Prevention and Treatment of Osteoporosis

The goal of treatment for osteoporosis is the prevention of bone fractures by stopping bone loss as well as increasing bone density and bone strength. Treatment doesn't have to solely occur after osteoporosis is diagnosed, if you think you are at risk, these are things you should start considering now.
Although treatments for osteoporosis will not completely cure it (rebuild bones that have been weakened) they will dramatically reduce the impact this disease will have on your life now and in your old age.

There are three treatment styles for Osteoporosis:

1. Lifestyle changes
2. Medications that stop bone loss and increase bone strength
3. Medications that increase bone formation

Lifestyle changes

Exercise

Exercise has a variety of benefits but for osteoporosis, exercise will aim to prevent falls, fractures and injuries by building fitness, muscle and bone strength.

The best exercise for osteoporosis is a combination of cardiovascular activity and weight bearing exercises. Doing a cardio workout will increase your overall fitness keeping you more energetic and more mobile. It can also prevent excess weight gain which can also put pressure on bones and joints increasing the risk of bone damage. Such cardio workouts would include walking on a regular basis, using gym machines (which are low impact), trying aerobic and strength classes at gyms, swimming which is especially great as it puts no pressure on bones and joints and running. Although running may not be advisable for those with already weakened joints and bones it can be surprisingly good for your bones (unlike popular belief!) and encourages the re-growth of bone tissue.
Strength exercises aim to prevent fractures and damage to bones by encouraging the regeneration of bones after exercise and keeping joints sturdy (especially tendons and ligaments). It plays a major role is reducing the likelihood of injury as with stronger joints and bones you are not as vulnerable.

Such exercises may include:

• Weights machines which work both the legs and arms
• Core body exercises ( plank, press ups, gym ball, bosu and wobble board to develop balance)
• Leg exercises such as lunges and squats incorporating a medicine ball for weight
• Proprioceptive exercises to strengthen ankles, hips and knees ( hopping, jumping, skipping, and running in different directions to increase agility)

It is also important to look after your body as part of your exercise routine by stretching well before and after exercise, and being careful not to overload your joints with too much weight.

Reduce your smoking

Smoking on its own can lead to a loss of 5 to 10 percent bone mass. Smoking decreases oestrogen levels in women and can lead to earlier menopause. Reducing the amount you smoke or stopping completely will therefore have a dramatic positive effect on not only your bone mass but also your general health.

Diet

To build strong bones there is a requirement of a daily intake of calcium. Where osteoporosis is a risk, calcium supplements can help this situation. Although supplements can prevent malnutrition they are not an alternative to a healthy diet and as their name suggests 'supplements' to a diet that includes sources of nutrients already. Foods such as milk, plain yogurt, cheese, creams and fortified orange juice contain calcium (but beware of their high fat content).

Vitamin D

Vitamin D is also important in preventing osteoporosis but aiding the absorption of calcium in the intestines. A lack of vitamin D causes calcium depletion in bones and further weakens them.
Vitamin D comes from a good diet and the exposure to sunlight. Therefore getting regular outdoor exposure to sunlight will be beneficial. Vitamin D is present in many of the same foods that contain high levels of calcium but supplements are additionally recommended to ensure adequate levels.

Hormone therapy

HRT (hormone replacement therapy) can prevent bone loss, increase bone density and prevent osteoporosis. This is due to replacing levels of oestrogen and progesterone. However caution must be taken with this treatment method as every woman will need a different balance of oestrogen and there may also be adverse side effects with some medications.

Medications that prevent bone loss and breakdown

Currently, the most effective medications for osteoporosis are anti-resorptive agents which prevent bone breakdown by preventing calcium being reabsorbed into the blood wearing away the bone. Anti-resorptive medications inhibit bone removal and help increase density. There are many different brands of this medication on the market but here are a few: alendronate, risedronate, raloxifene, ibandronate, calcitonin and the newest zoledronate.

Prevention of osteoporosis due to long term corticosteroids

Long term used of corticosteroids can lead to osteoporosis. Corticosteroids decrease calcium absorption from the intestines, increase loss of calcium from the kidneys and increase loss of calcium from the bones. To prevent these effects patients should:

• Have a high calcium and vitamin D intake through their diet and supplements.
• Discuss with their doctor medications which can reduce the symptoms of corticosteroid induced osteoporosis.
• Have regular checkups and scans to monitor their bone density levels over time.

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