Non-surgical Treatment of Osteoporosis
There are several ways to treat osteoporosis, depending on the severity of bone loss. A good diet and exercise can often be the first steps to take to help slow down or halt the loss of bone mineral density (BMD), even after a diagnosis of osteopenia or osteoporosis. Taking dietary supplements such as calcium, vitamin D, and other minerals can slow down or halt bone loss. A good diet and supplements may still be needed even if other treatments for osteoporosis are recommended.
Calcium carbonate and calcium citrate are the best forms of calcium supplementation because the body can absorb more calcium from them. Calcium should be taken with vitamin D supplements as they have been shown to help maintain bone strength and increase calcium absorption into bones. Check with your spine specialist for the proper dosage.
Some or all of bone loss in women going through menopause can be prevented using estrogen and progesterone hormone supplements. Women in menopause are encouraged to consider estrogen hormone replacement therapy (HRT) if there is a strong family history of osteoporosis among immediate female family members. Unfortunately, hormone replacement therapy is linked to an increased risk of breast cancer, heart disease, and stroke and may not be recommended for women with a family history of those diseases. However, there are drugs called selective estrogen receptor modulators, one of which is raloxifene (Evista®). These drugs appear to have less risk than estrogen and progesterone. Selective estrogen receptor modulators mimic estrogen?s effects on bones and have been shown to slow loss of BMD.
Because compression fractures of the spine can be painful, pain medications are often prescribed.
More serious cases of osteoporosis can be treated with drugs to help halt the loss of BMD. Some of these drugs, such as bisphosphonates, slow the breakdown of bone. Bisphosphonates include alendronate (Fosamax®), risedronate (Actonel®), etidronate (Didronel®), and ibandronate (Boniva®), and calcitonin. Other drugs, such as teriparatide (Forteo®), speed up bone regeneration. These drugs can slow and even reverse bone loss, but this effect stops when you cease taking them.
Bisphosphonates have side effects that can include irritation of the esophagus and stomach. You may be instructed to take your medication and remain standing or sitting upright for at least a half-hour afterwards to help reduce the incidence of irritation to the esophagus. Several once-a-week and once-a-month bisphosphonates are available. Calcitonin is available in a nasal spray or as an injection. Osteoporosis medications that are administered once every several months or only once a year are being studied.
Physical therapy can also help to treat osteoporosis. Special exercises help strengthen muscles and increase flexibility.
A new spinal fracture is sometimes treated with bed rest and wearing a special back brace.