Osteoporosis is a common condition that weakens bones over time, making them less dense and more likely to fracture. An estimated 54 million Americans suffer from low bone density or osteoporosis, yet many do not realize they have the condition until a painful fracture occurs. However, there are effective treatment options available to help manage osteoporosis and reduce the risk of fractures.
Lifestyle Changes and Medications for Osteoporosis
Making lifestyle changes is one of the best ways to support bone health and potentially slow bone loss. Getting regular weight-bearing and muscle-strengthening exercise is key, as it places mechanical stress on bones which signals them to become stronger. Aim for at least 30 minutes of exercise like walking, dancing, or yoga most days of the week. Maintaining a healthy diet rich in calcium, vitamin D, and protein through foods like dairy products, leafy greens, salmon, and nuts is also important for bone nourishment. Watching alcohol intake and stopping smoking can further support bone strength.
For those diagnosed with osteoporosis, medication treatment is usually recommended in addition to lifestyle modifications. Bisphosphonates are the most commonly prescribed class of osteoporosis drugs. They work by inhibiting bone resorption and reducing the breakdown of old bone, allowing new bone formation to match. Popular bisphosphonate options include alendronate (Fosamax), risedronate (Actonel), and ibandronate (Boniva). These medications come as once-weekly, once-monthly, or once every three months pills or intravenous infusions.
Other FDA-approved osteoporosis medications include denosumab (Prolia), calcitonin (Miacalcin), raloxifene (Evista), and teriparatide (Forteo). Denosumab is administered as a twice-yearly subcutaneous injection. Calcitonin comes as a daily intranasal spray. Raloxifene is a selective estrogen receptor modulator taken as a daily pill to help preserve bone mass. Teriparatide is a parathyroid hormone treatment taken daily by injection or pen to help build new bone and reduce vertebral fracture risk. Close monitoring with periodic bone density testing helps ensure osteoporosis drugs are effective.
Surgery and Other Advanced Treatment Options
For those who have already experienced painful or multiple fractures, additional treatment may be needed beyond lifestyle changes and medications alone. Vertebroplasty and kyphoplasty are minimally invasive surgical procedures used to treat osteoporotic compression fractures of the spine. In vertebroplasty, doctors inject bone cement into the cracked vertebra to reinforce it and relieve pain. Kyphoplasty involves first inserting a small balloon to restore height to the collapsed vertebra before filling it with cement. Studies show both procedures help control pain and reduce the risk of future fractures.
For severe cases of osteoporosis, a new cutting-edge treatment called Teriparatide and Denosumab Sequential Therapy (TDS) has shown promise in restoring bone mineral density and strength where other options have failed. The approach involves 1-2 years of daily teriparatide injections followed by denosumab biannual injections to continue rebuilding bone. Early research found TDS significantly improved bone mineral density, microarchitecture, and decreased fracture risk more than traditional osteoporosis treatments alone. More clinical trials are underway to further evaluate its efficacy and safety long term.
Staying on Treatment and Managing Osteoporosis Long Term
Living well with osteoporosis requires ongoing management and treatment adherence. Those on osteoporosis medication should continue taking their prescribed doses long-term, even after seeing improved bone density results, as bone loss will resume without continued therapy. Having regular follow-up appointments with their healthcare provider helps ensure treatment is properly monitored and risks like side effects can be addressed. Adhering to lifestyle modifications including regular exercise and a bone-healthy diet should remain priorities as well.
With advances in research, more personalized treatment options are being developed to better manage both existing osteoporosis and help prevent future fractures. By understanding risk factors and treatment possibilities, it becomes easier for those affected to proactively care for their bone health long term through a combination of medication, lifestyle changes, and medical advancements when needed. With proper management, osteoporosis patients can effectively reduce fracture risk and live active lives.
