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Can You Reverse Osteoporosis?

5 questions and answers about osteoporosis treatment.
By
WebMD Feature
Reviewed by Laura J. Martin, MD

For many people, hearing "You have osteoporosis" is startling.

Some hear it in the hospital after breaking a hip. Others get the news after getting a bone density test.

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Osteoporosis Pain

Osteoporosis is often called the "silent disease," because most of the time, bone loss occurs without any symptoms at all. But when osteoporosis becomes severe, it can lead to fractures and a condition called kyphosis. Kyphosis is spinal compression, sometimes described as the "dowager's hump." Both fractures and kyphosis can be very painful. This pain is usually more severe than the typical "aches and pains" many people feel as they get older.

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Osteoporosis is most common in women after menopause, people with osteoporosis in their family, and people with a small frame. But others can also get it, raising their risk of bone fractures.

Cutting that risk is crucial. About half of women and a quarter of men over age 50 will have an osteoporosis-related fracture, notes the National Osteoporosis Foundation. Fractures most often affect the hip, spine, and wrist, but can affect any bone.

Often, the first question patients ask their doctors is, Can I reverse osteoporosis?

Here, bone health experts answer that and other osteoporosis questions.

1. Can You Reverse Osteoporosis?

Not exactly. But you may be able to curb it.

''Realistically, we are not talking about complete reversal," says Felicia Cosman, MD, clinical director of the National Osteoporosis Foundation (NOF) and medical director at the Clinical Research Center of New York's Helen Hayes Hospital.

"A realistic goal is to prevent fractures from occurring," says Cosman, who researches osteoporosis treatments and has consulted and spoken for the drug companies Eli Lilly, Novartis, Merck, and Amgen, which make osteoporosis drugs.

2. So What Can I Do About Osteoporosis?

You can make fractures less likely by maintaining or improving your bone density, Cosman says.

That is, "you can reverse theconsequences of osteoporosis," says Robert Heaney, MD, vice president for research and professor of medicine at Creighton University in Omaha, Neb. A bone biologist, Heaney has spoken for Merck and Amgen. 

Doing that typically involves being active, getting enough calcium and vitamin D, and taking osteoporosis drugs.

3. What Will Osteoporosis Drugs Do for Me?

Depending on the state of your bones, "you can build some bone and get out of the osteoporosis range with drug therapy," says Jeri Nieves, PhD, a Columbia University associate professor of clinical epidemiology. 

"You can slow down the bone loss, [but] it's not the same as reversing it," says Nieves, who also works at New York's Helen Hayes Hospital.  

There are several types of osteoporosis drugs, which are available by prescription only:

  • Bisphosphonates, such as Fosamax, Boniva, Actonel, and Reclast
  • Calcitonin, sold as Fortical and Miacalcin
  • Hormone therapy, or estrogen
  • SERMS (selective estrogen receptor modulators), such as Evista (raloxifene)
  • Parathyroid hormone (Forteo or teriparatide)
  • Prolia, a biologic drug

Some types of osteoporosis drugs slow bone breakdown, which is part of bone's natural and ongoing remodeling process. Others spur new bone growth.

How good is the resulting bone? "The quality of the new bone is probably very good," Cosman says. "But the quality of your overall bone may not be back to normal."

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