Rheumatoid Arthritis and Osteoporosis
Osteoporosis Management Strategies
Strategies for preventing and treating osteoporosis in people
with rheumatoid arthritis are not significantly different from the strategies
for those who do not have the disease.
Nutrition: A diet rich in calcium and vitamin
D is important for healthy bones. Good sources of calcium include low-fat dairy
products; dark green, leafy vegetables; and calcium-fortified foods and
beverages. Also, supplements can help ensure that the calcium requirement is
met each day.
Vitamin D plays an important role in calcium absorption and
bone health. It is synthesized in the skin through exposure to sunlight. While
many people are able to obtain enough vitamin D naturally, older individuals
are often deficient in this vitamin. This is partly because they spend limited
time outdoors. Such individuals may require vitamin D supplements in order to
ensure an adequate daily intake.
Exercise: Like muscle, bone is living tissue
that responds to exercise by becoming stronger. The best exercise for your
bones is weight-bearing exercise that forces you to work against gravity. Some
examples include walking, climbing stairs, lifting weights, and dancing.
Exercising can be challenging for people with rheumatoid
arthritis, and it needs to be balanced with rest when the disease is active.
However, regular exercises such as walking can help prevent bone loss and, by
enhancing balance and flexibility, can also reduce the likelihood of falling
and breaking a bone. Exercise is also important for preserving joint
Healthy lifestyle: Smoking is bad for bones as
well as the heart and lungs. Women who smoke tend to go through menopause
earlier, triggering earlier bone loss. In addition, people who smoke may absorb
less calcium from their diets. Alcohol can also negatively affect bone health.
Those who drink heavily are more prone to bone loss and fracture, because of
both poor nutrition and an increased risk of falling.
Bone density test: Specialized tests known as
bone mineral density (BMD) tests measure bone density in various sites of the
body. These tests can detect osteoporosis before a fracture occurs and predict
one’s chances of fracturing in the future. A person with rheumatoid arthritis,
particularly someone who has been receiving glucocorticoid therapy for 2 months
or more, should talk to his or her doctor about whether a bone density test is
Medication: Like rheumatoid arthritis,
osteoporosis has no cure. However, there are medications available to prevent
and treat osteoporosis. Several medications (alendronate, risedronate,
ibandronate, raloxifene, calcitonin, teriparatide, and estrogen/hormone
therapy) are approved by the Food and Drug Administration (FDA) to prevent and
treat osteoporosis in postmenopausal women. Alendronate is also approved for
use in men. For women and men with rheumatoid arthritis who are on
glucocortiocoid therapy and who have glucocorticoid-induced osteoporosis,
alendronate (for treatment) and risedronate (for prevention and treatment) are