As bone density decreases, the bone loses its internal stability. Its fine structure becomes more porous, meaning that forces can no longer be absorbed evenly. This significantly increases the risk of fractures.

Even minor stresses such as tripping, bracing oneself with a hand or a slight fall can be enough to cause a fracture. In some cases, so-called spontaneous fractures can even occur without any obvious accident.

The spine, hip and wrists are particularly frequently affected, as these areas are subjected to heavy strain in everyday life and play a vital role in stability and movement.

As bone mass continues to break down, individual vertebrae lose stability and height. They may compress or collapse, causing the shape of the spine to change.

This often results in an increased curvature in the upper back, which becomes visible as a hunched back. At the same time, the upper body leans forwards. As several vertebrae may be affected, the spine shortens overall. Over time, this can lead to a measurable loss of height of up to several centimetres.

These changes usually develop gradually over several years.

Due to the loss of bone mass, the vertebral bodies lose stability and may become deformed or collapse. This often results in small fractures in the bone.

These changes lead to persistent back pain, which can worsen with movement or prolonged standing. At the same time, the spinal alignment is altered. The muscles respond to this with increased tension in order to compensate for the altered load and ensure stability.

This constant tension leads to additional muscular discomfort, which can further exacerbate the pain. Mobility also decreases, as the body attempts to relieve pressure on painful areas.

Over time, the symptoms may worsen and increasingly interfere with daily life.

Pain, instability and a growing sense of uncertainty when moving often lead to those affected becoming less physically active. Many avoid everyday activities for fear of falling or sustaining further injuries.

This reduced activity also affects the muscles. They weaken, which further reduces stability and increases the risk of falling.

Serious fractures, particularly in the hip area, can significantly alter daily life. In many cases, those affected are temporarily or permanently dependent on support, which can considerably limit their independence.

Regular physical activity is one of the most important ways to maintain bone health. Mechanical stress stimulates the bones, which helps to preserve bone mass. Activities that involve bearing one’s own body weight, such as strength training, brisk walking, hiking or climbing stairs, are particularly effective.

At the same time, the muscles play a crucial role. Well-trained muscles stabilise the joints and relieve the strain on the bones in everyday life. They help to perform movements in a controlled manner and avoid incorrect loading.

In addition, balance and coordination exercises improve physical confidence. They reduce the risk of falls, which can have serious consequences, particularly in cases of reduced bone density.

A combination of strength, endurance and coordination therefore provides the best conditions for long-term bone stability.

An adequate intake of calcium and vitamin D is crucial for bone health. Make sure to regularly include calcium-rich foods in your diet. These include, above all, milk and dairy products such as yoghurt or cheese, but also green vegetables such as broccoli or kale, as well as nuts and seeds.

Calcium-rich mineral water can also make an important contribution. It’s worth checking the label: some mineral waters contain over 300 mg of calcium per litre and can therefore usefully supplement your daily intake. These are labelled as ‘calcium-rich’.

Vitamin D supports the body’s absorption of calcium. It is largely produced in the skin through exposure to sunlight. Supplementation may be advisable, particularly during the winter months or if you spend little time outdoors.

However, we recommend consulting a doctor.

Certain lifestyle habits can significantly accelerate bone loss. Smoking has a direct impact on bone metabolism and can impair blood circulation and the regeneration of bone tissue.

A persistently low body weight places less strain on the bones, meaning that important stimuli for maintaining bone mass are lacking. Frequent alcohol consumption or an unbalanced diet can also have a negative impact on bone health.

A healthy lifestyle involving sufficient exercise, a balanced diet and avoiding harmful habits therefore plays a key role in slowing down bone loss.

In DXA (dual-energy X-ray absorptiometry) bone density measurement, bone density is assessed using two X-ray beams of different intensities. These beams pass through the bone, enabling the mineral content to be calculated precisely. This reveals just how dense and stable your bones actually are.

The examination usually focuses on the lumbar spine and the hip. Osteoporotic changes occur particularly frequently in these areas. At the same time, they provide reliable values for assessing the entire skeleton.

The DXA scan not only shows how much bone mass is present, but also classifies the result in comparison to reference values. The T-score plays a key role here. It indicates how much your bone density differs from that of a healthy young adult.

This allows a clear distinction to be made as to whether

• your bone density is within the normal range,
• you have reduced bone density (osteopenia), or
• you already have osteoporosis.

This classification is crucial for assessing your personal risk of bone fractures and for taking appropriate action at an early stage.

For the examination, please lie down comfortably on your back on a couch. No special preparation is required. The only important thing is that you remove any metal objects, such as jewellery, beforehand.

During the scan, please lie still so that the machine can scan the relevant areas of your body.

The entire examination is calm and straightforward. The results can be analysed immediately afterwards, so you will receive an assessment of your bone density promptly.

The T-score is a key measure in bone density testing. It indicates how much your bone density differs from that of a healthy young adult. This reference is considered the optimal state, as bone density peaks during young adulthood.

The value is expressed as a number. A T-score below -1.0 means that your bone density is below the reference value.

The following guidelines apply for classification:

• T-score above -1.0: normal bone density
• T-score between -1.0 and -2.5: reduced bone density (osteopenia)
• T-score below -2.5: osteoporosis

The lower the value, the lower the bone density and the higher the risk of fractures. The T-score helps us to clearly classify the findings and plan the next steps on an individual basis.

In this condition, the joint gradually changes due to wear and tear. The cartilage, which normally ensures smooth movement, becomes thinner and loses its protective function. This makes the joint surfaces more sensitive to stress. This process most commonly affects the knees, hips, hands or spine.

The pain is particularly noticeable during movement. Many patients experience discomfort when walking, climbing stairs or after prolonged exertion. The pain often subsides at rest. Another typical symptom is brief stiffness after getting up or after sitting for long periods, which resolves with movement. As the condition progresses, mobility may decrease. In addition, the joint often feels less resilient overall.

The diagnosis is based on a thorough medical consultation and physical examination. The decisive factors are when the pain occurs and which movements trigger discomfort. Imaging techniques such as X-rays or MRI scans reveal typical changes in the joint, such as narrowing of the joint space or bony growths.

Treatment is based on the symptoms and the stage of joint change. The focus is on measures that reduce pain and maintain joint function. These include regular, appropriate exercise, building stabilising muscles and strategies to relieve strain in everyday life. Pain-relieving medication is also used In cases of severe symptoms and advanced changes, surgery may also be advisable.

You can find out more here: Arthrosis therapy in Frankfurt

Unlike wear-related changes, this condition is primarily caused by a malfunction of the immune system. The synovial membrane becomes permanently inflamed, causing pain and swelling. The disease often begins in small joints, such as the fingers or toes, and usually affects both sides of the body at the same time.

The symptoms often occur independently of physical activity. Many sufferers report pronounced morning stiffness that only subsides as the day progresses. This is often accompanied by painful, swollen and overheated joints, as well as fatigue or exhaustion.

Several factors play a role in the diagnosis. In addition to the consultation and physical examination, blood tests provide important information about inflammatory processes or certain antibodies. Imaging techniques make early inflammation visible even before structural damage occurs.

The aim of treatment is to control the inflammation in good time and thus prevent joint damage. Anti-inflammatory drugs and special active substances that intervene in the immune system are used. In addition, exercise therapy and everyday strategies that protect the joints help to maintain mobility.

Further information: Arthritis therapy in Frankfurt

Elevated uric acid levels in the blood cause crystals to deposit in the joints. The body responds to this with a pronounced inflammatory reaction. This particularly often affects the big toe joint, but symptoms can also occur in the knee, ankle or elbow.

The pain usually comes on suddenly and reaches a high intensity within a short time. Those affected describe the joint as very sensitive to pressure, reddened and hot. Attacks often occur at night or in the early hours of the morning. There may be longer symptom-free periods between gout attacks, especially at the onset of the disease.

In addition to a clinical examination, the diagnosis includes blood tests to determine the uric acid level. In certain cases, uric acid crystals can also be detected directly in the joint. Imaging techniques support the diagnosis.

Treatment has two objectives: rapid relief of the acute attack and long-term reduction of uric acid levels. Anti-inflammatory drugs are used in acute cases. In addition, long-term medication is important. Dietary and lifestyle adjustments can also help prevent further attacks.

This form of joint disease occurs in connection with psoriasis. Inflammatory processes affect not only the skin, but also the joints and areas where tendons and ligaments attach to the bone. This causes discomfort not only in the joint itself, but also in its immediate vicinity.

Pain, swelling and limited mobility are the main symptoms. Typical symptoms include sausage-shaped thickened fingers or toes and discomfort that can occur both at rest and during movement. In some affected individuals, joint problems precede skin changes.

The diagnosis is based on a combination of several factors. In addition to a physical examination, the patient’s history of known skin changes and imaging procedures provide important clues. Blood tests help to rule out other inflammatory joint diseases.

Treatment depends on the severity and progression of the disease. The aim is to control the inflammation and maintain joint function. Anti-inflammatory drugs and agents that interfere with the immune system are used. In addition, exercise therapy and individually tailored measures support the everyday life of those affected.

This condition causes changes in bone stability. Bone density decreases, making the skeleton as a whole more susceptible to fractures. The joints themselves usually remain unchanged, but pain can still occur. In this context, pain can be attributed to misalignments or changes in stress as a result of bone fractures.

The symptoms often develop inconspicuously. Many affected individuals do not experience any pain for a long time. Only when so-called spontaneous fractures occur, for example in the vertebral bodies, do back pain or restricted movement suddenly appear. A reduction in the height of the vertebrae puts greater strain on neighbouring joints.

The diagnosis is primarily based on bone density measurements. We also take into account risk factors such as age, hormonal changes or previous bone fractures. Imaging techniques help to identify existing fractures and rule out other causes.

The aim of treatment is to slow down further bone loss and reduce the risk of fractures. This includes drug therapies as well as adequate calcium and vitamin D intake. Exercise and muscle training support the stability of the skeleton and help to better distribute the load on bones and joints.

Further information: Osteoporosis therapy in Frankfurt

Not all joint problems are caused by structural disorders. Repeated strain, unfamiliar movements or uneven stress can also lead to irritation, which may be accompanied by pain in the joint or adjacent tendons.

The problems usually occur in response to stress and intensify with certain movements. The symptoms often subside at rest. Swelling or signs of inflammation are often absent or not very pronounced.

The diagnosis is made on the basis of the patient’s medical history and a physical examination, which reveals typical stress-related pain and restricted movement. Imaging techniques are mainly used to rule out structural damage.

The aim is then to relieve the irritated tissue and avoid overuse. The focus is on adapted exercise, physiotherapy measures and temporary rest. In certain cases, anti-inflammatory medication or measures such as kinesio taping are used.

Injuries to ligaments or the joint capsule often occur after accidents, twisting injuries or repeated incorrect loading. Older injuries that have not fully healed can also lead to long-term problems. The joint loses stability, which affects its load-bearing capacity.

Typical symptoms include pain during movement or exertion and a feeling of instability in the joint. Some affected individuals report a feeling of giving way or buckling, especially during sporting activities or on uneven ground. Swelling may occur, but does not necessarily persist.

Diagnosis involves a physical examination and functional tests. Imaging techniques such as MRI help to visualise ligament or capsule damage and assess the extent of instability.

Treatment depends on the severity and the structure affected. Stabilisation through muscle building, physiotherapy, bandages, etc. are useful. In cases of severe instability or persistent symptoms, surgical treatment may also be necessary.

More on this: Treatment of orthopaedic injuries in Frankfurt

Changes in the leg or joint axes affect the distribution of stress in the joint. Over time, this leads to increased pressure zones, which can cause pain even if the cartilage is still intact. Common examples are bow legs or knock knees, as well as misalignments in the foot or knee area.

The symptoms usually develop gradually and occur mainly during exertion. Those affected often report unilateral pain or faster fatigue of the affected joint. In the course of the disease, adjacent structures such as tendons or bursae may also become irritated.

Diagnosis involves a detailed examination of body statics and imaging techniques that reveal axial relationships and joint stress. This classification is important for the early detection of consequential damage.

Treatment depends on the extent and consequences of the misalignment. Conservative measures are the first line of treatment. In cases of pronounced axial deviations or persistent symptoms, surgical correction may also be considered.

A healthy hormone balance is crucial for maintaining bone density—even in men. The male sex hormone testosterone plays a particularly important role in bone metabolism: it supports the formation of new bone tissue and counteracts natural bone loss. A permanent drop in testosterone levels can significantly impair bone health.

Such a deficiency – medically referred to as hypogonadism – can occur due to age or be caused by diseases of the testicles, pituitary gland, or hypothalamus. Additional signs include fatigue, loss of libido, reduced muscle mass, or depressive moods.

In addition to disease-related hormone deficiency, medically targeted hormone suppression can also weaken bone substance: In men with prostate cancer, the body’s own testosterone production is often deliberately reduced as part of so-called androgen deprivation therapy in order to slow tumor growth. Although this form of therapy has a positive effect on the cancer, it can lead to a significant loss of bone density within just a few months.

It is therefore important for men undergoing hormone blockade to have their bone mass checked regularly – ideally accompanied by preventive measures against osteoporosis.

Some medications (especially when taken long-term or in high doses) can have a negative effect on bone metabolism and thus increase the risk of osteoporosis.

Of particular concern here are cortisone preparations, which are often used to treat chronic inflammatory diseases such as rheumatism, asthma, or Crohn’s disease. They inhibit bone formation and at the same time promote bone resorption.

Antiepileptic drugs, certain cancer drugs, and antidepressants can also disrupt calcium metabolism or influence hormonal processes that are important for bone health.

Another risk factor is the long-term use of proton pump inhibitors (PPIs), i.e., stomach protectors. These drugs can impair calcium absorption in the intestine, which can have a negative effect on bone density.

Regular review of medication is particularly important in the case of chronic diseases. Anyone who relies on such drugs should discuss with their doctor how the effects on their bones can be reduced.

Many men who develop osteoporosis have what is known as hypercalciuria. This means that the body excretes too much calcium in the urine, which can weaken the bones over time. According to estimates, this affects about one in ten men (source: Ärztezeitung).

If hypercalciuria is detected during diagnosis, calcium and vitamin D supplementation alone is often not sufficient. In these cases, it may be advisable to use a specific medication from the thiazide diuretic group. These reduce calcium excretion via the kidneys and can help stabilize bone density.

Important: Whether this treatment is suitable depends, among other things, on blood pressure. If blood pressure is generally low, treatment with bisphosphonates may be more appropriate. These medications slow down the breakdown of bone substance.

Furthermore, certain chronic underlying diseases can reduce bone health. This often occurs through indirect but long-term mechanisms.

For example, cirrhosis of the liver can disrupt vitamin D metabolism and thus impair calcium absorption in the intestine—an important building block for bone stability. The same applies to chronic kidney disease, where an imbalance in mineral metabolism can lead to bone loss.

Gastrointestinal diseases such as Crohn’s disease or celiac disease can also pose a risk: inflammatory processes or damage to the intestinal mucosa can reduce the absorption of important nutrients such as calcium, magnesium, or vitamin D. This can have long-term consequences for bone strength.

Another example is type 1 diabetes mellitus. In addition to blood vessels and nerves, this disease can also affect bone metabolism. Rheumatoid arthritis is also a risk factor, as it is associated with chronic inflammation and often with cortisone therapy. Both place additional strain on the skeletal system.

With these chronic diseases, it is particularly important to keep an eye on bone health. Regular check-ups and targeted prevention can help reduce the risk of osteoporosis and subsequent fractures.

Personal lifestyle also has an impact on the risk of osteoporosis in men.

Lack of exercise is one of the most common causes. Bones need regular stress to remain stable. People who do not get enough exercise—for example, due to sedentary jobs or physical inactivity in everyday life—risk a reduction in bone mass.

Excessive alcohol consumption and smoking also have a negative effect. Alcohol can disrupt bone metabolism, inhibit nutrient absorption, and impair hormone production. Nicotine, in turn, reduces blood flow to the bones and accelerates their breakdown.

Body weight also plays a role: being underweight is often associated with nutrient deficiencies and low mechanical stress. Both weaken the bones. Being severely overweight, on the other hand, puts strain on the joints and can promote inflammatory processes that can have negative consequences for bone health.

A conscious lifestyle with a balanced diet, regular exercise, and avoiding nicotine and excessive alcohol consumption is therefore an important contribution to the prevention of osteoporosis—especially in men.

From the age of 60, bone density decreases measurably and natural bone loss increasingly outweighs bone formation. In addition, there are age-related changes in hormone balance, a frequent reduction in physical activity, and an increased risk of deficiencies, such as vitamin D or calcium.

Another important risk factor is family predisposition. Those who have close relatives with osteoporosis are themselves at increased risk of being affected earlier or more severely. Genetic factors influence not only bone structure, but also the individual’s ability to absorb nutrients or regulate hormone balance.

Men with a family history of the disease or who are getting older should therefore pay particular attention to any changes and consider seeking medical advice in good time. Early detection is the key to limiting or completely avoiding further damage.