Osteoporosis (bone degeneration) is a syndrome, in the course of which the bone mass continuously decreases. The skeleton becomes increasingly unstable and porous, while the risk of bone fractures increases. Osteoporosis affects the entire skeleton, but the impact may be more severe in specific areas.
In older people the bone mass decreases according to the frequently reduced level of physical activity. The bone metabolism is disturbed with osteoporosis, so that the natural process of bone degeneration is accelerated, resulting in an imbalance between bone formation and bone loss.
The causes of osteoporosis are found in an altered bone metabolism or in the insufficient, mechanical or muscular deformation of the bone materials. As a person ages, the muscular stimulus that deforms the bone via the tendons is reduced. The speed of movement and performance also decrease with age. When measuring the bone mass, this is why a reduction in the muscle cross-section at the measurement site is frequently seen as well.
Causes of secondary osteoporosis are illnesses that disrupt the metabolism and/or hormone balance. Other possible triggers include taking medications over the long term, or the excessive consumption of alcohol and nicotine. Primary osteoporosis occurs without discernible direct causes. Depending on the time of onset, it is called post-menopausal osteoporosis which occurs after menopause, or old-age osteoporosis which can occur starting around age 70.
As long as the reduction in bone mass is minor, there are no significant symptoms of osteoporosis. However, spontaneous fractures may occur in its subsequent course, especially vertebral body fractures. The consequences include pain, a reduction in height and other locomotor system disturbances. This is frequently associated with reduced physical activity, which impairs muscular performance and coordination that is sufficient to cause more frequent falling on its own.
A detailed consultation regarding the history of the illness is followed by a physical examination with several tests regarding mobility, muscle strength, muscle performance, balance and coordination. A DXA/pQCT radiology measurement is used to measure and evaluate the bone mass/bone density as well as the muscle cross-section where applicable. An X-ray can provide information regarding existing fractures.
Therapy depends on the cause and type of osteoporosis. Initially it is intended to influence the bone metabolism in order to prevent bone fractures. If bone fractures have already occurred as a result of osteoporosis, their acute treatment is required: this means alleviating the pain associated with the fracture as well. Osteoporosis treatment is also intended to reduce or entirely eliminate possible permanent complaints.
Left untreated, bone degeneration continues so that the bones become increasingly brittle. Beginning with osteoporosis treatment as early as possible is therefore important.
Orthoses can help stabilise and straighten the spine. They improve the body posture and activate the torso musculature.
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