Treatment paths for osteoporosis are all different. The patient’s overall physical condition and health are a deciding factor in this. The doctor takes a decision on the targeted treatment after talking to the patient. Doctors have different approaches. These include treatments with and without medication. In the case of so-called “secondary osteoporosis”, which arises because of another disease (e.g. hyperthyroidism), the doctor will treat this underlying disorder. In some cases, certain forms of medication have led to secondary osteoporosis. Usually the doctor will then switch to medication that does not negatively impact bone density. Non-medicinal treatment of osteoporosis Every patient suffering from osteoporosis should ensure they get sufficient exercise and eat a balanced diet. What is more, there are numerous possibilities to prevent falls. Physical measures can provide support or alleviate pain. These include cold therapy or thermotherapy, massages and acupuncture. Medicinal treatment of osteoporosis Numerous active agents aimed at fighting osteoporosis are available on the market. Which active agent is the right one for a patient depends on the individual case, for example the severity of the disease and the patient’s medical history. The active agents fighting osteoporosis usually serve to help build up the bone or stop bone loss. As a general rule, this prevents deformations and fractures in the long term. The medication is usually taken for three to five years. Included among the most commonly-used active agents or groups of active agents are:

• Bisphosphonates: Bisphosphonates are intended to prevent or stop bone loss and strengthen

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Have you been diagnosed with osteoporosis? The good news is: Effective treatments are available for osteoporosis today. You can contribute decisively to this – provided you comply with the requirements and indications for treatment. This is the only way to ensure good efficacy. Your doctor has surely spoken with you about the treatment. He/she described the various forms of osteoporosis treatment to you: the therapy with and without medication. It is important to adhere to the treatment plan exactly. What do you have to pay attention to with a medication-free osteoporosis treatment?

• Enough exercise: Especially if you are not used to exercising, discussing with the doctor

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Better Understanding Osteoporosis

                            Better Understanding Osteoporosis World Osteoporosis Day occurs once every year. It was initiated by the British Osteoporosis Association in 1996. Its objective is to increase social awareness of osteoporosis and its prevention. In the meantime, informative events and campaigns about this type of bone loss take place year after year on 20th October in almost 100 countries worldwide (http://worldosteoporosisday.org/). But what is osteoporosis? How does osteoporosis develop? And what can patients do to prevent it or treat it? Osteoporosis – a common disease Osteoporosis is considered a common disease. Currently osteoporosis is estimated to affect more than 200 million women worldwide, but according to the World Health Organization this number will increase. The WHO ranks osteoporosis among the ten most common chronic diseases of our time. The most difficult thing is that it is often not recognised as such. According to the International Osteoporosis Foundation (IOF), less than a quarter of all cases are identified at an early stage and treated appropriately. What is the reason for this? Osteoporosis usually develops slowly and can be asymptomatic and therefor go unnoticed for many years. The diagnosis often only comes after a slight fall, for example, which resulted in bone fractures and would otherwise have remained without consequences. The patient may thus already be suffering from reduced bone density before a fracture occurs. The fracture is only a late consequence. How does bone loss occur? Bones are not a dead substance. They consist of living tissue. This tissue builds up regularly over the course of our lives – but it also breaks down. This is actually a normal process. The bone mass increases until about the age of 30. Then the opposite happens: it decreases. This means that we lose more old bone mass than we produce. But as soon as this natural balance is disturbed, the bone mass changes. Bone loss accelerates. Even slight strain or harmless falls – at least from other people’s point of view – may lead to bone fractures. A preliminary stage of osteoporosis is osteopenia. It refers to a reduction of bone density, which is not as severe as in the later stage, so it is the midway point between healthy bones and osteoporosis. However, people suffering from osteopenia also have an increased risk of bone fractures. Another bone-related condition is osteomalacia, which describes the softening of bones, usually caused by a lack of calcium and vitamin D. What disturbs the balance? Calcium deficiency, insufficient exercise and hormone-related illnesses can inhibit bone formation and stimulate bone resorption. Women are more frequently affected than men, especially after menopause due to the hormonal changes. In 30 per cent of women, the risk of bone loss increases during this stage of life. The metabolism in our bones is partly controlled by oestrogen and testosterone, the female and male sex hormones, as well as vitamin D and other hormones, for example, produced by the thyroid gland. From the age of 35, the female body produces less oestrogen. The consequence: It breaks down more bones than it builds up. If the body merely lost one per cent of its bone mass before menopause, the figure quickly rises to four per cent. Some women lose almost 40 per cent of their bone mass between the age of 40 and 70. By contrast: for most men, the figure is just 20 per cent. However: Despite the proven link between oestrogen and osteoporosis, not every woman necessarily falls prey to it after menopause. Other factors also play a role.           How do I prevent osteoporosis? The best case scenario is to prevent or treat osteoporosis before the first fracture, because it is very difficult to rebuild bone mass once it has been lost. Some of the risk factors can be mitigated by each individual, while others cannot. Risk factors that cannot be influenced:  

• Genetic traits
• Age-related drop in oestrogen

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Early Detection of Osteoporosis Osteoporosis patients often feel no pain whatsoever at the beginning of the disease. Back or knee pain may not occur until much later. A bone fracture after a seemingly harmless fall or without any recognisable cause can also be a sign of osteoporosis. If the disease has progressed, such fractures, for example a femoral neck fracture or fractures of the vertebral bodies, tend to occur more frequently. Early detection to stop progression The earlier osteoporosis (bone loss) is detected and treated, the better the progression can be stopped. Accordingly, if you think you have broken your bones without any apparent reason, you should seek medical attention early. Doctors call this a ‘spontaneous fracture’. People who belong to the risk groups for osteoporosis should routinely have their bones checked by a physician. The first point of contact is usually the primary care physician. The general practitioner often refers the patient to a specialist, for example an orthopaedist. Who belongs to the osteoporosis risk groups? 1. Women and men aged 70 and over 2. People aged 50 and over with various risk factors for osteoporosis-related fractures, for example

• Patients with vertebral body fractures after minor injuries
• People who are underweight,

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