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Osteoporosis Treatment and Pain Management

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Non-surgical Treatment for Osteoporosis
The patient needs to understand the diagnosis and how osteoporosis may affect his or her life. This might include making healthy life style changes to diet and exercise, and addressing home safety to prevent falls. The treatment for osteoporosis is usually non-operative. Conservative treatment options may include the following:

  1. Pain management may include nonsteroidal anti-inflammatory drugs (NSAIDs), narcotics, prescription anti-inflammatory medications, topical pain relieving agents, nerve blocks, or nerve ablation (nerve removal). A pain management specialist is consulted when pain is difficult to control.
  2. Hormone replacement therapy (HRT) or Estrogen replacement therapy (ERT) may be beneficial to many post-menopausal women or those at high risk for osteoporosis. It is known that for the first 5 years following menopause women rapidly lose bone mass. The medication is available in pill, topical gel or skin patch form.
  3. Alendrontate is a drug known to stop the breakdown of bone.
  4. Raloxifene is part of a class of drugs called Selective Estrogen Receptor Modulators (SERMs).
  5. Calcitonin is a non-sex hormone known to slow the loss of bone while helping to increase bone density. It is reported to relieve pain associated with fractures. It is available in nasal spray form.
  6. Calcium and Vitamin D is important to bone health. Follow the physician's instructions.
  7. Bracing may be used to alleviate pain and provide spinal support. However, this treatment is controversial. In severe cases of osteoporosis, bracing may do more harm than good. A spinal physician is able to determine if the patient would benefit from bracing.
  8. Physical therapy (PT) may be incorporated into the treatment plan. PT can help the patient build strength, flexibility, and increase range of motion. Exercise promotes circulation that stimulates bones to heal and strength builds balance, which may help to prevent falling. During PT the patient is taught 'safe' movements to help prevent injury. The therapist may provide a customized home exercise program.

Surgery for Osteoporosis:  Kyphoplasty or Vertebroplasty
Kyphoplasty, or balloon kyphoplasty, is a performed to stabilize vertebral compression fractures, restore lost vertebral body height, and alleviate pain.

Vertebroplasty is performed to treat some patients with osteoporosis. An ortpedic cement is injected into the affected vertebrae to stabilize the fracture.

A spinal physician is able to determine if kyphoplasty or vertebroplasty is the best treatment for the patient.

Steps to a Healthy Recovery after Surgery for a Spinal Fracture
Always follow the instructions provided by the physician and/or physical therapist.

  • Take medication as directed. Report side effects to your physician immediately.
  • Follow the home exercise program provided by the physical therapist.
  • Modify your physical surroundings (eg, home) to prevent falls.
  • Remember a proper diet is essential to treating and preventing osteoporosis.
  • Avoid alcoholic beverages.
  • Stop smoking.

If symptoms persist or change, contact your spinal physician.

Updated on: 09/07/12
Harry N. Herkowitz, MD
This article provides an overview of osteoporosis. It is a significant national health problem due in part to a lack of patient awareness. It is critical that patients understand what osteoporosis is and what their responsibility to their own body is. They should do impact exercise on a regular basis, avoid smoking and excessive alcohol. They should maintain a reasonable weight, begin taking calcium with vitamin D well before menopause begins, and get regular checkups especially if there is a history of osteoporosis in the family.
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