Osteopenia - a disorder characterized by a decrease in bone density, which causes weakening of the bones and increased risk of fractures. Approximately 80% of patients with osteopenia are women.

Causes

The main causes of osteopenia are:

• Genetic predisposition;
• Changes in hormone levels, for example, reduced levels of estrogen Estrogen - the key to bone health   (which usually occurs in women after menopause) or testosterone Five myths about testosterone ;
• Smoking;
• Alcohol abuse;
• Prolonged immobilization (eg, due to treatment or frequent long trips or flights);
• Taking certain medications (eg, corticosteroids and antispasmodics);
• Malabsorption due to some irregularities, including celiac disease Celiac disease - not quite intestinal pathology ;
• Chronic inflammatory processes (e.g. rheumatoid arthritis).

Symptoms

Osteopenia causes no pain, except when it causes fracture. A man can over the years not to suspect that he had osteopenia. Sometimes cracks in some bones does not cause the patient pain. Therefore, osteopenia is usually diagnosed when it has already managed to cause serious damage to the bone.

A very common injury among those suffering from this disorder people is a hip fracture. This is not only very painful injury; it requires a complex and sometimes long-term treatment. More than 30% of patients after hospitalization for hip fracture need to be treated at home for quite some time. In addition, about 20% of people die within one year after a hip fracture. Typically, this is due to the formation of blood clots, due to prolonged immobilization and pneumonia. Because fractures often cause thinning of bone tissue resulting osteopenia should not underestimate this disease.

Diagnostics

For the diagnosis of osteopenia measured bone mineral density (BMD) at the hip, spine, and sometimes in the hands. Z-parameters in the test results show the difference in BMD patients with the average people of the same age and sex. T-score compares the patient's BMD with the mean BMD of a healthy thirty-year man of the same age.

The less these indicators, the lower the bone density, and the higher the risk of fractures even when dropped to a healthy person would have gone without a trace. People with a T-score between -1 and -2.5 diagnosed osteopenia; T-score below -2.5 is an indicator of osteoporosis.

Who should be screened for osteopenia?

The following groups of people are strongly encouraged to take the test on BMD:

• Women over 65 and men over 70 years.
• Post-menopausal women and men aged 50 to 69 years, with an increased risk of osteopenia or osteoporosis.
• Adults older than 50 years who have had bone fractures.
• Adult diseases associated with a decrease in bone density (eg, rheumatoid arthritis) and / or taking medications that may have a negative effect on the bone (eg, steroids).
• People who have been diagnosed with osteopenia, you must have regular examinations.

Treatment

First of all, patients with osteopenia is recommended to make certain changes to your diet - in particular, increase the intake of calcium and vitamin D. Some patients are prescribed special preparations to increase bone mass. It usually depends on the test results and the presence of risk factors that may contribute to exacerbate osteopenia.

Even walking for half an hour a day will have a beneficial effect on bone. In addition, patients should stop smoking and to minimize the consumption of alcohol - when these conditions, treatment of osteopenia is likely to be successful.

Prevention

• Like most diseases, osteopenia can be prevented, without neglecting regular exercise Myths about exercise: do not believe   and following a balanced diet rich in calcium and vitamin D.
• Another source of vitamin D - the sun.
• Avoid smoking, alcohol and carbonated drinks.
• Strengthen bones with regular exercise helps with weight lifting.

Treatment of lumbosacral osteochondrosis always starts with pain relief. As soon as the intensity of the pain decreases, attached physiotherapy (physical therapy). LFK is performed first in the supine position, and only after the final removal of pain the patient may be engaged in a standing position with increasing loads.

Basic principles of treatment of degenerative disc disease of the lumbar sacral

Basic principles of treatment of lumbosacral degenerative disc disease is to remove the severe pain and create a muscular corset that supports the spine and vertebrae allowing further traumatize the spinal discs.

In addition, the appointed medical treatment, promoting the suspension of degenerative disorders of the intervertebral discs.

Removal of severe pain in the lumbosacral spine

To remove severe pain patients prescribed painkillers, more often, it's drugs for systemic or topical use, which include NSAIDs - non-steroidal anti-inflammatory drugs (diclofenac, ketorol, ibuprofen, nimesulide and others.). For moderate pain, these preparations are administered in the form of ointments, creams or gels for topical application, applying and slightly rubbing the skin in the field of pain 3-4 times per day.

If severe pain, NSAIDs are applied systemic action - as a solution for injection, tablets or capsules for oral or rectal suppositories. Appointed as diuretics, well relieves swelling in the tissues of the disadvantaged.

At the same time prescribed drugs, relieves spasms of the back muscles - muscle relaxants, such as Mydocalmum Mydocalm: drug from muscle spasms .

If pain is very strong and can not be removed NSAIDs prescribed hormones glucocorticosteroid (GCS), such as prednisone Prednisolone - against inflammation, allergy and pain, but with complications Dexamethasone Dexamethasone - one of the most effective glucocorticosteroids   and so on. They have a very strong anti-inflammatory effects and quickly relieve pain, but GCS used very rarely - they give too many side effects. Conducted paravertebral procaine blockade and blockade of long-acting corticosteroids.

Sometimes, severe pain can be removed by means of manual therapy - hand tricks to restore the normal anatomic relationship in the tissues.

Creating muscle corset in the treatment of lumbosacral spine

With a very strong pain in the spine is the treatment situation - the patient lies on his back in the most comfortable position for him, helps to reduce pain. Once the pain subsides, physical therapy are starting to be able to lying down, walking with crutches for the unloading of the spine, then gymnastics is performed sitting and standing, gradually increasing the load, prescribed stretching dry cargo and snorkeling.

At the same time to relax and strengthen the back muscles that support the spine, prescribed courses of massage. Massage also helps to improve blood supply to the tissues of the spine, including intervertebral discs. This, in turn, activates the metabolism and stops degenerative-dystrophic processes in the spine.

Further enhances the therapeutic effect of the appointment of physiotherapy - electricity and phonophoresis with various drugs, darsonvalya, magnetic therapy, laser therapy, and so on.

How to treat lumbar sacral osteochondrosis - you need to do?

The most important thing in the treatment of degenerative disc disease - a suppression or slowing the degenerative processes in the intervertebral discs. One relief for the spine for it a little. Therefore assigns active medication, whose task is to restore blood flow in damaged spinal segment and the suppression of the process of destruction of cartilage disks.

To improve the blood circulation in the spine prescribe niacin and trental - they provide the inflow of arterial blood to the spine. At the same time trying to intensify the outflow of venous blood, for it is prescribed venotoniki - drugs, toning the walls of veins and helps enhance blood flow - Ascorutinum Ascorutin - strengthen capillary walls and warn toxic effects svob , Trksevazin and so on. To stimulate cell metabolism appoint B vitamins - energy, together with carbohydrates they contribute to the inflow of energy in cells.

Assign also chondroprotectors - drugs that protect cartilage from destruction of the intervertebral discs. These drugs include chondroitin, structum, Donna, and so on. All products of this group possess analgesic and anti-inflammatory action. They stimulate the synthesis of substances necessary for the formation of cartilage and inhibit the activity of enzymes that cause its destruction.

Treatment of osteoarthritis should be prolonged.

Galina Romanenko