Treatment of Osteoporosis

• medication to help maintaining bone denisty and reducing pain
• a healthy eating program which ensures adequate intake of calcium, vitamins and minerals
• a good exercise program which facilitates healthy bone growth and muscle strengthening

1. Alendronate

Well-conducted clinical trials utilizing alendronate sodium indicate that treatment reduces the incidence of fracture at the spine, hip, and wrist by 50% in patients with osteoporosis. Alendronate must be taken on an empty stomach, first thing in the morning, with a large glass of water, at least 30 minutes before eating or drinking. Patients should remain upright during this interval. Although in clinical trials the incidence of side effects was no different than placebo, clinical experience suggests that some patients will experience upper gastrointestinal disturbance, particularly esophageal symptoms (chest pain, heartburn, painful or difficult swallowing)

2. Risedronate

Studies showed that 5mg of risedronate slows bone loss, increase bone density and reduces the risk of spine and non-spine fractures. Risedronate must be taken on an empty stomach, first thing in the morning with a glass of water. The patients should remain upright and refrain from eating, drinking or taking other medications for at least 30 minutes after taking risedronate. Few side effects were reported included stomach upset, constipation, diarrhea, bloating, gas or headache.

3. Raloxifene

This drug is in a class of compounds called selective estrogen receptor modulators (SERMS), which have been developed to provide the beneficial effects of estrogen without their potential disadvantages. Raloxifene has been shown to prevent bone loss, and preliminary data in women with osteoporosis show that it reduces the risk of vertebral fracture by 40-50%. Raloxifene increases the risk of deep vein thrombosis to a degree similar to that observed with estrogen. In addition, an increase in hot flashes is observed, and it cannot be used to treat menopausal symptoms.

4. Calcitonin

It is delivered as a single daily nasal spray that provides 200 units of the drug. Efficacy data for calcitonin are weaker than for either HRT or alendronate.

5. Hormone Replacement Therapy, HRT

Many women will benefit from the effects of HRT on bone and possibly other organ systems. Since HRT may be associated with a modest increase in risk of breast cancer with long term use and deep vein thrombosis, women with a history of, or at significant risk for, these conditions may consider using other alternative methods. Some patients on HRT may experience some side effects, including vaginal bleeding, breast tenderness, mood disturbances, and gallbladder disease.

6. Relieving pain

Osteoporosis without fractures or complications does not produce pain. It is usually the fractures that cause pain. One should not neglect the pain caused by acute compression fracture of the spine. Treat pain as normally and alendronate or calcitonin actually also helps to relieve pain caused by fractures.

Source of information:National Osteoporosis Foundation