It is an old saying that everyone knows: “Life is old when you are seventy”. But with the progress of society and the trend of human development, today there are many elderly people over 70 years old, even “60-70 years old” has been called the golden age, many people retired to have their own time to do their favorite things, participate in entertainment, travel and other activities, the spirit of another kind of sublimation. However, one of the dangers that comes along with this is osteoporotic fracture, which is becoming a serious problem that affects the quality of life. In the past, the medical profession did not know enough about “osteoporotic fracture”, and the focus of prevention and treatment was on cardiovascular disease, diabetes, cancer, etc. With the gradual improvement of research in this area, we found that “osteoporotic fracture” is an important cause of many diseases in the elderly patients, especially motor system diseases. The research in this area has been intensified, and we found that “fracture laxity” is an important cause of many disorders in elderly patients, especially motor system disorders. Definition of osteoporosis or fracture-sparing disease: It is a systemic bone disease characterized by a decrease in bone mass and degeneration of the microstructure of bone tissue (microscopically thinning, fracture and reduction in the number of cancellous bone trabeculae; porous and thinning of cortical bone), resulting in an increase in bone fragility and fracture risk. Clinical manifestations: mainly pain, height shortening, hunchback, fracture and respiratory disorders. Among them, osteoporotic pain is the most common and main clinical symptom, accounting for about 58% of clinical symptoms, of which low back pain accounts for 70%-80%, mostly dull pain without fixed pressure points; the older the age, the higher the incidence, women’s symptoms are heavier than men’s, women’s symptoms are heavier after menopause than before menopause, pain is aggravated by sitting and standing for a long time, pain is relieved when lying down, late at night The pain is relieved when lying down, stiffened when waking up late at night and early in the morning, and increased bone pain, but often relieved during the day; the pain is increased when coughing or defecating. According to statistics, 67% of patients with osteoporosis have limited low back pain, 9% have low back pain with radiating pain in the extremities, 10% have low back pain with band pain, 4% have low back pain with numbness, and 10% have not only low back pain but also numbness in the extremities and intercostal neuralgia and weakness when flexing and extending the low back. Some patients do not know enough about “osteoporosis” and think that it is a “chronic strain”, and they do not realize that there is serious osteoporosis until a fracture occurs. Osteoporotic fractures mostly occur in areas of greater stress, most commonly vertebral fractures, mostly caused by lifting objects (sometimes not necessarily too heavy), compression of the vertebral body, loss of height, narrowing of the intervertebral foramen compressing the nerve roots causing numbness and weakness of the lower limbs, sensorimotor dysfunction, pain in the lower back spreading to both sides of the ribs, also similar to angina pectoris, acute abdomen; followed by hip fractures, mostly caused by falls. After the injury, the lower limbs are deformed and cannot move due to severe pain, and if the treatment is not timely, it is often a life-threatening condition due to long-term bed rest. Causes: Under normal circumstances, bone metabolism includes two processes: osteogenesis and osteolysis, and osteogenesis is higher than osteolysis in young people; on the contrary, osteolysis is higher than osteogenesis in elderly people. The former includes ethnicity (Caucasians and yellow people are at higher risk than black people), old age, female menopause and maternal family history, while the latter includes low body weight, drug use (corticosteroids and drugs affecting bone metabolism cause secondary osteoporosis), low sex hormones, smoking, excessive alcohol consumption, coffee and carbonated beverages, lack of physical activity, lack of calcium in the diet The clinical diagnosis of osteoporosis is based on the following factors: lack of physical activity, lack of calcium in the diet, vitamin D deficiency (low light exposure or low intake) and diseases affecting bone metabolism. Clinical diagnosis: “Bone densitometry” is currently the best quantitative indicator for diagnosing osteoporosis, predicting osteoporotic fractures, and monitoring the natural course of the disease or the efficacy of drug interventions. “Dual-energy x-ray absorptive bone densitometry is currently recognized as the gold standard for diagnosing osteoporosis in the international academic community. Other methods include conventional radiography, single photon and single energy x-ray absorptiometry, quantitative CT, micro CT, quantitative MRI and quantitative ultrasonography, but for various reasons these methods are less commonly used. Laboratory tests are mainly used for differential diagnosis with other diseases and for further determination of the type (cause) of osteoporosis. Prevention and treatment of osteoporosis Osteoporotic fractures caused by controllable factors can be prevented, and drug treatment with appropriate physical exercise is necessary. There are three types of medications: 1. Calcium, as a basic medication, is gradually being recognized. The most representative drug at present is “Calcium D”. Some studies have shown that 1200mg/day calcium supplementation does not increase the risk of atherosclerotic vascular disease in older women. The typical clinical dose is 600mg/day (1 capsule), or 1200mg/day (2 capsules) when other medications are used. Other calcium agents are calcium gluconate, etc. 2. Drugs that promote the absorption of calcium ions, i.e. “active vitamin D”, act directly on the intestinal mucosa to increase the absorption of calcium. Under normal conditions, the body itself can produce enough active vitamin D after the sun’s ultraviolet rays irradiate the skin, but as we age and the body’s various functions diminish, this “photosynthesis” basically stops, and the direct result is – calcium deficiency. Active vitamin D has many trade names (depending on the manufacturer): osteotriol, rogaine, alfa osteotriol, etc. 3, promote “osteogenic” drugs, with the function of active transfer of calcium ions in the blood to the bones, by promoting osteogenic metabolism to achieve the result of enhancing bone density. These drugs are mainly “calcitonin”, the clinical use of salmon calcitonin, there are two kinds of domestic and imported, imported drugs have nasal spray and injection two kinds of dosage form. Both need to be used under the guidance of a doctor, and must be used on the basis of adequate calcium supplementation. Calcitonin has a definite calcium transport function, but it can also provide direct pain relief through another mechanism, thus having a good therapeutic effect on pain caused by osteoporosis. 4, to prevent “osteolysis” drugs, through the inhibition of osteolysis cell osteolysis, hinder osteolysis metabolism, prevent the loss of calcium salts in the bone, so as to achieve the purpose of preventing osteoporosis. At present, the representative drugs of this kind are mainly “bisphosphonates”, including: alendronate sodium (trade name: Fosamax, oral form), zoledronic acid (trade name: MIGUDA, injectable form). They also need to be used under the guidance of a doctor, especially the use of zoledronic acid must be used under the guidance of an experienced physician to reduce the occurrence of complications. The above four drugs can be used alone or in combination, depending on the degree of osteoporosis. The combination is generally more effective, 1+2+3 or 1+2+4, and for patients with severe fractures, more than four classes of drugs are used simultaneously. A database of 63,897 subjects evaluated in 29 randomized trials of calcium supplementation alone or in combination with vitamin D to prevent fractures or osteoporotic bone loss concluded that supplementation with calcium and vitamin D in people over 50 years of age significantly increased bone mineral density in the lumbar spine and hip and significantly reduced the risk of fracture by 12%. There is also information that the risk of fracture is reduced by about 20%. The importance of proper physical activity. The principle of functional adaptation of bone suggests that stress stimulation within normal limits is necessary for normal bone development. Older adults can prevent the incidence of age-related osteoporosis by increasing the stress stimulation of bone through appropriate exercise. Some studies have shown that exercise intervention can reverse osteoporosis in the elderly and alleviate the process of bone loss due to aging, thus maintaining normal bone morphology. The mechanism lies in the fact that the stimulation of exercise load is necessary to promote the increase of bone calcium salts, and the mechanical load of muscle contraction and diastolic exercise will contribute to the increase of bone calcium salts during the growth period. Exercise also produces stress on the bone through muscle activity, and increased skeletal stress produces a negative pressure potential in the bone, making it susceptible to binding cationic calcium ions and promoting osteoblast proliferation and differentiation. Starting exercise at any time has a positive effect on maintaining a certain amount of bone mass. Some studies have also pointed out that too long an exercise session is not beneficial to bone health, and that the frequency of exercise is based on the subjective feeling of the individual, to the extent that no fatigue is felt the next day. Preventive treatment is more economical than the costly treatment of osteoporotic fractures.