Русский 
English 
Deutsch 
Español 
العربية 
中文 
Türkçe 
Français 
Italiano 
What happens with osteoporosis
Bone tissue is constantly renewed: osteoclasts break down old bone, osteoblasts build new bone. With osteoporosis, the balance is disrupted — destruction exceeds restoration. The bone becomes porous and fragile.
Risk Factors
Non-modifiable
Female sex (estrogens protect bone). Age over 50 years. Menopause (loss of up to 5% bone mass per year in the first 5 years). Family history of fractures. Caucasian or Asian race. Low weight/asthenic build.
Modifiable
Vitamin D and calcium deficiency. Sedentary lifestyle. Smoking (-10% bone mass). Alcohol abuse (> 3 servings per day). Low BMI (< 19).
Secondary Osteoporosis
Glucocorticoids (> 5 mg prednisolone > 3 months — the most common cause). Hyperthyroidism. Hyperparathyroidism. Testosterone deficiency. Celiac disease (malabsorption). Rheumatoid Arthritis. Type 1 Diabetes Mellitus.
Typical osteoporotic fractures
Vertebral Compression Fractures (46%)
The most common. Often asymptomatic (incidental finding on X-ray). Height loss, kyphosis («widow's hump»). May cause chronic back pain. Each fracture increases the risk of the next by 5 times.
Femoral Neck Fracture (16%)
The most dangerous: 20% mortality in the first year. 50% of patients do not return to previous activity level. Requires surgical treatment. Average age: 80 years.
Distal Radius Fracture (16%)
«Colles' fracture» — from falling on outstretched hand. First «warning sign» of osteoporosis, often at 55-65 years. Densitometry is mandatory after this fracture.
Proximal Humerus Fracture
From falling on shoulder. Especially common in women over 70 years. Complex treatment, prolonged rehabilitation.
Diagnosis
DEXA (Densitometry)
Gold standard. Dual-energy X-ray absorptiometry of lumbar spine and femoral neck. T-score: normal > -1.0, osteopenia -1.0 to -2.5, osteoporosis < -2.5. Indicated: all women > 65 years, men > 70 years, earlier with risk factors.
FRAX
10-year fracture risk calculator (WHO). Considers: age, sex, BMI, previous fractures, family history, smoking, alcohol, glucocorticoids, RA, secondary osteoporosis, BMD. Helps decide on treatment necessity.
Laboratory Tests
Calcium, phosphorus, vitamin D (25-OH), PTH, TSH, testosterone (in men). Bone turnover markers: CTX (resorption), P1NP (formation). Exclusion of secondary causes.
Spine X-ray
Lateral views Th4-L4 to detect compression fractures. VFA (Vertebral Fracture Assessment) on DEXA machine — screening for fractures with minimal radiation dose.
Osteoporosis: treatment options and what is known about them
The treatment plan is made by the clinic doctor after an examination and a review of your images. The table shows the options usually discussed for this diagnosis and how well they have been studied.
| Option | What to expect | How well studied |
|---|---|---|
| Bone-strengthening medication | Prescribed by a bone specialist or endocrinologist; lowers the risk of fractures — the basis of treatment | Well studied, recommended |
| Exercise therapy and physiotherapy | Reduces pain, strengthens muscles, improves function; the basis of treatment | Well studied, recommended |
| PRP / CGF | — | Not usually used for this diagnosis |
We send your request to several partner clinics. Some will suggest conservative treatment or injections, others surgery; each clinic quotes its own conditions and price. We help you compare the options.
Regenerative methods: realistic expectations
Osteoporosis means reduced bone strength. Treatment aims to prevent fractures: bone-strengthening medication, vitamin D and calcium when indicated, weight-bearing exercise and fall prevention. Regenerative injections do not affect bone density.
When surgery is discussed. Surgery is performed for fractures — for example a hip fracture or some vertebral fractures.
If an injection helps, the effect usually builds up over 6–12 weeks, and the result is assessed after 2–3 months. No clinic can guarantee a result.
Prevention of Osteoporosis
Vitamin D and Calcium
Vitamin D: 1000-2000 IU/day (target level 25-OH-D > 30 ng/mL). Calcium: 1000-1200 mg/day (preferably from food: dairy products, broccoli, almonds). Vitamin D deficiency affects 70% of the population in northern latitudes.
Physical Activity
Weight-bearing exercise: walking 30 minutes/day, dancing, climbing stairs. Strength training 2-3 times per week. Balance training to prevent falls (tai chi has been shown to reduce risk by 40%).
Lifestyle
Smoking cessation. Limiting alcohol. Maintaining normal weight. Fall prevention: rugs, handrails, lighting, vision correction, medication review (sedatives).
Who it is not suitable for and possible risks
Contraindications
- Active infection — at the injection site or systemic, with fever.
- Active cancer or ongoing chemotherapy.
- Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
- Pregnancy and breastfeeding — the procedure is usually postponed.
- A corticosteroid injection into the same area in recent weeks.
- Urgent surgery, not injections, is needed if there is progressive leg weakness, numbness in the groin area or bladder dysfunction.
Possible risks
- Pain and swelling at the injection site for 1–3 days.
- Bruising where blood or fat tissue is taken.
- Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
- The effect may be absent or smaller than expected.
- Injections into the intervertebral disc carry a rare risk of disc inflammation (discitis).
If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.
Scientific evidence
Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:
- Compston JE et al. Osteoporosis. Lancet, 2019.
- Black DM, Rosen CJ. Clinical Practice. Postmenopausal Osteoporosis. N Engl J Med, 2016.
Next: Treatment methods · Treatment costs · Contact a coordinator
Questions About Osteoporosis
RegenPAS is a patient service centre in Munich, not a clinic. We review your images and symptoms and send a request to several partner clinics at once. Clinics that can accept you send their own conditions and price; prices differ between clinics, and you choose the option that suits you. The coordinator replies within 24 hours, and a clinic physician’s preliminary opinion follows in 1–3 business days. We then arrange the appointment, visa invitation, interpreter, transfers and accommodation. Treatment decisions are made by the clinic physician. Contact a coordinator.
Your MRI (or CT, X-ray) report and the images if you have them, plus a short description of your symptoms and previous treatment. Send them via the form on the website — the assessment is free and without obligation: the coordinator replies within 24 hours, and the clinic physician’s preliminary opinion follows in 1–3 business days.
The cost depends on the method, the diagnostics needed and the clinic itself: prices differ between clinics. We request offers from several clinics and send you their conditions and quotes so you can compare. Price guidance is on the treatment cost page. For an outpatient procedure, 2–3 days in Munich are usually enough: examination, procedure and follow-up visit.