It is important to understand the goal of treating osteoporosis: strengthening the skeleton to reduce fracture risk. Not always do the DEXA scans show increases in bone mineral density. The medical provider will evaluate each patient to determine the risk of breaking a bone within the next ten years. If the risk level is low, a patient may not yet need medications. The focus may be on modifying behaviors to decrease risk, ensuring proper calcium, vitamin D, and dietary habits, and including anti-gravity exercise (walking is a great example) in one’s lifestyle. Physical therapy interventions to decrease fall risk are advised for patients who fall or are at risk of falling.
Many medications are available for treating osteoporosis. The primary medications are oral, including Fosamax, Boniva, Actonel, and Evista. These are usually the first-line medications relied upon for uncomplicated and less severe OP. They are often demanded to be tried first by various payers as they are less expensive.
For patients who cannot tolerate them and/or for patients with severe disease, often including fractures, a second group of more potent medications exist (which are more expensive):