An Overview About Osteoporosis Management
Breaking of bones in even minor accidents or fall is the first clue that you have osteoporosis (porous bones). Steps involved in preventing osteoporosis such as a diet adequate in vitamin D and calcium, and exercise is usually continued in managing the condition also. But if the fracture risk is high, along with lifestyle options, medications will be prescribed. Osteoporosis management includes safe exercise options, medicines, and falls prevention.
Medications In The Treatment And Management Of Osteoporosis
1. Medications That Slow Bone Breakdown:
The physician will likely recommend medications if your bone density test shows a T-score of -2.5 or lower, if you have a history of hip or spinal fracture caused by a fall or osteopenia (bone weakness) and a high risk of fractures.
a) Bisphosphonates: Bone cells are formed and broken down constantly. Bisphosphonates decrease the rate at which bone is broken down. They are commonly prescribed medications in men and women with an increased risk of fractures. They are available as tablets and injections. Examples are Alendronate sodium, Risedronate sodium, Ibandronate sodium, and Zoledronic acid.
b) Denosumab: Like bisphosphonates, denosumab also decreases the fragility of bone. It reduces the risk of fractures in almost all areas, including the spine and hips. Denosumab is given as an injection every six months.
2. Hormone-Related Therapy:
a) Estrogen therapy: In women, estrogen, the female sex hormone, plays a crucial role in maintaining bone tissue strength. Boosting estrogen levels increase the bone density in the hip and spine and lowers the fractures at both sites. They are available as skin patches and tablets. Due to the long-term risks of blood clots, and breast cancer, they are typically used in younger women and menopausal women who need treatment for their symptoms.
b) Testosterone therapy: Male hormone testosterone helps keep the bones healthy. In men, testosterone therapy can be given if osteoporosis is caused by low testosterone levels. They are given as oral capsules, injections, implants or skin patches.
c) Selective estrogen receptor modulators (SERM): They act on the estrogen receptors and produce similar effects on bones as estrogen. They reduce the risk of fractures and increase bone density, especially in the spine. Raloxifene is the only SERM drug used in osteoporosis.
3. Medications That Build Bone In Osteoporosis Management:
a) Parathyroid hormone (PTH): Parathyroid hormone is naturally formed in the body and helps regulate calcium, phosphorus, and magnesium levels in the bone. This medication stimulates bone formation and is given as daily injections for up to 2 years.
This medication is used in patients whose bone density is severely low and when other treatments are not working. Nausea, vomiting, and increased blood calcium levels are the side effects. Examples are Teriparatide, and Abaloparatide.
b) Romosozumab: This is the new medication used in osteoporosis management. It enables bone formation and also decreases the breakdown of bone. Two injections are given one after the other each month and are limited to one year of treatment.
Your doctor will prescribe medication for Osteoporosis suitable for your condition and it is very important to take medicines exactly as prescribed to get the benefits and minimize the side effects. If you experience any side effects while taking medication, contact your doctor as soon as possible.
Prevent Falls And Fractures:
You are at greater risk for fractures if you have osteoporosis, even from a relatively minor fall or mild stresses such as bending over. Reducing the risk of falls is vital in osteoporosis management.
- Make your home trip proof. Remove clutter, trailing wires and frayed carpet. Use non-slip rugs and mats. Install handrails in the toilet and shower.
- Make sure all rooms, staircases, and passages are well lit. Have a regular sight test and if you use prescription glasses, wear them as recommended by the eye doctor.
- Clean up the spillages immediately. Avoid using cleaners that make your floors slippery.
- Wear good-fitting flat-heeled shoes. Trim the toenails regularly and take care of your feet.
- Limit the amount of alcohol you drink. Alcohol can cause loss of coordination and increase the risk of falls.
- Your physician may suggest you wear a hip protector. This reduces the impact of a fall over hip bone and lowers the hip fracture risk.
- Use bags such as a backpack that leaves your hands free while going outside.
Get Enough Exercise:
Regular exercise is essential in osteoporosis management. Weight-bearing and resistant exercises are especially important for improving bone strength and help prevent osteoporosis. Weight-bearing exercises include brisk walking, dancing, running, skipping, and aerobics. They help strengthen muscles and joints.
Resistant exercises (strength training) such as weightlifting or press-ups can also help prevent osteoporosis. They develop and maintain muscular endurance and strength and improve bone mineral density. Aim for thirty to forty minutes of these exercises at least 4 times a week.
Activities such as tai chi and gentle yoga can promote balance and coordination and reduce the risk of falls. Tai chi is ideal for older people as it does not involve rapid physical movements. In people with osteoporosis, high impact or poorly performed exercises may increase the risk of fracture. Hence, it is important that balance and strength training exercises are tailored to the individual by a physiotherapist or exercise physiologist.
Prevent Further Bone Loss And Step Out Strong:
Osteoporosis can lead to life-altering fractures. But, remember, a person with this condition can lead a productive life. Treatment and management of osteoporosis can stop bone loss and significantly reduce fracture risk. Therapies can only work if taken exactly as recommended by your physician. Follow the lifestyle changes and medical treatment strictly and lead an active life.
