How is osteoporosis treated?
The pain arising from a fractured bone can be reduced by immobilising the bone in a plaster cast such as might occur after a wrist fracture, or surgery to align the bones in their correct position. Fractures of a major bone such as a hip do often require surgery. Fractures of the spine, causing chronic back pain and acute back pain sometimes, can also be relieved by a surgical procedure known as vertebral kyphoplasty or balloon kyphoplasty.
There are other treatments that are needed to reduce pain arising from fractures such as the use of painkillers, hydrotherapy, which is pool based exercises that reduce muscle spasm and pain and allow us to mobilise the patient. And alternative treatment with TENS.
It is important to mobilise a patient as quickly as possible since bed rest increases bone loss and therefore increases the risk of further fractures. Apart from reducing pain we are fortunate there are a number of drugs available to treat the condition of osteoporosis. These drugs fall into two groups. Firstly the drugs that reduce the amount of bone being resorbed by acting on the bones resorbing cell osteoclast. These drugs are known as antiresorptive.
The second group consists of drugs that stimulate the activity of the bone forming cell called the osteoblast. These drugs are known as anabolic agents The most common drugs used are the antiresorptives. Of the antiresorptives the bisphosphonates are the drugs of choice. These drugs are given either orally once a week or once a month. They can also be given through an injection into the vein at every three month intervals or once a year. When taken orally it is important to adhere to the instructions since these drugs are not absorbed very well if there’s food present in the stomach. Therefore most of the time its advisable that the drug is taken on an empty stomach and then one waits for about thirty minutes to 45 minutes to aid the absorption of the drug before taking any further food.
In order for these drugs to work effectively the amount of the calcium and Vitamin D your intake should be optimum. To obtain this optimum intake its best to be given supplements of calcium and Vitamin D.
For patients who fail to respond to the bisphosphonates or antiresorptive drugs, and by failure I mean their bone density is not increasing or they have sustained further fractures after one or two years of treatment, then one can resort to using anabolic drugs.
At the present time there are only two anabolic drugs licensed. These are drugs that go under the name of parathyroid hormone (PTH). They have to be given by daily injection under the skin for a period of eighteen months (see also Medication for osteoporosis).