“In young people too, sport is evidently very good for the health of the skeleton, as long as it is not reduced to an unbalanced sport like throwing the javelin, and it is not practised to excess. Therefore some athletes who over-train and worry about their weight to the point of becoming anorexic are subject to hormonal problems and serious osteoporosis”, explains Professor Reginster=;

Fear of falling

The article published in Osteoporosis International also emphasises the importance of a good body mass index and in addition, the importance of a lifestyle without tobacco and alcohol abuse. Furthermore, it examines the important question of falls among elderly people. The majority of these could be avoided by common-sense solutions based on creating a safer environment: removing slippy carpets, fitting a handle to the shower or bath, checking spectacles, and by refraining from taking benzodiazepines or sleeping pills. Besides these extrinsic environmental causes of falls there are also intrinsic causes of falls: calcium or vitamin D deficiency, conditions such as Parkinson’s disease, etc.

In order to reduce the risk of hip fracture, hip protectors have been developed. These “pads” have been tested in nursing homes. In the context of experimental studies they significantly reduce the impact of falls, but these results have not been verified in cohort studies due to low therapeutic adherence to these systems by elderly people.

Osteoporosis can be easily diagnosed, prevented and treated. Different molecules which we will not list here are available. Some frequently prescribed medicines, including bisphosphonates, block the function of osteoclasts and thus slow down loss of bone mass. Others stimulate the action of osteoblasts and therefore bone formation. Yet another substance, strontium ranelate, is the only one to act on both counts - reduction of bone resorption and stimulation of bone formation. Each one of these medicines has its own performance profile and secondary effects.

For around twenty years, two surgical techniques have enjoyed growing success in the treatment of severe osteoporosis characterised by vertebral lesions. Vertebroplasty (VP) consists in injecting bone cement into the diseased vertebral body in order to reinforce the weakened vertebra and treat the bone pain. Kyphoplasty is a variant of this technique. Bone cement is injected into two balloons which are introduced into the vertebral body. The main risk linked to these methods involves the toxicity of the cement in case of leakages. These are rare but can cause intense pain when the cement leaks into the intervertebral foramen.