Osteoporosis – a common but treatable evil

An essential part of orthopedics and trauma surgery is the diagnosis and treatment of bone diseases (so-called osteology). For this purpose, there are internationally recognized and constantly updated guidelines of the Dachverband Osteologie (DVO).

The best-known and most common bone disease is undoubtedly osteoporosis. In Austria, about 600,000 to 800,000 people are affected by osteoporosis. Particularly at risk are postmenopausal women or men over the age of about 65 who are known to have osteoporosis in the family. Other risk factors for osteoporosis include the use of certain drugs (e.g. cortisone) over a prolonged period of time, underweight, internal or neurological comorbidities, long-term immobilization e.g. by being bedridden for prolonged periods of time, unbalanced diet and physical inactivity, milk intolerance, and e.g. smoking.

In osteoporosis, the bone becomes increasingly brittle due to reduction of the bone mass and loosening of the normal network structure (so-called trabeculae). This can lead to severe fractures of the femoral neck, the wrist, or vertebral bodies, in case of trifling injuries or even without any accident at all.

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Human bones undergo constant restructuring, i.e. degradation of old bone and production of new bone. Up to the age of about 35 years, bone build-up predominates, after which bone degradation prevails in every human being. This means that up to the age of about 35 years, people should accumulate as big a “bone credit” as possible. This is achieved, for example, by regular exercise and balanced nutrition. Bone loss quantitatively differs between individuals and depends, among other things, on the above risk factors. Thus, you can compare the bone to a muscle: if it is not regularly burdened, it becomes ever weaker and thus more brittle.

To determine whether you have or are at risk for osteoporosis, the doctor uses a variety of diagnostic methods. Through a targeted interview, the individual risk of osteoporosis can be determined. If the risk is increased, bone density measurement with extremely weak X-rays (so-called DXA measurement) on the spine and possibly also on the hip is used. The diagnosis of osteoporosis can be complemented by radiography of the spine and a special blood test.

All examination results are included into the selection of the treatment. At the pre-stage of osteoporosis (so-called osteopenia), nutritional supplementation with vitamin D and calcium can be useful. In case of manifest osteoporosis, modern, well-tolerated drugs are used nowadays, which can considerably reduce the risk of (renewed) bone fracture. This has been proven in many studies worldwide. In addition, physiotherapeutic measures as well as orthopedic aids and appliances, e.g. for fall prophylaxis, can be prescribed.

As the first inpatient rehabilitation clinic in Vorarlberg, embedded into the its unique natural landscape, the Rehabilitation Clinic Montafon is committed to optimal and holistic treatment of patients and stands for first-class orthopedic, cardiological and neurological rehabilitation according to international standards.

The author, Prim. Dr. Christian Fränkel, is the medical director and head of the orthopedics and traumatology department of the Rehabilitation Clinic Montafon-Schruns in Vorarlberg, a healthcare facility of VAMED.

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