There are medications and hormones (chemicals that
are made in your body) that are used to slow down the bone loss
and even help build the strength of the bones back up. These treatments
help keep your bones from breaking. Talk with your doctor to find
out which treatments are best for you.
A comprehensive osteoporosis treatment program includes
a focus on proper nutrition, exercise, a change in lifestyle and
safety issues to prevent falls that may result in fractures. In
addition, your physician may prescribe a medication to slow or
stop bone loss, increase bone density, and reduce fracture risk.
The foods we eat contain a variety of vitamins, minerals, and
other important nutrients that help keep our bodies healthy. All
of these nutrients are needed in a balanced proportion. In particular,
calcium and vitamin D are needed for strong bones as well as for
your heart, muscles, and nerves to function properly. (See Prevention
section for recommended amounts of calcium.)
· Exercise. Exercise
is an important component of an osteoporosis prevention and treatment
program. Exercise not only improves your bone health, but it increases
muscle strength, coordination, and balance and leads to better
overall health. While exercise is good for someone with osteoporosis,
it should not put any sudden or excessive strain on your bones.
Asextra insurance against fractures, your doctor can recommend
specific exercises to strengthen and support your back.
· Therapeutic Medications.
Currently, estrogen, calcitonin, alendronate, raloxifene, and
risedronate are approved by the U. S. Food and Drug Administration
(FDA) for the treatment of postmenopausal osteoporosis. Estrogen,
alendronate, risedronate, and raloxifene are approved for the
prevention of the disease. Alendronate is approved for the treatment
of osteoporosis in men. Alendronate and risedronate are approved
for use by men and women with glucocorticoid-induced osteoporosis.
Estrogen replacement therapy (ERT) has been shown to reduce bone
loss, increase bone density in both the spine and hip, and reduce
the risk of hip and spinal fractures in postmenopausal women.
ERT is administered most commonly in the form of a pill or skin
patch and is effective even when started after age 70. When estrogen
is taken alone, it can increase a woman's risk of developing cancer
of the uterine lining (endometrial cancer). To eliminate this
risk, physicians prescribe the hormone progestin in combination
with estrogen (hormone replacement therapy or HRT) for those women
who have not had a hysterectomy. ERT/HRT relieves menopause symptoms
and has been shown to have beneficial effects on both the skeleton
Experts recommend ERT for women at high risk for
osteoporosis. ERT is approved for both the prevention and treatment
of osteoporosis. ERT is especially recommended for women whose
ovaries were removed before age 50. Estrogen replacement should
also be considered by women who have experienced natural menopause
and have multiple osteoporosis risk factors, such as early menopause,
family history of osteoporosis, or below normal bone mass for
their age. As with all drugs, the decision to use estrogen should
be made after discussing the benefits and risks and your own situation
with your doctor.
· Raloxifene. Raloxifene
(brand name "Evista") is a drug that is approved for
the prevention and treatment of osteoporosis. It is from a new
class of drugs called Selective Estrogen Receptor Modulators (SERMs)
that appear to prevent bone loss at the spine, hip, and total
body. Raloxifene has been shown to have beneficial effects on
bone mass and bone turnover and can reduce the incidence of vertebral
fractures by 30-50%. While side-effects are not common with raloxifene,
those reported include hot flashes and deep vein thrombosis, the
latter of which is also associated with estrogen therapy. Additional
research studies on raloxifene will be ongoing for several more
Alendronate (brand name "Fosamax") is a medication from
the class of drugs called bisphosphonates. Like estrogen and raloxifene,
alendronate is approved for both the prevention and treatment
of osteoporosis. Alendronate is also used to treat the bone loss
from glucocorticoid medications like prednisone or cortisone and
is approved for the treatment of osteoporosis in men. In postmenopausal
women with osteoporosis, the bisphosphonate alendronate reduces
bone loss, increases bone density in both the spine and hip, and
reduces the risk of both spine fractures and hip fractures. Side
effects from alendronate are uncommon, but may include abdominal
or musculoskeletal pain, nausea, heartburn, or irritation of the
esophagus. The medication should be taken on an empty stomach
and with a full glass of water first thing in the morning. After
taking alendronate, it is important to wait in an upright position
for at least one-half hour, or preferably one hour, before the
first food, beverage, or medication of the day.
· Calcitonin. Calcitonin
is a naturally occurring non-sex hormone involved in calcium regulation
and bone metabolism. In women who are at least 5 years beyond
menopause, calcitonin slows bone loss, increases spinal bone density,
and according to anecdotal reports, relieves the pain associated
with bone fractures. Calcitonin reduces the risk of spinal fractures
and may reduce hip fracture risk as well. Studies on fracture
reduction are ongoing. Calcitonin is currently available as an
injection or nasal spray. While it does not affect other organs
or systems in the body, injectable calcitonin may cause an allergic
reaction and unpleasant side effects including flushing of the
face and hands, urinary frequency, nausea, and skin rash. The
only side effect reported with nasal calcitonin is a runny nose.
Risedronate sodium (brand name Actonel®) is approved for the
prevention and treatment of osteoporosis in postmenopausal women
and for the prevention and treatment of glucocorticoid-induced
osteoporosis in both men and women. Risedronate, a bisphosphonate,
has been shown to slow or stop bone loss, increase bone mineral
density and reduce the risk of spine and non-spine fractures.
In clinical trials, side effects of risedronate were minimal to
moderate and those that were reported occurred equally among people
taking the medication and those taking a placebo. Risedronate
should be taken with a glass of water at least 30 minutes before
the first food or beverage of the day other than water. After
taking risedronate, it is important to remain in an upright position
and refrain from eating for at least 30 minutes.
· Fall Prevention.
Falling is a special concern for men and women with osteoporosis.
Falls can increase the likelihood of fracturing a bone in the
hip, wrist, spine or other part of the skeleton. In addition to
the environmental factors listed below, falls can also be caused
by impaired vision and/or balance, chronic diseases that impair
mental or physical functioning, and certain medications, such
as sedatives and antidepressants. It is important that individuals
with osteoporosis be aware of any physical changes they may be
experiencing that affect their balance or gait, and that they
discuss these changes with their health care provider.
Some tips to help eliminate the environmental factors
that lead to falls include:
Use a cane or walker for added stability; wear rubber-soled shoes
for traction; walk on grass when sidewalks are slippery; in winter,
carry salt or kitty litter to sprinkle on slippery sidewalks;
be careful on highly polished floors that become slick and dangerous
when wet. Use plastic or carpet runners when possible.
Make the environment safe by keeping rooms free of clutter, especially
on floors. Keep floor surfaces smooth but not slippery. Be sure
carpets and area rugs have skid-proof backing or are tacked to
the floor; be sure stairwells are well lit and that stairs have
handrails on both sides. Install grab bars on bathroom walls near
tub, shower, and toilet; use a rubber bath mat in shower or tub;
keep a flashlight with fresh batteries beside your bed. If using
a step stool for hard to reach areas, use a sturdy one with a
handrail and wide steps; add ceiling fixtures to rooms lit by
lamps. Consider purchasing a cordless phone so that you don't
have to rush to answer the phone when it rings or you can call
for help if you do fall.
Wear supportive, low-healed shoes even at home;
avoid walking in socks, stockings, or slippers. Be careful on
rainy days and slippery roads.
Remember to check with your doctor. Remedial action
in each individual case should be determined with professional
medical advice directed toward the individual's particular circumstances