Treatments for osteoporosis

Recovering from broken bones

Bones heal in six-eight weeks but pain and other problems may continue for longer.

Recovering from a broken hip can be a long process and you may need a referral to a physiotherapist and social services to help you recover.

Compressed or wedge shaped bones in the spine (spinal fractures) are sometimes very painful but not always.

Long-term chronic pain may continue even after bones have healed due to changes in posture and the strain this puts on muscles and ligaments. Exercises to help strengthen the muscles that support the spine can be helpful.

Simple over-the-counter pain relievers, or stronger pain relieving drugs prescribed by your GP, can also make a big difference if taken properly. A referral to an NHS pain clinic may sometimes be necessary.

Drug free ways to manage pain include physiotherapy, hydrotherapy (exercise in water) or using a TENS (transcutaneous electrical nerve stimulation) machine, although evidence of the clinical benefits of these treatments is inconclusive. Self-management courses such as the Expert Patient Programme may be helpful.

Complementary therapies such as acupuncture, homeopathy, the Alexander Technique and aromatherapy may also be of some benefit, but again evidence of clinical benefit for some of these therapies and activities is unclear.

Some specialists sometimes use a surgical procedure called percutaneous vertebroplasty or kyphoplasty to help with painful spinal fractures.

Drug treatments have been shown to reduce the risk of fractures by up to 50 per cent (1).

Drug treatments

The following are the main drug treatments for osteoporosis:

  • Bisphosphonates: alendronic acid / alendronate, etridronate, ibandronate and risedronate – available in tablet form on a daily, weekly or monthly basis
  • Ibandronate is also given as a three monthly injection. Another bisphosphonate, zoledronic acid is given as a yearly infusion via a drip in the arm
  • Calcium and vitamin D – often prescribed to older people to help prevent broken hips
  • Selective estrogen receptor modulator (SERMs) – prescribed to reduce the risk of spinal fractures in women after the menopause
  • Strontium ranelate – appears to affect both cells that build bone and those that break it down thus reducing the risk of hip and spinal fracture. It comes in powder form that is mixed in water and taken daily
  • Parathyroid hormone (PTH) treatment – Available in the form of teriparatide to reduce the risk of spinal fracture. The drugs are self administered as daily injections, given over a period of 18-24 months. They can only be prescribed by specialists or consultants and are generally prescribed to those who have suffered a number of spinal fractures

There are other treatments that are generally only prescribed when others are not appropriate, including calcitonin and calcitriol.

Hormone replacement therapy (oestrogen for women and testosterone for men) is no longer prescribed as a first line osteoporosis treatment for women because of long-term risks of blood clots and breast cancer. Testosterone is prescribed to men with low hormone levels to strengthen their bones.

Infolinks:

Reference:

  1. National Osteoporosis Society | Osteoporosis Facts and Figures (V1.1) | Accessed Jun 2009

All Dr Foster health content is provided for general information only and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional, or relied upon as a source of comprehensive practitioner material.

All Dr Foster health content has been peer reviewed by GPs and is updated anually when necessary.

Dr Foster is not responsible or liable for any diagnosis made or treatment given by a user based on the content of the supplied health content. Dr Foster is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites.

Always consult your own GP if you are concerned about your health.