Osteoporosis treatment can:
- Slow down bone loss or improve bone density
- Lower the risk of fractures
- Reduce the risk of falls
- Reduce the pain of osteoporosis and help in pain management
Non-Drug Strategies for Treatment and Prevention
The best approach for treating age-related bone loss is reducing the risk of a bone fracture. Improving exercise and diet are important first steps.
The Importance of Exercise
Exercise makes bones stronger. Consider:
- Exercising three times a week at a moderate to high intensity.
- Doing weight bearing exercise, like walking and strength training.
- Doing balance exercises, which can reduce both falls and fractures.
- Exercising or moving around as soon as possible after being on bed rest
- Doing a rehabilitation program, if needed.
If you have osteoporosis, talk to your healthcare provider before starting any type of exercise so you don’t get hurt. You may need to see a physical therapist to learn the exercises that work for you.
Weight-Bearing Exercises
This type of exercise works against gravity to strengthen muscles and put healthy stress on your bones. Try to do 30 minutes of this exercise most days of the week. You do not need to do it all at once. Breaking up the 30 minutes throughout the day works just as well.
There are two types of weight-bearing exercises:
- High-impact weight-bearing exercises are especially helpful. They include dancing, climbing stairs, jogging, hiking, playing tennis, or other active sports. However, if you have osteoporosis or have broken a bone, check with your healthcare provider about safety first. High-impact exercise could be too hard and may actually cause a fracture.
- Low-impact weight-bearing exercises include fast walking (including treadmill walking), low-impact aerobics, or using an elliptical training machine or a stair-step machine. This type of exercise will also strengthen bones and does not increase the risk of a fracture during exercise.
Muscle-Strengthening or “Resistance” Exercises
These exercises work against gravity or against another form of resistance. They can use weights, weight machines, elastic exercise bands, or your own body. The exercises should be done two or three times per week.
Yoga and pilates use many resistance techniques. If your bones have lost significant mass, these forms of exercise may harm you.
Check with your healthcare professional or physical therapist to make sure that your exercise choices will not harm you.
Non-Impact Physical Activities
Other types of exercises can help prevent falls and fractures. These exercises need to be done daily. They include:
- Balance exercises, including Tai Chi and yoga
- Posture exercises that straighten rounded shoulders and reduce the risk of spine fractures
- Exercises that help you do your daily activities in the safest way possible (which can help to avoid a fall)
Importance of Diet
Calcium
Bones and teeth need calcium more than any other mineral because it is their main building block. Our bodies lose calcium every day, so it is important to eat foods high in calcium.
Many older people tend to eat fewer foods rich in calcium. This is often because milk, cheese, or yogurt become harder to digest. Older adults are more likely to have problems digesting lactose (a sugar found in milk). Many lactose-free dairy products are now available, including milk and ice cream. Certain aged cheeses (such as very sharp cheddar) and yogurts are naturally low in lactose.
Most healthcare professionals recommend getting at least 1,200 mg of calcium every day. The best way to get enough calcium is to eat calcium-rich foods such as dairy and leafy, dark greens. Many other foods can also have a lot of calcium. They include.
- Sardines in oil with bones and Canned salmon with bones
- Yogurt and milk
- Kale and broccoli
- Tofu
Calcium supplements are inexpensive and readily available. The supplements are absorbed best in divided doses (for example, 600 mg at a time).
- Calcium citrate can be absorbed efficiently without food
- Calcium carbonate is best taken with food
You should not take more than 2,500 mg of calcium daily from supplements. If you do, you raise your risk of developing kidney stones, especially women who have had menopause. Dietary sources of calcium may lower your risk of kidney stones.
Vitamin D
Your body needs this “sunshine” vitamin to be able to use calcium. Normally, the body makes vitamin D when skin gets direct exposure to sunlight. Risks of not getting enough vitamin D are related to:
- Increased sunscreen use
- Not enough skin exposure to sunlight
- Skin changes as we age that reduce production of vitamin D
- Spending less time outdoors with age
You can get extra vitamin D by:
- Eating foods with added vitamin D such as fortified milk, bread, and juices.
- Taking supplements. The current recommended daily dose of vitamin D is 800-1,000 international units (IU).
- Your health care professional may recommend higher amounts if your vitamin D levels are too low.
- Your healthcare provider may ask you to take a blood test to check the vitamin D level in your blood.
Medication Treatments
Treatment with medications is appropriate for older adults who have:
- Already had a broken hip or a bone in the spine.
- A bone mineral density (BMD) T-score of less than -2.5.
- A BMD T-score between -1 to -2.5, which is considered osteopenia. Medication treatment may be appropriate. This depends on a combination of the T-score and a person’s evaluation by the fracture risk assessment tool (FRAX).
Several medications are available to treat bone loss.