Nowadays, when it comes to the common diseases and illnesses of the elderly, everyone will be the first to think of osteoporosis, and once the elderly around us have traumatic fractures, we will often remind that you should go to check if you have osteoporosis, which shows that we all have the awareness of health care, which is also the credit of our social media to vigorously promote the guidance. So what is osteoporosis? Now osteoporosis in the eyes of our people is a lack of calcium, so the texture of the bone becomes worse, loose off, prone to fractures. The real meaning of osteoporosis should be defined by WHO: a systemic skeletal disease characterized by a decrease in bone mass, damage to the microstructure of bone (patients can be found with a significant thinning of bone trabeculae, a decrease in the number of bone trabeculae, and traces of fracture between bone trabeculae), and an increase in the brittleness of bone, which leads to an increased risk of bone fracture. The main pathological change is the decrease in the content of bone matrix and bone minerals, which makes the bone brittle and prone to fracture due to the decrease in bone mass and the basically normal calcification process. So here we want to correct a misunderstanding about osteoporosis, now we all think that the treatment of osteoporosis is calcium supplementation, but here please note that there are two main components of the pathological changes that lead to the reduction of bone mass, namely bone matrix and bone minerals, and calcium is only part of the bone minerals. Therefore, when we understand what osteoporosis is, we should know that osteoporosis is not just a lack of calcium. Classification of osteoporosis Osteoporosis can generally be divided into three categories: primary osteoporosis, which is a physiological degenerative disease of bone that occurs with age; secondary osteoporosis, which is induced by other diseases or drugs; and idiopathic osteoporosis, which is mostly seen in adolescents aged 8-14 years old, most of whom have a family history of genetic predisposition. Primary osteoporosis can be divided into two types: Type 1 is postmenopausal osteoporosis, which generally occurs in middle-aged and older women after menopause; Type 2 is senile osteoporosis, which generally occurs in older people over 65 years of age. From the above classification, we can see that there are various factors that contribute to the occurrence of osteoporosis, which can be related to hormone levels, nutritional factors, physical factors, genetic factors, and the influence of certain medication factors. In our TCM theory, osteoporosis belongs to the scope of “bone impotence”, and the impotence of bone can be functional and structural atrophy, and TCM believes that the occurrence and development of this disease is closely related to “kidney qi” and “kidney essence”. Chinese medicine believes that the occurrence and development of this disease is closely related to the “kidney qi” and “kidney essence”, as stated in the “Six Sections of Su Wen”: “The kidney is the main dormant, the essence of the essence, and the essence of the essence is also in the hair and the bone.” Since the Su Wen, there has been the theory that “the kidney is the master of bone”, but of course the concept of kidney in Chinese medicine is different from the concept of anatomical structure of the kidney we are talking about now. So what are the consequences of osteoporosis? Now we all know that the consequences of osteoporosis are more serious because the bones become loose, so it is easy to produce fractures, once the fracture occurs, will certainly affect the life of the patient. Osteoporosis-induced fractures most often occur in the thoracolumbar vertebrae, wrists and our hips. But in fact, more patients with osteoporosis are not bothered by fractures, their main symptom is pain, and this pain can significantly affect their lives, and the cause of pain occurs mainly due to excessive bone conversion and increased bone resorption. There are three main causes of pain: first, the generalized pain caused by the destruction and disappearance of bone trabeculae and subperiosteal bone destruction during the process of bone resorption, which is mainly manifested in the more widespread low back pain; second, the occurrence of progressive vertebral compression fractures and fracture of bone trabeculae, which induces low back pain; third, the loss of height of each vertebral body of the spine The third is the loss of height of each vertebra in the spine, which leads to a forward hunchback deformity, causing long-term tension in the low back muscles, resulting in muscle fatigue and muscle spasm strain, which in turn induces myalgic pain. How to know the severity of osteoporosis? Then how can we know the degree of our osteoporosis? Because osteoporosis is characterized by a decrease in bone mass, bone densitometry is currently used clinically as the main diagnostic tool. There are various methods for bone densitometry: X-ray film method, single photon absorption method (SPA), dual energy X-ray absorption method (DEXA), quantitative CT method (QCT) and ultrasonic detection method (QUS), and the two most effective methods are QCT and DEXA at present. Let’s briefly understand what the difference between the different examination methods is. 1.X-ray method is an experienced expert to look at the X-ray film with the naked eye and estimate its bone density, it cannot be quantitatively analyzed, and the judgment of whether osteoporosis is based on experience, this method has been gradually eliminated. 2.Single photon absorption method (SPA) uses the radioisotope 125 iodine or 241 americium emitted mono-energy γ-rays to do transverse single-line scan of tubular bone, through the bone, due to the absorption of bone minerals and weakening, the degree of weakening is measured by the sodium iodide detector placed on the opposite side of the ray synchronous movement. Based on the principle of γ-ray absorption, the bone mineral content is automatically calculated by the calculation formula. 3, dual-energy X-ray absorption method (DEXA) through the X-ray source emits two different energy rays, the use of two different energy X-rays through the human bone after the attenuation and absorption is not the same, after computer processing to obtain the mineral content of human bone. 4.Ultrasonic testing method (QUS) Calculate the amount of bone according to the speed of ultrasound propagation in the bone tissue, the degree of attenuation, and may also provide the quality of bone. Ultrasonography should only be used for peripheral limb bone. 5.Quantitative CT method (QCT) QCT utilizes the 3D imaging technology of the CT machine to achieve true volumetric bone mineral density (mg/cm3) measurement. The measurement site is the spine, and the measurement results are in the unit of bulk density: mg/cm3, while fractures and microstructural changes can be observed. However, we should know that bone densitometry is only a test method, and the following criteria are needed for a specific diagnosis of osteoporosis: 1, must have generalized pain, mostly pain in the lower back is obvious; 2, minor trauma can lead to fracture, or kyphosis deformity of the spine; 3, those with more than two standard deviations of bone density reduction. Nowadays, it is also usually expressed by T-Score (T-value), that is, T-value -1.0 is normal, -2.5 value -1.0 is bone loss, and T-value -2.5 is osteoporosis. Many patients often ask us why they sometimes feel that the bone densitometry is not accurate. Sometimes our patients with concurrent fractures have obvious pain, but they go to check the bone density and find that the test result is not as low as they think; sometimes the patients do not feel anything abnormal, but they go to do a health check and find that the T value is very low, as a result, we all doubt whether the bone density measurement is accurate or not, which involves the difference in the concept of osteoporosis and osteopenia that we often talk about in the clinic, a normal person from the development After the peak of the development of a normal person began to enter a gradual decline, to old age everyone will have the corresponding degeneration, including osteoporosis muscle atrophy, and the current standard for measuring osteoporosis bone density is the average value of the general healthy population as a reference, when you detect a lower value, can only indicate that you are lower than the average person, but it does not necessarily mean that this low bone density measurement is the cause of your symptoms, so we say that you have osteoporosis manifestation, but if there is no symptom manifestation, you should not say that you are osteoporosis.