Osteoporosis and osteopathy
What is osteoporosis?
Osteoporosis is a pathology that deteriorates the internal structure of the bone. The bone mass is therefore less important, the bone is therefore more fragile and the risk of facture is therefore increased.
Who is affected by osteoporosis?
- Osteoporosis affects mainly the elderly
- 39% of women aged 65 suffer from osteoporosis!
- 70% of women over the age of 80 suffer from osteoporosis
- Osteoporosis affects women 2 to 3 times more than men (due to menopause).
Some young adults can also be affected, for example in cases of malnutrition, anorexia, early menopause, etc.
Pathophysiology of osteoporosis
The roles of bone are:
- Create a rigid support for the body
- Allow anchoring to all soft tissues and organs
- To serve as a lever to move
- Protecting the brain in particular
Bone structure:
Although the compact bone appears dense and rigid, it is in fact made up of multiple galleries that allow the passage of neurofibers, blood vessels and lymphatic vessels.
Bone reshaping
In the adult, a bone remodeling is set up with a phenomenon of deposition and withdrawal of the bone material. Bone cells (osteoblasts and osteoclasts) are responsible for these processes. The osteoclasts are the cells responsible for the shrinkage of the bone cells. These deposition and shrinkage phenomena are in equilibrium in adults, i.e. they always keep the same bone mass.
The rate of bone reshaping varies according to the bone. For example, the distal part of the femur (at the knee) is completely replaced every 6 months.
Menopause
The menopause, with the cessation of sex hormone synthesis, is partly responsible. In fact, estrogen and testosterone help maintain bone density. Women are therefore more affected than men, but 1/4 of osteoporotic fractures occur in men.
Areas most affected by osteoporosis:
It is estimated that more than 375,000 fractures occur each year due to osteoporosis.
Although osteoporosis affects the entire skeleton, some areas are more affected than others (from more to less frequent):
- Hip: The femoral neck fracture is one of the most common osteoporotic fractures.
- The spine: its spongy bone is one of the most affected, which causes fracture and compression of one or more vertebrae
- The wrist: the famous Pouteau-Colles fracture corresponds to the fracture of the distal end of the radius and is one of the best known osteoporotic fractures.
Factors that make osteoporosis worse:
- Lack of physical exercise ++++: mechanical and gravitational stresses are important elements that promote bone renewal
- Smoking
- Alcohol consumption
- Undernutrition, poor diet
- Menopause
- Hormonal pathologies such as hyperthyroidism, diabetes mellitus, rheumatoid arthritis
- Medications: long term corticosteroid therapy
How is osteoporosis assessed?
After a precise interrogation, the reference examination for osteoporosis is theosteodensitometry (BMD). This examination gives a score that is then compared to a reference value for young adults: the lower the score, the higher the risk of fracture.
The FRAX® or "WHO Fracture Assessment Fracture tool" is a computerized system developed by the WHO to assess the risk of fracture. It takes into account 12 parameters (BMD score, age, weight, history of fractures in the patient or hip fractures in his/her parents, etc.) and thus determines the risk of fracture over the next 10 years.
Treatment of osteoporosis:
- Exercise +++.
- Good nutrition: proteins, vitamins C, B12, minerals (calcium, phosphorus, magnesium, manganese, etc)
- Vitamin D cure
- Calcium cure
- Drug treatment: the most commonly used are those of the bisphosphonate family, which slow down the activity of osteoclasts (bone cells responsible for bone destruction). Taken for 3 to 5 years, they reduce the risk of fracture by 2.
Osteopathy and osteoporosis?
Your osteopath does not treat osteoporosis per se, but he is there to advise you on exercises adapted to your condition. His role is to remove all blockages and relieve all your pain so that you can resume physical activity. If you suffer from osteoporosis or osteopenia, your osteopath will adapt his techniques and practice so that no technical gesture is deleterious. Do not hesitate to contact your osteopath if you have any questions.
Marie Messager
Osteopath D.O
2 rue Alexis de Tocqueville
78000 Versailles
