Osteoporosis And Fracture In Multiple Sclerosis - Underestimated And Ignored?

Multiple sclerosis (MS) is a frequent debilitating chronic inflammatory autoimmune disease of the central nervous system. Multiple studies report a significantly increased prevalence of osteoporosis and fractures in MS patients: several studies show a 3-fold increased risk of hip fractures in MS patients, the prevalence of osteopenia and osteoporosis is reported to be 10-fold increased in comparison to the general population. The most frequent correlation exists between osteoporosis and immobility. However, the inflammatory etiology as well as life style factors like Vitamin D levels, smoking as well as hormonal dysregulations, comorbidities and co-medication contribute to the increased risk of osteoporosis and fractures in MS. The early presence of osteoporosis and its high prevalence in MS is underestimated so far and should be considered in clinical routine and communicated to patients. Due to the importance of preventive strategies, patients and physicians should more often be aware of the high prevalence of osteoporosis in MS. The most important preventive strategies for osteoporosis and fracture risk are physical activity (or better sports) and substitution of insufficient Vitamin D serum levels.