What is the treatment of Osteoporosis?

Doctors treat osteoporosis by prescribing calcium and vitamin D, by recommending weight-bearing exercises, and by modifying other risk factors. In addition, several effective medications are available. For women, estrogen replacement therapy, alendronate (Fosamax), risedronate (Actonel), raloxifene (Evista) and nasal calcitonin (Miacalcin), a spray that inhibits bone breakdown, all treat osteoporosis and are approved by the U.S. Food and Drug Administration (FDA). Long-term estrogen therapy has been associated with many risks, including an increased risk of heart disease, stroke, breast cancer and gallstones. For this reason, many doctors prefer one of the other options as a first choice. Among men, a low level of testosterone is the most common cause of osteoporosis (other than aging). If testing reveals that testosterone levels are low, other tests will look for the cause so that treatment can be started. Men also can use alendronate and raloxifene.

For people who experience problems or side effects with alendronate or risedronate, several other medications are available, including etidronate (Didronel), ibandronate (Boniva), pamidronate (Aredia), zoledronate (Zometa or zoledronic acid). All are bisphosphonates, like alendronate and risedronate.

A form of parathyroid hormone, called teriparatide (Forteo), is a new option for treating osteoporosis. Given by a daily injection, it will probably be reserved for the worst cases of osteoporosis, those that failed to respond to other treatments.

How well a treatment works is monitored by bone density measurements every one to two years. To get the most accurate comparison, all bone density measurements should be done on the same machine in the same facility.

If a person with osteoporosis fractures a hip, surgery may be needed to realign and stabilize the hip. A wrist fracture may heal well simply by being put in a cast, or surgery may be needed to restore proper alignment and function. Other treatments for fracture include pain medication and rest for a short time. Calcitonin injections may reduce spine pain from a new compression fracture.