A 67-year-old woman, Huang, was halfway down the stairs when she suddenly heard her bones click and felt some pain in her lower back, thinking she hadn’t fallen and shouldn’t be bothered, so she went shopping for groceries. As a result, the next day she felt so much pain in her back that she couldn’t even walk. After being persuaded by her family, Granny Wong eventually went to the hospital to have a film taken and was diagnosed with a compression fracture. Granny Huang felt very surprised, just going down the stairs could also be fractured? In fact, examples like Granny Huang are not uncommon. In the absence of an obvious history of injury, elderly people with osteoporosis may still suffer compression fractures due to some minor external forces, and some elderly women may even suffer compression fractures due to an arm extension while sunbathing or simply getting off a bus, causing back pain and sleeplessness. When compression fractures occur in the elderly, most will feel widespread low back pain, sometimes with a constant dull ache, sometimes with leg pain, or with cramps because of calcium deficiency. Some patients with severe geriatric compression fractures are even unable to walk at all and may eventually become paralyzed. The prevalence in postmenopausal women can be as high as 40% Most of the patients with geriatric compression fractures suffer from osteoporosis, a systemic disease that manifests itself as a reduction in bone mass per unit volume and is prone to fracture. Currently, about 100 million people worldwide are at risk of osteoporosis, and the World Health Organization has designated the first decade of the 21st century as the decade of prevention of osteoporosis and osteoarthrosis The World Health Organization has designated the first decade of the 21st century as the decade of prevention of osteoporosis and bone and joint diseases, which also highlights the seriousness of this problem. Currently, the prevalence of primary osteoporosis among postmenopausal women in China can reach 30-40%, much higher than in men, with almost two out of 10 patients being men. The main reason for the high incidence of osteoporosis in the elderly in China is that the “bone foundation” is not well laid when you are young. Bone foundation around 30 years old is the key The bones are usually the strongest in a person’s life around 30 years old, and the bone volume reaches its peak, that is, the peak of bone. At that time, the bone cortex is the thickest, the bone volume is the highest, and the bone trabeculae are the most, so it is not easy to fracture when you fall. From the age of 35 to 40 years old, bone volume begins to gradually decrease. After menopause, the body’s ability to retain bone calcium decreases as estrogen production decreases, and calcium is easily lost. When the amount of bone per unit volume decreases, the bone cortex becomes thinner and the bone trabeculae decrease, osteoporosis will easily occur. If you build a good foundation when you are young, so that your peak bone mass increases, then in old age you will generally not get serious osteoporosis, young people should pay attention to exercise from their 20s, maintain balanced nutrition, and eat more calcium-rich foods, such as milk, seafood, beans and eggs. In addition, proper sun exposure is also important because vitamin D needs to be exposed to ultraviolet light in order to become active vitamin D3 that can promote calcium absorption. Women should pay attention to calcium supplementation and sun exposure before and after menopause For women around 50 years old, before and after menopause, they should take proper calcium supplementation. The calcium intake from food is generally only 300-600 mg, and there is still a shortage of several hundred mg, so some more calcium supplementation is needed. The elderly should also take some vitamin D supplements along with calcium to promote calcium absorption, and they should also do some outdoor activities and get some sunshine properly. Active treatment to avoid further damage to the vertebrae In addition to calcium supplementation and prevention of osteoporosis, the elderly should also undergo active treatment for compression fractures that have already occurred. Once a compression fracture occurs, the elderly should first try to rest in bed to avoid further damage to the vertebrae, and go to the hospital in a timely manner to take pictures. Elderly compression fractures often have only one vertebrae injured at first, but if left untreated, it may lead to multiple vertebrae being compressed, and even eventually develop into a hunchback. When the chest and abdomen of the elderly are compressed for a long time, it will not only affect lung function, but also cause loss of appetite. If they cannot walk and are bedridden for a long time, it will not only further cause bone loss, but also may lead to a series of complications such as lung infection, decubitus ulcers, and deep vein embolism in the lower limbs. A retrospective statistics shows that in a follow-up survey of 280 cases of hip fractures in elderly people over 60 years old, it was found that 26% of these elderly people died in the year after the fracture occurred, only 74% survived, and 20% of the survivors had another fracture within a year. This is truly alarming. Besides compression fractures, osteoporosis has many other clinical manifestations, such as low back pain, body aches, shortened height, hunchback, etc. How is osteoporosis diagnosed? The main medical test is to check bone density. The most recognized test method is the dual-energy X-ray absorptiometry, which can accurately measure the degree of bone loss in a simple and safe process. The amount of radiation is only 1% of that of a typical radiograph. This test was carried out several years ago at Ningbo Hospital of Traditional Chinese Medicine. The most effective and low-risk method of internal treatment for osteoporosis is to take a bisphosphonate preparation along with calcium and vitamin D. The most commonly used is Fosamax. There is insufficient evidence that calcium and vitamin D supplementation alone can replace other anti-osteoporosis medications. In the event of a fracture, vertebroplasty and kyphoplasty are the new minimally invasive methods currently available to treat compression fractures. Hormone replacement therapy is another drug therapy in addition to calcium supplementation and bisphosphonates. This therapy generally requires both estrogen and progesterone supplementation, but some studies have found that this practice has an increased risk of gonadal and breast tumors in women, so patients need regular hospital visits for breast, uterine and ovarian examinations during the use of hormone replacement therapy. These reasons have led to the less frequent use of hormone replacement therapy for the treatment of osteoporosis. Because there are a series of complicated issues such as judging the efficacy, course of treatment and side effects of drug therapy, it is not recommended for patients to take it by themselves, and they should go to a hospital to see an experienced rheumatologist or orthopedic specialist.