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Osteoporosis

Osteoporosis

Introduction

Osteoporosis means porous bones. It is a disease, in which bones lose their strength and become brittle. Thus, even a sudden movement or coughing can cause their fracture. In most cases, the bone strength depends on the level of calcium and other minerals. The most common manifestations of osteoporosis are fractures of the spine, hip, and wrist. In this group, the most frequent are osteoporotic fractures of the spine. According to the World Health Organization, every fourth woman after 50 years old has one or more osteoporotic fractures of the spine (Hamdy & Lewiecki, 2013). Osteoporosis is considered a feminine disease. However, men also suffer from it. Osteoporosis is the most common bone disease. It affects more than half of people over 50 years old (Hamdy & Lewiecki, 2013). The relevance of the problem is caused by the disability as well as an increased risk of mortality among the patients.

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General Information on Osteoporosis

Osteoporosis is a condition characterized by the rarefaction and decrease of the density of bone tissue in the skeleton and violation of bones micro architectonics with a consequent increase in their fragility and a higher risk of fractures. In many countries worldwide, osteoporosis is one of the least studied diseases. Meanwhile, with the aging of the population, this disease strikes a growing number of people having a negative effect on health, style, and quality of life. In the book Osteoporosis: Diagnosis, Prevention, Therapy, Bartl & Frisch (2013) mention that “Osteoporosis slowly but surely nibbles away at the bones, possibly unrecognized for years, until finally it is revealed by the occurrence of a fracture almost without a case” (p. 1). Osteoporosis is extremely widespread throughout the world. It is known that in the United States, 25 million people suffer from osteoporosis (Bartl & Frisch, 2013). Each year, 250 thousand of Americans are diagnosed with hip fractures, 500 thousand – vertebrae, 3 million 240 thousand – carpal and radius (Bartl & Frisch, 2013). Annually, more than $ 10 billion is spent on the problem of osteoporosis in the United States (Bartl & Frisch, 2013). Bone tissue is a dynamic system that throughout a person’s life undergoes a physiological restructuring, which is based on the processes of destruction-reconstruction. If the skeleton is in a state of a “balance”, the number of resorbable bone equals the amount of the newly created. If the number of the resorbable tissues exceeds the number of the formed ones, the bone tissue density is reduced, which leads to osteoporosis. Osteoporosis is characterized by the absence of violations in a ratio of osteoid and calcified bone tissue. In the bone, the number of trabeculae reduces per unit volume. Primarily, it happens in the loaded areas. Firstly, cross trabecular bone disappears, later – longitudinal one. The reduction of bone tissue is accompanied by the expansion of inner trabecular spaces.

During the first three decades of life, the amount of bone mass increases due to the predominance of the process of bone formation. However, starting from the age 35-40 years, the intensity of the process of the resorption of bone tissue begins to exceed the intensity of formation of the new one, and bone mass decreases. Gradually and imperceptibly, the picture of osteoporosis develops. In this case, genetic as well as hormonal and physical factors play an important role in the development of the disease. If the total weight of the bone tissue at the age of 25-30 is taken as 100%, for men aged 60 and older, it will be 70%, and for women – only about 60%. According to the WHO, in 15-20% of people over 50 years old, osteoporotic changes are detected (Bartl & Frisch, 2013). These changes may result in fractures in 30% of them (Bartl & Frisch, 2013).

Signs and Symptoms

Very often, the symptoms of osteoporosis are absent in the early stages of the disease. People first learn about the illness only after non-traumatic fracture. The disease often manifests itself by pain syndrome, which usually lasts for a long period of time and is non-intensive. It is often located in the lumbar or cervical spine area. Painful sensations arise after prolonged staying in the forced position of the body or after long walking. An important symptom of osteoporosis is a change in posture, a pronounced slouch, and the inclination of the body. It is due to the fact that the vertebrae gradually take a wedge shape. The patient also has a sharp decrease in body weight. In a typical clinic of osteoporosis, the patient never has sharp pains that are more common for other diseases of the musculoskeletal system. This is due to the fact that the processes of reduction of the density and destruction of bone tissue occur slowly and gradually. The patient may also experience cramps in the calf muscles which appear mostly during the night hours, premature graying of hair, teeth and gum disease, fatigue, weakness, palpitations, and arrhythmia. It is extremely important to know how osteoporosis is manifested. When the initial symptoms of the disease appear, it is necessary to contact a specialist to confirm the diagnosis and if necessary, to start its treatment or prevention.

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Effects of the Disease on Human Body

Osteoporosis has a huge impact on the human body. It is often accompanied by fatigue and leg pain, cramps, increased fragility and dissection of nails, pain in the lumbar spine and the back, heart palpitations, and even the curvature of the spine. Clifford Rosen (2012) stated that “Tightness and tenderness are frequently observed in paravertebral muscles of the lower back and in the interscapular region of the patients” (p. 196). A person also experiences a general weakness of the body. One of the clearest signs of osteoporosis is the formation of dense dental plaque and the development of periodontal disease. It is a disease which is characterized by the denudation of the neck of the tooth because of the reduction of the gum. The connection of osteoporosis with dental health is obvious. In both cases, a normal amount of calcium in the body is of great importance. Calcium supports the bones and teeth.

Risk Factors and Preventive Steps

There are a number of indications, which may serve as a catalyst for the development of osteoporosis. They include poor diet in particular the frequent use of salty foods, coffee, alcohol, and frequent overeating.

There is also a genetic predisposition to osteoporosis. Smoking can be one of the causes of this disease. When a person applies drugs, side effects of which include the excretion of calcium from the body, it can lead to osteoporosis. The other risk factors affecting the development of the disease include sedentary lifestyle, rejection of sports, and the lack of physical activity. For women, rising of heavy weight and frequent wearing of high heels have extremely negative consequences (Reid, 2011). The thinning of bone tissue begins after 30 years. It is a natural process that cannot be completely stopped. However, even in the young age, there are preventive steps that can reduce the risks of the osteoporosis development. It is known that physical activity in the young age increases bone mass. In such a way, it decreases the risk of osteoporosis in adulthood. For prevention of osteoporosis, it is necessary to consume adequate doses of vitamin D and calcium. A person should avoid bad habits and maintain a healthy lifestyle.

Maintenance of Quality of Life

Aging is a physiological process. It is a step that inevitably occurs in the life of every person. Thus, the main task is to ensure the best quality of life of people in this age group. Important indicators that determine the quality of life of older people include independent life, opportunities in the preservation of mental functions, and the ability to self-care and mobility. In this case, osteoporosis and its complications are important factors limiting the independence of the elderly people.

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Diagnostic and Therapeutic Tools

Currently, diagnosis of osteoporosis does not represent significant difficulties. It should be remembered that conventional radiography is not able to assess the degree of osteoporosis. In such a way, doctors use other techniques to diagnose this disease. Radiography only allows suspecting the presence of osteoporosis by a characteristic change in bone density on radiographs. Nevertheless, for the treatment planning and evaluation of the dynamics of change in bone density, it is necessary to have quantitative information on the state of the bones. It is necessary to have opportunities to express bone density digitally. Quantitative estimation of bone density is the most important in the diagnosis of osteoporosis. For this research, a special term, densitometry, was invented. Densitometry is the density measurement. Diagnosis of osteoporosis using ultrasound densitometry has several advantages. Ultrasound densitometry is not accompanied by irradiation. It may be realized in a comfortable environment within a relatively short period of time. The safety of the research is so high that the ultrasound densitometry may be performed both for children and pregnant women (Marcus, Feldman, Dempster, Luckey, & Cauley, 2013). The main objectives of osteoporosis treatment are grafting of bone mass, prevention of fractures, reduction or complete elimination of pain, and provision of an optimal motor mode for patients.

Expected Outcomes and Prognosis

The main and most dangerous complication of osteoporosis is fractured. The most dangerous fractures are the ones of the vertebrae and femoral neck. Due to fractures of the femoral neck, osteoporosis occupies the fourth place among the most common causes of death of people in the world. Osteoporosis of the spine leads to the development of compression fractures even under light load. It is important to understand that in a significant number of cases, immobility following fracture of the spine or femoral neck ends with bedsores, congestive pneumonia, infectious complications, and thrombosis.

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Current Areas of Research

Over the past decade, there is a significant progress in understanding of the development mechanisms, principles of diagnosis, prevention, and treatment of osteoporosis. Each year, new methods of treatment appear. A group of doctors at the hospital of the University of San Francisco developed a new drug called alendronate. It promotes bone mass in women with osteoporosis. The scientists also concluded that the admission of such components as isoflavones increases bone density in the lumbar spine in women after the menopausal period.

Future Areas of Research

In the future, more research on osteoporosis will be conducted with respect to men. Nowadays, there are many studies regarding the state of women’s health in a period of menopause. However, not so many studies were conducted on the topic of men and osteoporosis. Whereas, to a great extent, osteoporosis has been evaluated in women, relatively few studies have been conducted in men.

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Conclusion

Every year, the world’s population is getting older. It leads to the increase in elderly population, a great number of which suffers from osteoporosis. Osteoporosis is a thinning of the bone tissue in the human body. It leads to the decrease in bone strength. They become extremely brittle. In turn, this fact may ultimately result in serious injuries. Osteoporosis often occurs in women over forty years old due to the hormonal changes in their body during this period. However, this disease occurs in men as well. The main reason for osteoporosis is the acute shortage of a useful element in the body – calcium.

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