Osteoporosis is a chronic bone disease characterised by a decline in bone density. As a result, bones become more fragile, which causes fractures. The disease is often described as silent and painless, since people with the condition do not suffer pain until they have fractures. The risk of suffering from osteoporosis increases with age and it is particularly common among menopausal women but also among men aged over 65-70 and people taking corticoid treatments. Around one in three post-menopausal women (around the age of 50) are affected. Other symptoms may appear, such as vertebral pain, scoliosis or cyphosis, which are distortions of the spinal column, along with difficulties in carrying out certain everyday movements and as a result, a decline in quality of life.
Osteoporosis is viewed as a public health problem. Here are some key figures:
Understanding the disease means first understanding the bony skeleton. The skeleton is continually renewed by cells that destroy old bone (osteoclasts) and cells that make new bone. This process is governed by several factors, such as vitamin D and sex hormones, which regulate the formation of new bones. In the case of osteoporosis, cells make less bone than they destroy.
It is important to distinguish between two forms of osteoporosis, namely primary osteoporosis and secondary osteoporosis, which appears following another disease. The causes of primary osteoporosis include a genetic predisposition, pregnancy, the menopause – particularly early menopause – and aging in men over 70. Secondary osteoporosis can be caused by high doses of cortisone taken over a long period, rheumatic disorders, endocrine disorders or digestive conditions. Other risk factors are tobacco and alcohol consumption, malnutrition, excessive thinness and a lack of physical activity, and vitamin D or calcium deficiencies.
Osteoporosis can have a negative effect on the quality of life of people who have the disease but fractures can be avoided by diagnosing and treating it. Bone densitometry is used to measure bone density. It is important to be aware that a reduction in bone mass is normal as people age but it can be limited by taking preventive measures as early as possible.
A few simple precautions can help to maintain bone mass:
People who suffer from osteoporosis may benefit from a number of treatments. Medicines can strengthen bones and prevent fractures either by stimulating bone formation or by reducing bone destruction. Medicines can be either hormonal or non-hormonal. The first group includes hormone replacement therapy (although its efficacy is disputed since there are high risks of prompting the appearance of other diseases) and SERMS (selective estrogen receptor modulators) to protect bones. Non-hormonal treatments include biphosphonates and strontium ranelate to slow the pace of bone destruction and support new bone formation, and teriparatide, which regulates calcium levels and thus stimulates bone formation.
In all cases, you should consult your doctor, who will decide on the most suitable type of treatment for you. The minimum treatment period is three to six years. It is therefore important take your treatment exactly as required to ensure it is effective over the long term.