Osteoporosis: When The Bones Crumble

Many people don’t notice anything until a bone breaks at some point. Osteoporosis develops insidiously – and affects women in particular.

Osteoporosis – what is that actually?

In osteoporosis, the bones gradually become more and more porous and brittle. Even the slightest cause can cause the bones to break, particularly often affecting the vertebral body, femoral neck and wrists.

Those affected often suffer so-called silent fractures, which they themselves do not even notice, but which cause pain. The bone loss is particularly often caused by hormone deficiency after the menopause.

Who gets osteoporosis?

More than seven million Germans suffer from osteoporosis, including many women: Every fourth woman over 50 is affected. Women store less of the important bone building block calcium and therefore have a less stable skeleton than men. Although the female hormone oestrogen strengthens the bones, its production declines sharply during the menopause. This is why osteoporosis mainly affects older women.

Women who do little exercise, whose ovaries have been removed, who eat little milk or dairy products or who are severely underweight are also particularly at risk.

Osteoporosis can also be caused by medication or other diseases. For example, cortisone and blood thinners make bones break more easily, and intestinal diseases such as Crohn’s disease or hyperthyroidism make it harder for the body to absorb calcium.

Which complaints should make me sit up and take notice?

Severe back pain is an alarm signal for osteoporosis, as is the case when someone has become several centimeters shorter in recent years. In the worst case, the disease is only noticed when a bone breaks in a situation that is actually not dangerous – for example, when a person slips off the curb.

How does the doctor determine whether I am affected?

Bone loss can be determined by bone densitometry, which works with X-rays. However, the costs for the measurement are only covered by the health insurance company if there is a justified suspicion of osteoporosis.

How can osteoporosis be treated?

As basic treatment, patients receive calcium, usually 1000 milligrams per day, and vitamin D. Painkillers and physiotherapy help them to get back on their feet, for example if a vertebral body has already been broken.

There are a number of effective and well-tolerated medications that are used to treat osteoporosis. Bisphosphonates inhibit bone resorption and strengthen the bones that are still there. Raloxifene strengthens the bones like oestrogen, but does not increase the risk of breast cancer, in fact it reduces it. Strontium ranelate supports bone formation, as does teriparatide.

Because the body no longer produces natural bone protection hormones after menopause, estrogen tablets or patches can help prevent bone loss. But they also carry other serious health risks, such as breast cancer or heart attacks. All drugs must be taken in long-term therapy over three to five years.

Are there also gentle healing methods?

In pulsating magnetic field therapy, electromagnetic fields are said to promote bone formation. However, there is a lack of scientifically proven evidence that the method is actually effective.

Homeopathy recommends calcium salts such as Calcium carbonicum and Calcium fluoratum. Fango packs relieve pain, Feldenkrais or the Alexander Technique promote mobility.

Gentle, but most effective help against osteoporosis: In addition to drug therapy, those affected should take a lot of exercise and eat a calcium-rich diet.

How can I protect myself?

• Sufficient calcium: Adults should take 1200 to 1500 milligrams of calcium a day. Especially milk, yoghurt and hard cheese, but also green vegetables like broccoli or fennel are rich in this substance. When buying mineral water, make sure it has a high calcium and low sodium content.
• Air and light: The body produces vitamin D itself, but needs UV radiation to do so. In summer, half an hour a day outdoors is enough. In winter, additional vitamin D pills can make sense (ask your doctor). Nicotine is a vitamin D predator and should therefore be avoided.
• Movement: The bone gets stronger when it’s loaded. Light weight training and specific gymnastics, so-called isometric exercises, are ideal. Even if vertebral fractures have already occurred, it is important to quickly rebuild the muscles with targeted training. Strength training is ideal – but studies show that yoga three times a week, for example, can significantly increase bone density within two years. Doctors also recommend Qigong, the gliding movements from Chinese medicine, walking or swimming. Ideally 15 to 45 minutes per day and outside – in the light the body’s own vitamin D production is stimulated. It is important to exercise regularly: If you stop, you can expect your bones to become more porous again soon.
• Avoid falls: Especially if the bones have already become more brittle, a fall can have fatal consequences. Therefore, sleep aids, tranquilizers and other medications that affect the circulation should be avoided. Sport promotes coordination and helps to stay sure-footed. And of course all stumbling blocks should be eliminated.