Which doctor treats osteoporosis of bones and spine?

Which doctor treats osteoporosis

Osteoporosis is a disease of the bones of the skeleton, characterized by a violation of the metabolism of minerals, the destruction of tissues.

Bones become fragile, the process is progressing. This is a rather dangerous pathology, since the risk of disability is high.

In order to timely reveal the pathology, it is necessary to know which doctor treats osteoporosis.

What kind of doctor should I contact?

The disease develops for many reasons, so it is treated by different doctors:

• Traumatologist-orthopedist;
• rheumatologist;
• endocrinologist.

Patients may need to consult a vertebrologist, gastroenterologist, physiotherapist, gynecologist.

The trauma doctor-orthopedist treats traumas, disabilities of the bone system.

The endocrinologist deals with the treatment of diseases of the endocrine system, which include: pancreas, thyroid and parathyroid glands, adrenal glands, etc. The doctor - rheumatologist treats diseases of joints, connective tissues.

First of all, you need to contact an orthopedic traumatologist who will prescribe the research, tell you how to treat the disease, and send for consultations to specialist doctors. If there is no possibility to get to the traumatologist-orthopedist, you can contact the therapist. He, too, can identify the disease and send the patient to the doctors of a narrow profile.

What other experts can help

The disease also cures the gastroenterologist, since the cause of osteoporosis can be digestive disorders. Sometimes there is a need for a consultation with a nutritionist.

The specialist will make a menu and explain in detail what foods should be included in the diet, and which should be discarded.

In the absence of pathological fractures, osteoporosis is treated by a physiotherapist who selects a special gymnastics complex for patients. LFK improves the joints and helps strengthen bones. Women with osteoporosis should also be treated by a gynecologist.

Diagnostics

The doctor reveals osteoporosis based on radiography, densitometry. You should know that X-rays in the early stages of pathology do not give the necessary amount of information. In this case densitometry is performed, which makes it possible to estimate the amount of bone mass.

To determine the level of metabolic markers in bone tissues also examine the biochemistry of blood. The patient needs to donate blood to the thyroid hormones.

note

There are 4 degrees of osteoporosis. The first is characterized by a change in the smaller size of the bone trabeculae (crossbeams), the second - a noticeable decrease in tissue density.

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Osteoporosis of the third degree is characterized by biconcave vertebrae, at least one wedge-shaped vertebra is found in the study.

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At 4 degrees of osteoporosis, multiple deformations of the vertebrae are detected, and signs of strong demineralization of the bones are observed.

Symptoms

The doctor diagnoses "osteoporosis" on the basis of the patient's complaints. The main symptoms of the pathology are: frequent fractures, bone pains, deformation of the skeleton.

With the progression of the disease, the pain becomes permanent. Another symptom is a strong tension in the muscles.

Osteoporosis is accompanied by a violation of posture: stoop, decrease in growth.

When the disease becomes frequent fractures of the vertebral bodies, neck of the hip, radius (in the distal section), ribs.

Osteoporosis is suspected when the following symptoms appear: increased fatigue, brittle nails, dental diseases, gums, violation of heart rate, early appearance of gray hair.

Causes

Before starting to treat osteoporosis, the doctor reveals the reasons for his appearance. This is a polyethological disease that develops as a result of the influence of any negative factors.

These include:

• female;
• poor heredity;
• fragile physique;
• low weight;
• disorders of the cycle of menstruation;
• hormonal imbalance;
• a way of life or hard physical labor;
• a deficiency in the diet of calcium, vitamins (especially vitamin D);
• reception of glucocorticosteroids, any antibiotics, antitumor drugs.

Osteoporosis can appear due to such diseases as: diabetes, thyroid pathology, chronic hepatic and renal insufficiency, rheumatic diseases.

note

Development of pathology is facilitated by smoking, alcohol abuse, coffee, the prevalence of meat dishes in the diet.

Treatment

Doctors treat osteoporosis using medicamentous and non-medicament methods. A major role in complex therapy is given to drugs that affect bone metabolism.

These include:

• bisphosphonates, which inhibit the process of destruction of bone tissue;
• calcium preparations with vitamin D;
• Strontium preparations that promote the vital functions of bone tissue;
• estrogens;
• fluorine salts;
• growth hormone;
• flavone compounds that improve the metabolism in the bones;
• ossein-hydroxyapatite complex, stimulating activity of bone cells.

A patient with osteoporosis needs to know which diet is necessary for the disease.

The diet should contain enough vitamins and trace elements, especially calcium.

It is necessary to include in the menu low-fat sour-milk products, greens, nuts, eggs, fruits, dishes from fish, cereals, vegetables. You should give up alcohol, coffee, chocolate.

Osteoporosis is also treated with therapeutic gymnastics. Moderate stresses contribute to the strengthening of bone tissue. Special exercises are selected by the doctor taking into account the age of the patient and the condition of his body.

What the patient can do

To cure osteoporosis, it is recommended to revise the lifestyle. Walking and jogging in the fresh air, staying in the sun, swimming, dancing will be useful. For the successful treatment of osteoporosis, the refusal of cigarettes and alcohol is mandatory.

A full rest and sleep are important. It is necessary to maintain normal body weight, eat enough calcium and vitamin D. The optimal amount of calcium for patients under the age of 65 years is 1000 mg, after 65 years - 1500 mg.

Prevention

Prevention of the disease is carried out in accordance with the age period. Pregnant women should take multivitamin complexes. We need to pay attention to the nutrition of children. The diet should contain foods rich in calcium and vitamin D.

As prevention of the disease, gymnastics, dances, and sports games are recommended.

In adolescence and adulthood, you should stop smoking, drinking alcohol, sweet fizzy drinks, which contribute to the excretion of calcium. It is necessary to treat diseases that contribute to the appearance of osteoporosis.

Particular attention should be paid to the condition of the osseous system after the onset of menopause, since the degree of decrease in bone mass during this period is the maximum.

It is necessary to engage in the prevention of osteoporosis, taking vitamin-mineral complexes. It is recommended hormone replacement therapy, it must pick up a gynecologist. It should be checked regularly at the doctor for the condition of the bones of the skeleton, thyroid gland.

A source: https://spinous.ru/diseases/osteoporosis/u-kakogo-vracha-lechat-osteoporoz.html

Which doctor treats osteoporosis?

Changing the structure of bone tissue, loss of calcium in the bones, as a result - the fragility of bones, all this is osteoporosis.

Introduction

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At a young age, the disease is extremely rare.

The pathology of bone tissue develops gradually. And a person can not know about it for a long time, until a fracture occurs.

This is facilitated by a decrease in the level of hormones, in women - in estrogen, in men - in testosterone.

Therefore, it is not superfluous to know which doctor treats osteoporosis.

Factors provoking the disease

The reason for the development of osteoporosis can be such factors:

1. Rheumatic diseases (arthritis, osteoarthritis).
2. Diseases of the gastrointestinal tract, resulting in deterioration of calcium absorption.
3. The beginning of the climatic period in women.
4. Diseases of the endocrine system.
5. Age-related aging of the body.
6. Hereditary predisposition.
7. Taking medications that affect the structure of the bones.
8. The lack of vitamins and trace elements, in particular vitamin D.
9. Incorrect nutrition, smoking, alcohol abuse.

Symptoms of the disease

From what stage of osteoporosis damage the patient will turn to the doctor, the outcome of treatment also depends. Recognition of the first "bells" is very important, therefore it is necessary to pay close attention to the symptoms that appear. Especially after 40-45 years. Namely:

• Constant or periodic pains in the bones: the arms-legs "twist the back - "lomit". It often depends on weather conditions;
• Shoulders, hunched;
• Decreased growth due to deformity of the spine;
• Unreasonable weight loss;
• Muscle spasms and convulsions that occur without any apparent cause;
• Fragility and stratification of nails and hair, early appearance of gray hair;
• Hypersensitivity of teeth, periodontal disease;
• Tachycardia;
• Prostration.

But as a rule, all these symptoms are often perceived as a natural aging of the body. And many do not rush to see a doctor.

This will be followed at best by hip joint prosthetics. In the worst - disability and immobilization.

Needless to say, timely treatment to the doctor, with the first symptoms appearing, will positively affect the effectiveness of treatment. And for women during the menopause regular examination should become the norm.

To which doctor to apply

Treatment of osteoporosis is long and complex, so there should be several doctors.First of all, it is worth turning to an osteopath or a traumatologist - an orthopedist. It is also necessary to consult a doctor endocrinologist, rheumatologist.

In conditions when it is not possible to turn to a narrow specialist, the treating therapist is also quite suitable. He will make an anamnesis of the disease, assign studies and suggest a further option for action.

Assignable studies:

1. Radiography of the spine.
2. Densitometry. This is one of the types of X-ray examination, which allows to determine the density of bones and bone tissue.
3. Delivery of blood test for thyroid hormones.
4. Laboratory analysis of calcium and phosphorus levels, as well as other microelements.
5. You may need to consult a vertebrologist. This is when pathological changes have affected most of the spine.
6. Advising a nutritionist.
7. For women, a visit to a gynecologist is mandatory.

Having completed all necessary examinations, the doctor, when analyzing the results, prescribes treatment.

In the treatment of osteoporosis, the main task is to slow the aging of bone tissue, balance the amount of hormones and metabolism. It is important to prevent the formation of bone fractures.

Healing measures

At the initial stage of osteoporosis treatment is carried out with the help of diet and special gymnastics. Due to the uniform, correctly distributed physical load, the skeleton is strengthened, the body is supported in tone. Here the physiotherapist will help.

If the mass of bone tissue is close to the critical mark, drug treatment is necessary.

Calcitonin is primarily prescribed. This drug is an analogue of human hormone and promotes the accumulation of calcium in the bones. It is also necessary to take vitamins of group D (ergocalciferol, cholecalciferol).

When the occurrence of osteoporosis is associated with menopause, women are prescribed bisphosphonates. It is also necessary to take hormonal drugs, for women - estrogens, which prevent fragility of bones.

Not the least role in the treatment of osteoporosis in both women and men is played by diet. Foods fortified with calcium should be the first and enter the daily diet.

Can	You can not
All dairy products	Strong tea
White meat	Coffee
Nuts	Beef
Fish and seafood	Liver
Cereals	Chocolate
Green vegetables	Alcohol

Traditional medicine in the treatment of osteoporosis of the spine also gives a positive result. But only hope for homeopathy is not worth it.

To achieve a positive effect, treatment should be comprehensive.

Having completed the course of therapy, it is necessary to pass a blood test to determine the markers of osteoporosis of the spine.

Since osteoporosis is not completely cured, patients are under the constant supervision of an orthopedic trauma specialist.

A source: http://sustavlive.ru/drugie-bolezni/osteoporoz-kakoj-vrach-lechit.html

Which doctor treats osteoporosis? Osteoporosis: symptoms, causes, treatment and prevention

Osteoporosis is a serious pathology of the skeletal apparatus, in which a progressive decrease in the strength of bones is observed.

Without proper treatment, the patient is at increased risk of fracture.

Let's find out what is the manifestation of osteoporosis, which doctor treats the disease? Consider the symptoms, features of diagnosis and treatment of the disease.

Which doctor treats osteoporosis?

Elimination of the problem requires the use of an integrated approach to the selection of therapy methods. So which doctor treats osteoporosis of bones? Diagnose and prescribe treatment specialists such as traumatologist, endocrinologist, rheumatologist, orthopedist.

The main goal of therapy in the development of osteoporosis is the elimination of discomfort, which affects the quality of life of the patient. To determine the success of treatment, the patient periodically undergoes an examination with a radiologist.

Which doctor treats osteoporosis in elderly women? Failures in the recovery of bone tissue in older people can lead to a disruption of the functions of the pancreas, adrenal glands, thyroid gland. Therefore, such patients are required to undergo an examination with an endocrinologist.

Which doctor treats osteoporosis with frequent fractures? In such situations, patients seek help from traumatologists and rheumatologists, who specialize in the detection of disorders from the connective and bone tissue.

Forms of osteoporosis

Depending on the degree of development of the disease, it is divided into several forms:

1. Light - the density of bone tissue is reduced to the smallest extent. A person susceptible to developing a disease periodically experiences discomfort in the limbs, the spine area, suffers from a slight decrease in muscle tone.
2. Moderate - pronounced changes are formed in the structure of bone tissue. The pain syndrome becomes more stable. The patient develops stoop, the cause of which is the defeat of tissues in the spinal column.
3. Heavy - a fairly rare form of manifestation of the disease, in which the bulk of bone tissue is subjected to destructive processes. A characteristic feature is a decrease in growth, pronounced, pathological changes in posture.

As a rule, patients begin to learn which doctor treats the osteoporosis of the spine, disease in a moderate form, since an easy stage of its development proceeds practically is asymptomatic.

With a serious, progressive nature of the disease, most patients can not fully return to full-fledged life.

At the same time, having determined in time, which doctor treats osteoporosis in women and men, it is possible to prevent the most serious consequences of the disease.

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Among them, a special risk is the fracture of the spine, which often results in a loss of the ability to move independently, and in some cases, a fatal outcome.

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Next, we will consider what causes osteoporosis, symptoms, causes, treatment and prevention of the disease.

Symptomatology

Unfortunately, in the early stages of development, osteoporosis is hidden. For a long time the disease proceeds without bright signs. Therefore, its diagnosis is often belated.

Find out which doctor treats osteoporosis, a person is often prompted by sudden fractures that occur literally on level ground. Along with this, patients are concerned about changes in posture, problems of dental nature.

A common symptom is stable bone pain. The most pronounced discomfort is felt in the area of ​​the hips, forearms, lower spine.

In response to a deficiency of calcium in the body tissues, convulsive muscle contractions may occur.

Causes of the disease

Among the main reasons that contribute to the formation of pathology, it is worth noting the following:

1. Inadequate production of sex hormones in the body of women. Most of the representatives of the weaker sex note the presence of certain manifestations of the disease in the age after 60 years with the onset of menopause.
2. Aging is often accompanied by extinction of the working capacity of organs. In this case, bone tissue also suffers.
3. Negatively affects the condition of the skeletal apparatus, prolonged treatment with drugs, the main active ingredients of which are glucocorticoids. These hormones contribute to the activation of the adrenal cortex. One of the negative manifestations in this case is the delayed renewal of bone tissue.
4. Osteoporosis can occur against a background of chronic ailments, among which it is worth noting such: sugar diabetes, kidney failure, excessive thyroid activity, hepatitis, oncological pathology.
5. A common cause of the disease is a deficiency of vitamin D in the body, as well as a lack of calcium in bone tissue.

Diagnostics

The application of methods of modern medicine allows us to timely identify the prerequisites for the development of osteoporosis. In particular, densitometry is an effective diagnostic measure.

In fact, the technique is an ultrasound study aimed at obtaining images of the skeletal apparatus.

Unfortunately, the diagnostic technique makes it possible to fix pathologic changes only in case of loss of about 15% of bone tissue.

Auxiliary solutions aimed at diagnosing osteoporosis, are special laboratory studies. When examining a patient, specialists pay attention to the following indicators:

• the content of estrogen or testosterone in the body;
• the amount of calcium and hydroxyvitamin D;
• activity of thyroid hormone production.

Medication

What kind of a doctor treats osteoporosis? The endocrinologist is able to develop adequate medication.

In the course of treatment with the use of drugs, patients are often prescribed reception of funds with an elevated content of calcium salts. To get back to normal, the body needs an order, a gram of this mineral per day.

Since the assimilation of such a quantity of substance is impossible at a time, take the medicine containing calcium several times a day.

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To ensure the assimilation of the mineral and its concentration in the bone tissues, the patient is prescribed the intake of vitamin complexes, which contain an increased amount of D vitamins.

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Significantly slow the development of destructive processes in the bone tissue of biophosphonates. Substances of this category are injected into the body intravenously.

In the case of taking such drugs orally, probably damage to the mucous membrane of the digestive system.

As practice shows, competent therapy based on biophosphonates halves the risk of fractures.

Hormonal therapy

In women, osteoporosis is how to treat? The causes of the disease lie in the inadequate production of the sex hormone estrogen by the body. Therefore, patients prescribed drugs containing this substance.

The only danger in carrying out this type of therapy is the risk of stroke.

To avoid trouble, taking hormonal drugs should occur under the supervision of a specialist.

An excellent alternative to estrogen is their synthetic substitutes.

The use of synthetics avoids the reduction of blood coagulability, the formation of malignant cells in the tissues of the body.

Non-drug treatment

Therapy without medication requires regular walking tours, performing aerobics in a gentle manner. Loads on the body should not be strengthened.

For this reason, exhausting running for long distances, training with barbells, training on power simulators are excluded.

Patients are prohibited active games, which are accompanied by strikes, other mechanical stress on the body.

Diet

In addition to increasing physical activity and therapy with medications, patients with osteoporosis are shown to adjust their daily diet. In the treatment recommend a diet based on dairy products.

So, 100 grams of cheese contain about 1000 mg of calcium. In a similar volume of curdled milk or cow's milk, this element is about 120 mg.

The best calcium is absorbed by the body when using sour-milk products.

From food of vegetable origin, the emphasis is on the use of hazelnut and walnuts. Also high in calcium is sea fish, black bread, white cabbage.

Among other things, the diet is supplemented with food saturated with potassium, magnesium, phosphorus. At the same time, it is recommended to reduce the use of table salt, which is the most important decision not only to eliminate the manifestations of osteoporosis, but also reduce the risk of developing cardiovascular diseases.

Finally

So we found out which doctor treats osteoporosis, examined the symptoms, the main manifestations, the features of diagnosis and treatment of the disease.

In conclusion, I would like to note only that the development of the disease is easier to prevent than to eliminate its manifestations with the help of complex therapy.

That is why it is extremely important to adhere to a balanced diet, to resort to regular physical activity, to avoid bad habits.

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For people aged 45-50 years, it is crucial to take drugs with calcium content. All this makes it possible to avoid the development of the disease and to maintain health for many years.

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A source: http://.ru/article/259681/kakoy-vrach-lechit-osteoporoz-osteoporoz-simptomyi-prichinyi-lechenie-i-profilaktika

Which doctor treats osteoporosis?

Osteoporosis is a rather dangerous disease in which the human bones are damaged, the metabolism of minerals is disrupted, and tissues are destroyed. As a result, the bones become brittle.

The danger of the disease is that the patient can remain disabled. In order to take timely measures to combat pathology, it is necessary to know which doctor treats the osteoporosis of the spine.

Which doctors to go to?

Several specialists can treat osteoporosis. Which doctor will take the case, depends on the causes of the pathology.

• If a person observes the first signs of the disease, then an orthopedic trauma specialist should be visited. He will send the necessary examination and select the optimal therapeutic plan. This doctor can also treat the adverse effects of osteoporosis.
• Often, this pathology is treated by an endocrinologist, a rheumatologist and even a gastroenterologist. This is due to the fact that disruptions in the functioning of the endocrine, digestive system, as well as connective tissue diseases can be the causes of osteoporosis.
• If there is no way to go to these specialists, then you can consult a therapist. He will prescribe all the necessary studies, but only the appropriate doctors can confirm the diagnosis.
• If the patient has a large part of the spine, then you can visit the vertebrologist. This specialist deals with the treatment of diseases of the spinal column. Sometimes there is a need to bring a dietician to the therapy, which will make an approximate menu, tell you what you need to eat and what not.
• If there is no danger of pathological fractures, the physiotherapist is involved in the treatment. It helps patients to do special gymnastics, the purpose of which is to strengthen bone tissue and improve the functioning of the joints.
• If there is osteoporosis in women, then do not neglect the visit to the gynecologist. This is especially true for those who have had menopause. In severe course of pathology, a surgeon may be involved in therapy.

When do you need to visit specialists?

In most cases, clinical manifestations at an early stage of the disease do not make themselves felt. Because of this, the patient does not even realize that he is sick, and learns this only after a nontraumatic fracture.

With the passage of time, pain begins to appear that lasts for a long time, differs in intensity and is localized in the region of the waist or neck. Pain syndrome occurs when a person for a long time is in one position, or at least an hour walking.

In the development of bone pathology, the following symptoms also occur:

• The growth is reduced due to the fact that the spinal column collapses, and compression fractures occur. This decreases the height of the vertebrae, their central part becomes thin and collapses.
• The posture changes, there is a stoop, the body is bent forward. This happens when the vertebrae take the form of a wedge.
• The patient's body weight is quickly lost.
• Often, the bones break without the influence of external factors, but on their own.

To detect osteoporosis, doctors prescribe a roentgen of the spine. However, this method does not reveal the onset of pathological development. He is able to determine the presence of the disease only when more than 20% of the bones have already deformed.

To obtain the most effective result, specialists resort to densitometry. It is a kind of X-ray, which is prescribed for detection of the disease and for observation one year after the initiation of therapy. Among other things, we can not do without laboratory research.

For the treatment of ailments, prescribe such medicines:

1. Salts of calcium. They are necessary in order to normalize the density of bone tissue. The human body requires, g of this element per day. Due to the fact that the body can not immediately take such a dose, the drug should be used 2-3 times a day. In addition to it, you need to take vitamin D, which helps calcium easier to digest and accumulate in the bones in sufficient quantities.
2. Estrogens. They are used to treat the pathology of bone tissue in women who have menopause. However, it is not recommended to use them for a long time, as the risk of stroke, heart ischemia and malignant tumors increases.
3. Bisphosphonates. So called salts, which help slow down the process of bone destruction. Usually they are injected into the vein because the ingestion can cause damage to the walls of the stomach. If you systematically take this drug, the probability of fractures will be reduced by half.
4. Hormones of the thyroid gland. They are prescribed if the cause of the disease is the lack of such hormones in the body.
5. Modulators of estrogen receptors. They are used in place of estrogens, if the patient has contraindications to taking the latter.
6. Anabolic and biological flavanoids. They are necessary in order to stimulate the formation of bone tissue. But they are used quite rarely, since they are capable of causing many adverse side reactions.

What to do for prevention?

Preventive measures are carried out depending on the person's age.

• Women who are expecting a child should take multivitamin complexes.
• Parents should closely monitor what their child is feeding. The daily menu should contain foods that contain large amounts of calcium and vitamin D.
• You also need to do sports, gymnastics, dancing.
• It is important to abandon such harmful habits as smoking and drinking. Also, do not get carried away with sugary fizzy drinks, which only accelerate the excretion of calcium from the body.
• It is important to monitor your health, to treat pathologies on time, especially those that can cause osteoporosis. Women should pay special attention to bones when the menopause occurs. Because it is during this period that the degree of decrease in bone mass increases.

A source: http://GormonOff.com/zabolevanija/kakoj-vrach-lechit-osteoporoz

Which doctor should I use to treat osteoporosis?

Osteoporosis is not considered an independent disease among specialists. This condition usually refers to the consequences of age or pathological processes in the body, causing a violation of the structure of bone tissue and saturation of its mineral substances.

Very often it is detected when examining other diseases or after fractures of bones caused by minor trauma. In order to learn how to work on the causes and manifestations of osteoporosis, you need to know which doctor is able to cure it (see.

Osteoporosis of the spine).

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What is osteoporosis?

For various reasons, the bones in the human body can change their properties and become less durable. This phenomenon is called osteoporosis.

This process usually manifests itself and progresses in women in elderly and senile age (see. Signs of women). In some cases, it develops in young people.

The following factors can be the reasons for this violation:

• violation of the production and assimilation of hormones;
• premature menopause;
• reduced level of vitamin D formation;
• taking certain medicines;
• consequences of chronic intestinal and liver diseases, renal failure, lymphoma, diabetes, alcohol and toxic dependence;
• hereditary predisposition.

Some nationalities are more predisposed to increased destruction of bone tissue. Among them are representatives of the Mongoloid race, the peoples of the Caucasus.

Also predisposing factors of this process are people with low body weight or exhaustion, suffering from anorexia, having a monotonous diet, poor in vitamins and minerals.

Most often, people do not present any complaints with this disease. Objective signs of this condition are a decrease in growth and a violation of posture. Usually, these patients have other signs:

• common dental diseases (periodontal disease, caries, thinning of enamel);
• tendency to cramps in the muscles of the legs;
• thin and layered nails;
• hair loss;
• early and common gray.

However, most often it is detected already with fractures of the wrists, vertebrae, cervix, appearing suddenly without a special reason (see. Compression fracture).

Who treats osteoporosis?

For the diagnosis and treatment of osteoporosis, the following doctors are referred to: orthopedic traumatologist, endocrinologist, rheumatologist or therapist.

These specialists not only can visually determine the first signs of pathology, but also with the help of an appropriate survey to identify the factors contributing to its development.

The choice of a doctor depends mainly on the cause of the disease.

To treat osteoporosis with a trauma doctor or an orthopedist is necessary with the already existing traumatic and spontaneous fractures, age-related disorders occurring in the bones of women and men.

X-ray images and tomography data are evaluated during the examination.

Osteoporosis of the bones, caused by a violation of the internal glands of the body, is treated by a doctor endocrinologist.

It determines the level of sex hormones, the work of the adrenal glands, thyroid and parathyroid glands, the level of glucose and insulin.

This specialist is more often treated by people with already existing problems of hormonal metabolism, which need the prevention of bone tissue destruction.

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A doctor who deals with osteoporosis with common pathologies of connective tissue, bones and joints, is called a rheumatologist.

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To help this doctor resorted to arthritis, rheumatism and other chronic diseases of the human body.

A rheumatologist evaluates those changes in inflammatory nature that can lead to increased fragility of bones.

He treats the destruction of bones, caused by side effects of various drugs, a doctor-therapist.

In addition, to exclude the effect of concomitant diseases in osteochondrosis, consult the following specialists for consultation: gastroenterologist, nutritionist, gynecologist, physiotherapist. These doctors determine the likelihood of the impact of those diseases, the treatment of which they are directly engaged.

Methods of treatment of osteoporosis

The attending physician of any of the above specializations dealing with osteoporosis problems should explain to his patients that it is impossible to completely restore the anatomy and physiology of bone tissue.

But this does not mean that it is useless to combat its manifestations. The complex effect helps to strengthen not only the skeleton itself, but also the musculature supporting it.

The medicines for osteoporosis include the following drugs:

• calcium preparations in combination with vitamin D (Ostalon, Calcium D3 Nycomed);
• synthetic estrogens;
• bisphosphonates;
• thyroid-stimulating hormones;
• anabolics.

It is very important to consult a doctor to prevent this bone pathology during pregnancy, bone injury, manifestation the destruction of bones in parents and older relatives, the intake of hormones and other conditions affecting the structure and function of the supporting apparatus. These measures can not only postpone the development of this disease, but also give a high probability in order to avoid it.

A source: http://VashPozvonok.ru/osteoporoz/vrach-dlya-lecheniya-osteoporoza/

Osteoporosis

Osteoporosis is a pathological condition in which bone strength decreases. This creates the conditions for an easier appearance of fractures that can lead to a prolonged immobilization of a person.

The urgency of this disease is due to the increasing frequency of its cases.

So, according to the data of a mass densitometric study, osteoporosis in people, whose age is 50 years or more, is quite common.

In women, its prevalence at this age is 35%, and for men - 20%. These sex differences are due to the lack of protective action of estrogens in the female body after the onset of menopause.

From the socio-medical point of view, this disease is associated with the following problems, arising from one another:

• Fractures of the neck of the hip, vertebral bodies and other long tubular bones
• Increase in morbidity and mortality among elderly and senile patients
• Large material costs for the treatment of this category of patients.

Causes

Speaking about the causes of osteoporosis, it is necessary to distinguish a group of predisposing factors that have different levels of evidence, but still serve as predictors of the disease. The probability of developing osteoporosis is especially often increased by the following:

• Fractures in the anamnesis
• Age of the patient (45-50 years and older)
• Low bone mineralization, determined with densitometry
• Female sex, because at a critical age, the estrogen saturation of the body decreases, and also due to the smaller volume of total bone mass and smaller bone sizes
• Hereditary heredity for this disease
• Body mass index less than 20 kg / m² and weight less than 57 kg
• Smoking
• Reduced intake of calcium in the body
• Insufficient vitamin D content in the body
• Increased consumption of alcohol (more than 36 ml per day of pure ethanol or its products in an equivalent amount)
• Propensity to get injuries (falls).

Less significant risk factors for osteoporosis are the following:

• Lack of regular physical activity
• Long-term immobilization (immobility) due to various diseases
• Weightless state
• The European race (in, times the risk is higher than that of Afro-Caribbean women)
• Less than 5 years since the previous fracture
• Accepting corticosteroids for more than 2 years
• Reception of beta-blockers for more than 8 years.

The presence of concomitant pathology is also capable of increasing the risk of osteoporosis. In this respect, the most significant diseases are the following:

• Diabetes mellitus type 2
• Rheumatoid arthritis
• Ulcerative colitis
• Purpose
• Crohn's disease
• Some endocrine diseases
• Lack of kidney function
• Hemoblastosis
• Diseases of the lungs with chronic course and obstruction.

Symptoms

Osteoporosis as an independent disease does not include any clinical symptoms in itself.

The main manifestations are signs of a fracture (even with the slightest trauma), that is, the consequences of this disease.

Fractures of the following localizations are most often diagnosed:

• Vertebrae in thoracic and lumbar regions
• Radial bone in the distal part, that is closer to the hand
• Femoral bone in the proximal part, that is closer to the pelvis.

The main signs of vertebral fractures are such as:

• Decreased growth
• Increase in the thoracic spine (pathological thoracic kyphosis)
• Reduction of the length of the line drawn through the most prominent point of the costal arch from below and the most prominent point of the crests of the iliac bones
• Back pain (their severity varies).

In addition, one of the clinical criteria for the diagnosis of osteoporosis without additional research is the existence of a fracture in the history, which occurred from the impact of minimal physical load. In this case, the sex of the patient should be female, and the age - over 70 years.

If a person has accidentally or purposefully diagnosed vertebral fracture, then it is considered as a patient with osteoporosis.

Densitometry data are not taken into account, since bone mineral density, determined by instrumental methods, can even be within the limits of normative indices.

The growth of a person is an important guide for setting a preliminary diagnosis of osteoporosis.

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If within 1 to 3 years of dynamic observation of the patient his growth has decreased by 2 cm, then this is an occasion to make a radiograph of the spinal column.

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A similar statement is true, and if the growth at the time of the examination was 4 cm lower than in 25 years.

Diagnostics

Additional research methods are conducted with two main objectives:

• To determine the state of the bone system, or rather the bone mineral density
• Exclude or confirm the presence of a fracture.

The main methods used to solve the tasks are as follows:

• X-ray densitometry
• Ultrasound diagnostics
• Standard radiography
• Laboratory diagnostics - determination of the level of bone markers, sex hormones, parathyroid hormone, calcium and vitamin D.

The main recommendations for the diagnosis of osteoporosis are the following:

• For the most accurate assessment of the decrease in bone mineral density, which is associated with osteoporosis, it is necessary to use x-ray densitometry, rather than standard radiography
• For the diagnosis of osteoporosis, x-ray densitometry is performed in the lumbar spine and proximal part of the two femurs
• Densitometry is not a screening method, but is performed according to indications (in the presence of characteristic complaints and / or risk factors)
• Assessment of bone mineral density should be performed no more than once a year
• The use of ultrasound for informativity is inferior to densitometry, but it is a safer method (no radiation exposure)
• Bone ultrasonography (ultrasound of bones) is a screening method for identifying patients with an increased risk of developing osteoporosis. Later, to verify the diagnosis, he was shown x-ray densitometry
• Standard radiography is used to visualize fractures and determine the anatomical features of the bone
• The greatest diagnostic value for revealing osteoporosis is a combination of standard radiography and X-ray densitometry
• Standard radiometry can reveal the height of vertebral bodies. If it is less, and other reasons are excluded, then a diagnosis of osteoporosis
• When an X-ray fracture of the vertebra is detected, the densitometry is not shown
• High indicators of bone markers are evidence of increased destruction of bone tissue, however, they are not used to diagnose osteoporosis, since their role has not been proven
• Bone resorption markers, determined in dynamics (after 3 months), can predict the effectiveness of anti-osteoporotic therapy
• Before the start of pharmacological treatment of osteoporosis, it is necessary to determine the level of calcium and phosphorus in the blood, as well as creatinine to identify possible contraindications.

Treatment

Treatment of osteoporosis has the following objectives:

• Increased bone mineralization
• Prevention of fractures.

For this, pharmacological preparations and special orthopedic devices are used. One of them is the hip protector. It is recommended for elderly people with a high risk of hip fracture, as well as in the presence of risk factors for falls.

The appointment of pharmacological drugs is considered to be the "gold" standard in the treatment of this pathology.

The group of bisphosphonates is of primary importance in this respect. This is based on the proven fact of reducing the risk of fractures of different locations.

The main principles of therapy with these drugs are:

• Nitrogen-containing bisphosphonates (zoledronic acid, alendronate and others) are first-line drugs in postmenopausal women with diagnosed osteoporosis
• The duration of their therapy is from 3 to 5 years, but if a woman has a high risk of fracture, then therapy continues
• With the prophylactic purpose in postmenopause, these drugs are prescribed in half the dosage
• The intake of bisphosphonates is impossible without calcium intake (daily dose of 500-1000 mg / day) and vitamin D (800 IU).

An alternative drug for women in postmenopausal age can be considered strontium ranelate, which also requires the simultaneous administration of calcium and vitamin D. This drug can be administered for up to 8 years, when its safety is clinically proven.

The question of hormone replacement therapy in women after the termination of menstruation requires a separate examination. Thus, the following facts were proved:

• If the age of a woman is 60 years and older, while the duration of postmenopause is 10 years or more, there is no need to prescribe substitution therapy with female hormones
• If a woman is under 60, then this therapy can be prescribed, but only with a low risk of cardiovascular disease
• The duration of such treatment depends on the individual characteristics of the patient and is determined by the gynecologist.

Second-line drugs for the treatment of osteoporosis in postmenopausal women are selective estrogen receptor modulators along with calcitonin.

However, they are recognized as first-line drugs with a prophylactic goal in women. To treat severe forms of osteoporosis, it is necessary to take parathyroid hormone.

In men, the treatment of osteoporosis is as follows:

• Calcium
• Alendronate
• Calcitonin in the form of a nasal spray
• Active metabolites of vitamin D.

Prevention

Prevention of osteoporosis and fractures associated with it is as follows:

• Exercises with a body weight load, for example, walking, contribute to the growth of bone mass (a similar action has been proved for a short time period)
• Strength exercises and walking exercise have less effect on the increase in bone mass, but reduce the risk of falls leading to fractures
• Walking increases the mineral density in the thigh and spine, and aerobics and / or power loads - only in the spine
• Against the backdrop of physical activity, the quality of life of people with osteoporosis is improving
• In diagnosed osteoporosis, complex exercises should be used - aerobics, walking, strength exercises, weight load
• Educational programs on osteoporosis, especially in combination with individual counseling
• Prevention of falls.

The last point requires more detailed interpretation, since the prevention of falls will avoid the occurrence of fractures. To this end, a multicomponent program should be carried out, which includes:

• Correction of vision in the elderly person
• Abolition of psychotropic drugs
• Timely treatment of concomitant pathology
• Assessment of the home environment and ensuring its safety
• Training in fall and stereotyped movements
• Individually selected physical exercises.

In people over 65 years to determine the degree of risk of falling, you must use three simple tests, namely:

• The ability to stand on one leg with your eyes open (the risk rises if it is less than 10 seconds)
• Impossibility of non-stopping 100 m
• Inability to get out of the chair without the help of hands.

Which doctor heals

Treatment of osteoporosis is handled by a traumatologist, especially its complications. However, this disease lies within the competence of therapists, general practitioners, endocrinologists, gynecologists.

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A source: http://www.knigamedika.ru/kost/osteo/osteoporoz.html