predisposing factors in which the risk of osteoporosis increases significantly:
- alcohol abuse;
- malignant smoking;
- increased caffeine intake (strong coffee or tea);
- low body weight;
- lack of physical activity;
- long-term therapy with hormonal drugs (corticosteroids, thyroid hormones);
- menopause in women (decrease in female sex hormones);
- genetic predisposition;
- low calcium in the diet.
A rarer cause of osteoporosis is an imbalance between the activities of osteoclasts and osteoblasts, specific bone cells.
The following types of spinal osteoporosis are distinguished:
- postmenopausal osteoporosis occurs in women during menopause;
- senile osteoporosis develops in older persons when the processes of osteoclast and osteoblast work are disrupted;
- combined osteoporosis includes symptoms of two types;
- Osteoporosis that has developed as a result of other diseases is called secondary.
In the initial stages of the disease, when bone destruction is minimal, osteoporosis can develop without any obvious signs (osteoporosis of I degree). Indirect signs of brittle nails, excessive hair loss, and constant dryness of the skin can speak about the onset of the disease.
In the future, as the destruction of bone tissue increases, the first symptom appears – pain in the back. At the beginning of the pain of a whining character, occur after intense physical exertion (osteoporosis II degree).
With the progression of the disease occurs the destruction of the vertebrae, during this period the pain becomes pronounced. Pain syndrome becomes permanent, not only after exercise.
A decrease in human growth is observed, this is associated with a decrease in the height of the vertebrae, their “subsidence” (osteoporosis of the III degree).
There is a formation of postural disorders:
- vertebral flexion in the lumbar spine;
- hump formation.
Stage IV osteoporosis is rare – it is characterized by extreme neglect. At this stage, the patient, as a rule, cannot move and maintain himself independently.
Often, osteoporosis is manifested by compression fractures of the vertebrae, which are accompanied by the appearance of the following symptoms:
- there is severe severe pain in the spine;
- even with minimal movements, there is an increase in pain;
- with superficial palpation of the back in the spine there is severe pain.
Sometimes the diagnosis of osteoporosis occurs only in case of a fracture of the vertebrae.
First of all, they are examined by a general practitioner and a rheumatologist.
On examination, it is possible to identify the clinical symptoms and make a preliminary diagnosis.
Then an additional examination is appointed using instrumental and laboratory diagnostic methods.
1. Spine X-ray in several projections. You can identify:
- increase the transparency of the bone tissue of the vertebrae;
- lowering the height of the vertebral bodies;
- deformation of the vertebral bodies;
- fractures of the vertebral bodies.
2. Densitometry of the spinal bones makes it possible to estimate bone density. This method is used for the diagnosis of osteoporosis, and to evaluate the treatment.
3. Magnetic resonance and computed tomography are carried out for more accurate diagnosis and assessment of changes.
4. Evaluate the content of calcium, alkaline phosphatase in the blood (with osteoporosis, the calcium level will be lowered, and alkaline phosphatase will be increased).
5. Conduct research on the level of thyroid hormones , sex hormones.
6. If necessary, a survey is conducted to identify associated pathologies that could lead to the development of osteoporosis.
The goal of treatment is
- increased bone density
- normalization of calcium metabolism
- pain relief,
- prevention of complications.
Osteoporosis therapy requires long-term comprehensive treatment.
Diet and home treatment
Proper nutrition in osteoporosis carries one of the key loads. If the diet is not followed, the effectiveness of treatment drops significantly. And stage I osteoporosis can most likely be cured at home without resorting to medication.
The basis of proper nutrition in osteoporosis is foods with a high calcium content.
- Shown daily consumption of dairy products (cheese, cottage cheese, yogurt), fatty fish.
- Quitting alcohol and smoking;
- The decrease in the diet of meat products and the complete elimination of caffeine.
Daily physical therapy classes.
There is a whole set of exercises to strengthen the spine. The first classes are best done with an instructor in physical therapy. Most exercises are done while lying down.
Regular massage courses help to improve the blood supply to the spine and strengthen the back muscles.
It is carried out in several directions:
- administration of calcium preparations – calcium-D3-nycomed, Myocalcix, calcium gluconate (taken in order to quickly fill the calcium level);
- vitamins of group D for improvement of calcium absorption (akvadetrim, vimantol);
- hormone replacement therapy for women in the presence of evidence (estradiol, estriol);
- drugs that enhance the work of osteoblasts (ossin);
- drugs that slow down the destruction of bone tissue – bisphosphonates (for example, aclasts), myocalcium.
- Non-steroidal anti-inflammatory drugs (nimesulide, meloxicam, ketorolac) are used as anesthetics.
Physiotherapy is carried out to improve blood supply, relieve severity of pain. The following types of physiotherapy are used:
- magnetic therapy;
- ultrasound with hormonal drugs;
- electrophoresis with novocaine;
- laser therapy;
- mud therapy, paraffin therapy.
The most terrible complication of osteoporosis is a fracture of the spine. Most often occurs compression fracture, it develops with the load on the spine. In advanced cases, in stage III-IV, a fracture may develop under the weight of one’s own body.
For multiple fractures, surgical treatment is performed – vertebroplasty.
For the prevention of fractures, patients are recommended preventive measures:
- avoid heavy physical exertion, especially associated with weight lifting;
- do not go out during icy conditions;
- regularly wear restraining corsets;
- avoid prolonged vertical loads on the spine.
Consequences of the development of a spinal fracture can lead the patient to disability. A patient with severe, common vertebral fractures may become bedridden.
To prevent the development of osteoporosis, the following recommendations should be followed, especially in old age:
- daily consumption of foods rich in calcium or calcium supplements;
- exclusion from the diet of a large amount of coffee, alcohol;
- daily moderate exercise;
- maintaining normal body mass indexes;
- control of blood calcium levels and menopausal densitometry for women and men over 55 years old.