Osteoporosis: An Overview
Osteoporosis Tests and Diagnosis continued...
During an exam, your doctor will:
- Look at your age, consider whether women have reached menopause, whether you have ever broken a bone as an adult, your own family history, and your habits such as drinking, eating, and exercise.
- Ask about which medications you take. Some, such as corticosteroids taken long-term, can affect bone health adversely.
- Measure you to see if you have lost height. The doctor will inspect your spine. If it abnormally curves forward, that could be a sign that you've already had spinal fractures due to osteoporosis.
The bone density test results will help the doctor decide if you have osteoporosis. The test, which is noninvasive, can measure your bone density at the hip and spine.
Your doctor looks at the results, compares them to standards, and can determine if you have low bone density known as osteopenia, or even weaker bones, and osteoporosis.
Bone-maintenance drugs can help your bone health. These drugs help maintain bone density and can reduce fracture risk.
Examples of bisphosphonate drugs include:
- alendronate (Fosamax)
- alendronate sodium (Binosto)
- ibandronate (Boniva)
- risedronate (Actonel, Atelvia)
- zoledronic acid (Reclast)
Other drug options to protect against bone loss include:
- raloxifene (Evista): an estrogen-like drug that slows bone loss and helps increase bone thickness.
- teriparatide (Forteo): a synthetic form of parathyroid hormone for people with osteoporosis who are considered at high risk for fracture based on a doctor’s assessment.
If you start taking a bone-maintenance drug, be sure your doctor knows about all other medicines you are on. Some drugs can affect the bones, and your doctor may want to switch you to another drug or adjust the dose.
If you’re taking a bisphosphonate, you may be switched to another drug after five years. That is to avoid the risk, although low, of getting an uncommon thigh bone fracture linked with long-term use of bisphosphonates.
What to Expect After a Fracture
Fractures from osteoporosis often occur at the hip, wrist, and/or spine. Hip fractures often require surgery. Wrist fractures may need casting and/or surgery.
Spine fractures are the most common. About 700,000 spinal fractures occur a year. Weak bones can lead to a compression fracture in the vertebrae, the bones that form your spine. Over time, these fractures can change the strength and shape of your spine. You may lose height. Spine fractures sometimes can lead to chronic back pain. Soft, weak bones are the root of this problem.
Pain Relief Options for Fractures
Pain medicine and other therapies can help. Options include:
- Aspirin or acetaminophen (Actamin, Anacin AF, Tylenol).
- Non-steroidal anti-inflammatory medicines. Examples are ibuprofen (Advil, Dolgesic, Motrin, Nuprin) and naproxen (Aleve, Anaprox, Naprelan, Naprosyn). Both can reduce pain and swelling.
- If you need a stronger painkiller, your doctor can prescribe opioid pain medicines, such as codeine or morphine. However, doctors may discourage you from staying on these potent medicines long-term.
- Applying cold compresses or heat to the site can help the pain. You can pick, depending on which temperature feels best.
- Physical therapy can help you learn how to move properly, reducing risk for more fractures.