Osteoporosis - The Slow Loss of Bone Mass
What is osteoporosis?
Osteoporosis is a condition brought about when the bone has degenerated and the density has decreased to such an extent that the bone mass substantially decreases and the structure becomes porous.
On the inside, it resembles porous, volcanic rock. The support functions of the bone become weaker and it loses its elasticity and strength. On the surface, it appears to be healthy, but it has lost so much structure that it is liable to fracture even when subjected to routine stress.
Very often osteoporosis remains unrecognised for long periods of time due to the fact that the process of bone demoralisation is a long and slow one. Very much later, pain commences or fractures occur unexpectedly. The typical thighbone fracture suffered by many of the elderly - some 70,000 in Germany alone - is mostly a result of osteoporosis.
Half of those affected are subsequently dependent on external help and care.
How does osteoporosis occur?
There is no typical form of osteoporosis; much depends on the cause, the gender and the age of the patient. Dr. Semler, an osteoporosis expert with many years of experience, differentiates as follows:-
Primary osteoporosis is mainly caused by bone metabolism, although there may well be a hormonal component. Here there are two sub-types - type I, or post-menopausal osteoporosis and type II, senile osteoporosis. Type I occurs in every third or fourth woman after menopause, hence the designation post-menopausal osteoporosis. This type is caused by the drastic reduction in oestrogen subsequent to menopause. These hormones also have an influence on other hormone systems that are involved in bone metabolism.
Initially, oestrogen deficiency causes an increase in bone metabolism; however, degradation occurs more rapidly than synthesis, resulting in a loss of bone substance. In addition, during Osteoporosis - The Slow Loss of Bone Mass menopause, calcium is excreted to a greater extent than previously; this decreases the reserves of calcium in the body.
Similarly, if the ovaries are removed or, in the case of men, the testicles, there is an increased risk of type I osteoporosis as then the production of sexual hormones ceases abruptly. The weak points in this type of osteoporosis are the chest and lower back vertebrae. In most cases, the first fracture occurs eight to ten years after menopause.
Type II osteoporosis occurs in older men and women, usually after the age of 70 - hence the designation senile osteoporosis. Twice as many women as men are affected by this type. One of the possible reasons for this type of osteoporosis currently under discussion is lack of activity - hence the designation immobilization osteoporosis.
In addition to the vertebrae, the long bones of arms and legs are particularly susceptible to fracture. Secondary osteoporosis occurs in parallel with other conditions, mostly metabolic diseases such as diabetes and over-activity of the thyroid, parathyroid or suprarenal glands. In addition, chronic diseases affecting the kidneys, liver, pancreas, gastro-intestinal tract and bone marrow can give rise to secondary osteoporosis. The same applies to diseases such as asthma and rheumatic disease, chronic infection or skeletal and suprarenal tumours.
Long-term administration of medicines containing cortisone can also bring about osteoporosis.
What are the symptoms of osteoporosis?
The early stages of osteoporosis are normally without symptoms. The first signs are often severe lower back pain, but this may occur also in the neck, shoulders and even the legs. Typically, such pain doesn't diminish when in bed.
Initially, the pain occurs intermittently but later becomes chronic. Even at this stage, most tend not to think of osteoporosis as back pain is a very widespread condition with numerous causes. In the case of osteoporosis, the pain is usually caused by false posture due to the bones having been deformed by the disease, or by fractures in the region of the spine.