Treatment of Osteoporosis of the Spine

While lost bone cannot be replaced and osteoporosis cannot be cured completely, there are ways to slow down its progression, maintain healthy bone density and prevent symptoms.

Creating Your Plan

Creating a treatment plan for osteoporosis often involves a team of experts, which may include:

• an internist (a doctor of internal medicine)
• a spine specialist (both surgical and non-surgical, who spends the majority of their time diagnosing and treating spinal disorders)
• an orthopedic surgeon (a doctor who treats disorders of the musculoskeletal system)
• a gynecologist (a doctor who specializes in women’s health, with a focus on the female reproductive system)
• an endocrinologist (a doctor who specializes in glands and the hormones)

Your doctors may develop a treatment plan based on a few factors. Some of these include:

• The extent of your disease and your anticipated rate of bone loss. This rate is an estimate of your risk of breaking a bone in the next ten years using information such as the bone density test
• Your age and overall health including your medical history
• Your gender
• Previous reactions to medications, surgeries, or therapies

Sample Plan

A comprehensive osteoporosis treatment program usually includes a focus on proper nutrition, exercise, and safety issues to prevent falls that may result in fractures. In addition, if your risk is high, your doctor may also prescribe a medication to slow or stop bone loss, increase bone density and reduce fracture risk.

Reducing Your Body Weight: Maintaining a healthy body weight is important for your bone health. If you are underweight, your bones are at an increased risk to fracture and usually are more susceptible to bone loss. If you are overweight, you are putting more stress on your bones which may also lead to fractures.

A Balanced Diet

There are certain nutrients that our bones rely on to remain strong and healthy. These include Vitamin D and Calcium. It is important to eat a well-balanced diet that is rich in nutrients to preserve your bones.

Good sources of calcium may include:

• Low-fat dairy products, like cheese and yogurt
• Sardines and salmon
• Beans and lentils
• Seeds, such as chia seeds and sunflower seeds
• Nuts, such as almonds, hazelnuts and walnuts
• Soy products, such as edamame, tofu, tempeh, certain meat alternatives and soymilk
• Dark green leafy vegetables, such as mustard greens, kale, spinach, broccoli, chard and other cruciferous vegetables
• Fortified foods, such as cow’s milk, soymilk, orange juice, cereal and oatmeal

Good sources of vitamin D may include:

• Sun exposure (Vitamin D improves your body’s ability to absorb calcium and improves bone health in other ways. Spending some time out in the sun is the most accessible way to get your daily dose of vitamin D.)
• Salmon, herring, sardines, canned tuna, oysters, shrimp
• Cod liver oil
• Egg yolks
• Mushrooms
• Fortified foods, such as cow’s milk, soymilk, orange juice, cereal and oatmeal.

If you and your doctor are finding it difficult to get enough calcium into your diet, your doctor may recommend calcium and vitamin D supplements product and dosing recommendations.

Note: Make sure to follow your doctor’s instructions on how much of a supplement to take, as overdosing on supplements can make you sick.

Exercise

In general, exercise is a crucial part of treating osteoporosis. Exercise is a broad term, and this doesn’t look the same for everyone. However, certain types of exercise strengthen muscles and build bone mass, while other types are designed to strengthen your muscles and coordination which can improve you balance, preventing falls. Along with being active, focusing on these exercises can help slow down your osteoporosis.

These types of activities are often recommended for patients with osteoporosis:

• Strengthening the upper back
• Light weight bearing aerobic activities
• Stretching and flexibility exercises
• Balancing exercises

Consult your doctor before starting any exercise program for osteoporosis. Find out what exercises are appropriate for you.

Exercises You May Want To Avoid

Although exercise is good for someone with osteoporosis, it should not put any sudden or excessive strain on your bones. If you have osteoporosis, your doctor will likely advise you to avoid the following types of exercises:

• High-impact exercises, such as jumping, running, jogging or cycling, which can lead to fractures in weakened bones.
• Bending and turning/twisting, such as touching your toes or doing sit-ups can increase your risk of compression fractures if you have osteoporosis.

Therapeutic Medications

Drug therapy used to treat osteoporosis is typically recommended for more severe cases. Some drugs can slow the rate of bone loss and promote bone growth.

Several medications are available for the prevention or treatment of osteoporosis. Depending on what is causing your bone loss, your doctor may recommend one or more of the following medications:

• Bisphosphonates These have shown to increase bone mass and prevent both spine and hip fractures.
• Calcitonin This is used to decrease bone loss.
• Estrogen Replacement Therapy (ERT) This may be recommended for women at high risk for osteoporosis to prevent bone loss and reduce fracture risk.
• Estrogen agonists/antagonists (selective estrogen receptor modulators or SERMs) These can increase bone mass, decrease the risk of spine fractures and lower the risk of breast cancer.
• Parathyroid hormone (PTH) analog This stimulates new bone growth.
• Parathyroid hormone-related protein (PTHrp) analog This has shown to increase lumbar spine bone density.

You and your doctor will have to weigh the pros and cons of each treatment option.
Fall Prevention

Falling is the number one cause of osteoporosis-related fractures. Once one fracture has occurred, the chance of having another fracture increases. This means that patients who have suffered a fracture in their spine or hip are more likely to have another fracture within the next year, compared to those who have never had an osteoporotic fracture.

Prevention of falls is especially important for people with osteoporosis because of their fragile bones.

Risks of falling may include:

• Visual impairment
• Having blackouts
• Being impaired cognitively
• Impaired balance and muscle weakness
• Kyphosis
• Use of medications that can cause dizziness and drowsiness
• Multiple drug therapies
• Vulnerability due to surroundings and weather conditions

Here are a few steps to prevent falls:

• In your home: Remove objects you may trip over. Install grab bars for you to hold onto and make sure there is sufficient lighting.
• Maintain eyesight: If you wear glasses, make sure your lenses are clean and in good condition. You may also want to wear sunglasses when you go outside to prevent glare or squinting.
• Footwear: It is important that you wear comfortable shoes that provide support and allow you to move around with ease.
• Medication: Talk to your doctor if any of your medication makes you prone to dizziness or drowsiness.

Note: Other osteoporosis prevention methods may also include smoking cessation and avoiding heavy alcohol use to slow the progression of the disease.

Disclaimer – All information is for educational pursuit and information purposes only. It is not intended nor implied to be a substitute for professional medical advice. The viewer should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding their medical condition, diagnosis, procedures, treatment plan, or other health related topics.