Original title: She was a little tilted when sitting in the chair. She had a compression fracture of the lumbar spine. Beware of the "silent killer"! How to prevent it? This orthopedic expert shares the secret of "maintenance"
If you sit well, you will be broken; if you bend down and hug the child, you will be broken; if you sneeze, you will be broken; if you gently touch the tail of the bed, you will be broken; if you get up after going to the toilet, you will be broken... For patients with osteoporosis , fractures that may occur anytime and anywhere are like a "curse", which cannot be avoided and is distressing. In 2018, the National Health Commission of carried out the first epidemiological survey of osteoporosis in Chinese residents . The survey shows that the prevalence of osteoporosis among people over 50 years old in my country is 19.2%, and by the age of 65, the prevalence of osteoporosis reaches 32.0%. Among them, the prevalence rate of middle-aged and elderly women is much higher than that of men of the same age, and the prevalence rate of osteoporosis in women over 65 years old reaches 51.6%. October 20 is World Osteoporosis Day . Professor Hu Yihe, director of the orthopedic department of , the First Affiliated Hospital of Zhejiang University School of Medicine, said that although osteoporosis is an inevitable result of human aging, timely bone density screening can be carried out to effectively prevent and extend the time of osteoporosis as much as possible and to carry out good control to prevent the occurrence of fractures, which can greatly improve the quality of life. "Preventing osteoporosis is not only about preventing fractures, but also about moving the checkpoint forward. When you are young, you start to pay attention to maintaining your bones, regular exercise, and balanced diet." Professor Hu said.
Lucken and back bone pain is the most obvious symptom of osteoporosis. Be careful of osteoporosis fractures. Let’s first understand what osteoporosis is. Professor Hu Yihe introduced that osteoporosis refers to a systemic bone disease in which the pores of the bone become larger, the decrease in bone density and bone mass leads to an increase in bone fragility and an increase in the risk of fracture. "The bones in the human body are constantly metabolizing, on the one hand, constantly absorbing bones, and on the other hand, constantly losing bones. In childhood, absorption exceeds loss, our bones continue to grow, and basically reach balance when adults are adults. When middle-aged and elderly people, the loss exceeds the absorption, and over time, it will lead to osteoporosis." In the eyes of many people, osteoporosis is a natural aging phenomenon that occurs with age, and it does not hinder the problem and does not require special treatment. In fact, osteoporosis brings great harm. General bone pain, especially low back bone pain, is the most obvious symptom of osteoporosis. Professor Hu Yihe said that osteoporosis is often called the "silent killer" and its occurrence and development are often silent. In the early days, the body did not feel obvious, but in fact, bone calcium and bone mass were slowly passing, bone density and and bone strength were gradually decreasing, the microstructure of the bone was destroyed, and the bone brittleness increased, which in turn caused bone pain, deformation, comorbidities, etc., posing a huge threat to the spine, hip and wrist. When it develops to the late stage, severe scoliosis will occur, and even evolve into sneezing or coughing, or slightly touching furniture, or turning over while sleeping, which will cause fractures, which will seriously affect the physical health and quality of life of middle-aged and elderly people, and even shorten their lifespan.
Osteoporotic fractures are one of the main causes of disability and death in elderly patients. A set of data published by the International Osteoporosis Foundation shows that an osteoporotic fracture occurs every 3 seconds worldwide. "One-third of women and one-fifth of men will suffer a fracture after the age of 50. Within one year of hip fracture, about 20% of patients will die of various complications, and about 50% of patients will become disabled because of this." Professor Hu Yihe said, "Once osteoporosis is diagnosed, beware of the occurrence of osteoporosis fracture."
sat slightly off while sitting in the chair. 79-year-old grandmother lumbar compression fracture
Some time ago, 79-year-old grandmother came to Professor Hu Yihe's clinic accompanied by her family. "Doctor Hu, our old lady has always been very healthy. She suddenly couldn't sit still these days. As soon as she sat down, she said back pain . After thinking about it, she couldn't find the cause of the back pain. I don't know what happened."
looked at Grandma Yang with a hunched back and kept calling for back pain. After careful understanding of the medical history, Professor Hu initially judged that Grandma Yang was a lumbar fracture of caused by senile osteoporosis."Fracture? The old lady usually manages her tightly, and there are people following her when she goes out. Recently, she hasn't fallen down and has no bumps or bumps. Why did she get a fracture?" Professor Hu Yihe arranged for Grandma Yang to undergo an MRI examination, and the results confirmed Professor Hu's previous judgment: Grandma Yang's lumbar compression fracture, and the bleeding and edema at the lumbar spine indicated that this was a new injury, which was a relatively obvious osteoporotic fracture. At the same time, the bone density test results showed that -3.5 (the bone mass is normal at the bone density above -1, -2.5--1 is a decrease in bone mass, and below -2.5 is osteoporosis. If the osteoporosis fracture is below -2.5, it is severe osteoporosis). Grandma Yang suffered from severe osteoporosis. Before this, Grandma Yang had not undergone relevant screening for osteoporosis, let alone treatment, and her family did not know about osteoporosis. Faced with the doubts of his family, Professor Hu further explained, "Osteoporotic fractures usually occur in the hip, lumbar spine and wrist. We have received many elderly patients with osteoporotic fractures like Grandma Yang. They did not fall or bump. Some people had broken bones after sitting in a leap, some people had broken bones after lifting a thermos bottle, and some even broke their ribs after sneezing." "Oh, I remembered that some time ago, when I was sitting in a chair, I didn't sit upright and tried to use some force. After that, 's back and began to hurt. It turned out to be a fracture." Grandma Yang suddenly realized.
The population of low bone mass in my country is large in people over 50 years old. There is almost one in every two people with low bone mass
The occurrence of osteoporosis is closely related to the accumulation of basic bone mass and bone mass loss after age increase. The mineral content in the human skeleton reaches the highest peak bone mass around the age of 30. The higher the accumulation level of bone mass, the later the osteoporosis will occur in middle-aged and elderly people, and the milder the symptoms and degrees will be.
The number of people with low bone mass in my country is huge. An epidemiological survey on osteoporosis among Chinese residents released in 2019 showed that the low bone mass rate among people aged 40-49 in my country reached 32.9%, while the low bone mass rate among people aged 50 and above is as high as 46.4%. In other words, among people aged 50, almost one in every two people has a low bone mass. "People with low bone mass are all high-risk groups for potential osteoporosis." Professor Hu Yihe said that if patients with low bone mass do not actively intervene and further lose bone mass, they will reach the range of osteoporosis. Professor Hu said that low bone mass status and early osteoporosis usually do not show obvious clinical manifestations, and the public lacks understanding of the importance of osteoporosis prevention. In addition, the ability to prevent and treat osteoporosis in primary medical and health institutions is insufficient, and the bone density detection rate of Chinese residents is low. Most residents did not take timely prevention and control measures in the early stages of bone mass decline. They found themselves sick after pain, spinal deformation and fractures, which delayed the favorable opportunity for the prevention and treatment of osteoporosis.
survey shows that the awareness rate of osteoporosis-related knowledge among people over 20 years old in my country is only 11.7%. Among patients with osteoporosis, the proportion of people who know that they are suffering from illness is also low. The awareness rate of osteoporosis aged 40-49 is 0.9%, and the awareness rate of patients over 50 is only 7.0%. Among people over 50 years old, the proportion of those who have undergone bone density testing is 3.7%.
How to prevent osteoporosis in healthy adults? The most important thing is to exercise and balance diet. Bone density determined by dual energy X-ray absorption method is the main standard for the diagnosis of osteoporosis. The detection sites are mainly the hip (proximal femur) and the lumbar spine. Professor Hu Yihe said that the treatment barrier for osteoporosis should be moved at present. After menopause of women over 50 years old and men over 55 years old, bone loss should be accelerated, and a bone density test should be performed. If there is no problem, it can be tested every year; if there is any problem, a doctor should be asked to treat osteoporosis in time. "Preventing osteoporosis is not only about preventing fractures, but also about moving the gate forward. When you are young, you start to pay attention to maintaining your bones, regular exercise, and balanced diet." Speaking of this, Professor Hu Yihe "appeared to speak out." Professor Hu is 58 years old this year. At this age, his bone density is on the decline. Three years ago, Professor Hu began to do bone density tests once a year to check his own bone density. “The test results show that my bone density is still as good as a young man, very good."How did it be done? Professor Hu Yihe shared his "maintenance" experience, that is, reasonable exercise + balanced diet, which is the best method of prevention of osteoporosis for healthy adults. "I usually have the habit of fitness, play basketball and volleyball twice a week, and exercise a lot. I also bought mountain bike . Whenever I have time, I will ride along Qiantang River to exercise. Exercise will cause mechanical stress on bones, stimulate bone cells, increase bone level, and increase bone density, which is very helpful in preventing the occurrence of osteoporosis. "In addition, Professor Hu also attaches great importance to diet control, pay attention to the combination of carbohydrate , eat more foods rich in calcium, low salt and appropriate amounts of protein , and do not smoke or drink alcohol in normal times.
For exercise, Professor Hu also emphasized that you must find a way of exercise you like and most suitable for so that you can persist for a long time. For the elderly, walking, dancing square dance or playing Tai Chi are also good exercise choices.
"There is another reminder that you should receive more adequate illumination in daily life and supplement vitamin D. In addition, after , menopause , women should actively carry out estrogen replacement therapy under the guidance of a doctor. "
If osteoporosis has been diagnosed, relying solely on lifestyle intervention and balanced dietary nutrition is far from enough. Patients should also undergo standardized drug treatment to help slow bone loss, increase bone density, and prevent the occurrence of fractures and refractory.
Orange Persimmon Interaction·Urban Express Reporter Jin Jing Correspondent Wang Rui Zhu Shiyi
