Osteoporosis Archive

Men also get osteoporosis—but consider your risk factors before deciding to have a bone-strength test.

Men's and women's bodies differ in plenty of ways, but we all have bones, and with aging they may lose some of their strength and leave us more vulnerable to dangerous fractures of the hip or spine. Osteoporosis is not exclusively a women's health issue.

Q. I have sciatica. I also have vertebral fractures caused by osteoporosis. I'd like to get physical therapy for my sciatica but am worried about damaging my spine further. What do you advise?

A. I am glad that you are interested in pursuing physical therapy to treat the sciatica. It's the best treatment for it. The physical therapist is likely to show you how to do gentle stretching exercises for your upper legs, buttocks, and back, as well as how to use your back, core, and legs more effectively to avoid worsening the strain on your sciatic nerve. She will also train you to do exercises to strengthen your back and core. None of these maneuvers will damage the bones in your back. But it's important for you to tell the therapist that you do have osteoporosis and vertebral fractures. She will keep that in mind as she works with you.

A study published online April 13, 2015, in JAMA Internal Medicine indicates that a single infusion of the bisphosphonate drug zoledronate (Reclast) can be used to increase bone density in women who can't take oral versions of bisphosphonates. Taking an oral bisphosphonate like alendronate (Fosamax) is effective in building bone for women with osteoporosis, but it requires a commitment—taking the drug on an empty stomach and remaining upright for 30 minutes afterward. Because this may not be practical for women in assisted living facilities, they often aren't given bone-building drugs, even though their risk of hip fracture is eight to nine times that of women living at home.

The researchers studied 181 women with osteoporosis residing in assisted living facilities. The average age was 85. The women were randomly assigned to one of two treatments—1,200 milligrams of calcium and 800 IU of vitamin D daily as supplements plus a single intravenous infusion of zoledronate or the same daily doses of the supplements alone.

Here are some steps you can take to reduce your reliance on medication to control symptoms and stay functional.

Q. My internist told me to take calcium because I have osteoporosis. However, I heard that blockages in heart arteries could also contain calcium. Am I hurting my arteries by taking calcium supplements?

A. Doctors often recommend calcium supplements for people with osteoporosis, and I'd advise you to follow your physician's advice, as calcium is important for bone health. The Recommended Dietary Allowance for calcium for adults is 1,000 to 1,200 milligrams (mg) a day; dairy products are the best sources. For healthy people who get enough calcium in their diets, the role of calcium supplements is less clear, although some people hope that taking them may help preserve bone strength.

Fight back against declining bone density with calcium, vitamin D, and weight-bearing activity.

Disabling fractures of the hip and spine are often the result of osteoporosis, so keeping bones healthy in older age is crucial to protecting mobility and independence. But it takes more than the occasional glass of milk to do the job. "Most people don't really know all they need to do to keep their bones healthy. Increasing awareness is a huge step forward," says Dr. Marcy Bolster, who specializes in treating osteoporosis at Harvard-affiliated Massachusetts General Hospital. She recommends the following to help protect bone health.

Women with osteoporosis have many options for preserving bone strength and preventing fractures. The mainstays of treatment are bisphosphonate drugs.

For women with osteoporosis who are embarking on a “holiday” from taking a bone-building drug, the message from a study released today is “Bon voyage—see you in two years or so.” After menopause, loss of bone (osteoporosis) can lead to crippling fractures of the hip and spine. Drugs called bisphosphonates—alendronate (Fosamax) was the first on the market in the mid-1990s—slow bone loss. But after taking these drugs for a number of years, the balance can begin to tip from help to harm. A new report from the Fracture Intervention Trial Long-term Extension (FLEX) shows that measuring bone density after one year added no information that would have helped doctors identify who was at risk and perhaps should start taking a bisphosphonate again. Waiting two years is a good option for most women.

Q. I've had osteoporosis for several years, and I've been taking alendronate (Fosamax) once a week. I wasn't very good at remembering to take it regularly, so my doctor recently recommended that I start on once-a-year infusions of zoledronic acid (Reclast). Will it work as well to prevent me from breaking a bone?

A. Zoledronic acid is an intravenous bisphosphonate that is frequently used to treat osteoporosis. It is a very effective medication. Several studies have demonstrated that it increases bone density and, more importantly, reduces fracture risk.