Osteoporosis
Osteoporosis makes bones fragile and more likely to fracture with minimal or low trauma. While it is more common in women due to bone loss after menopause, it also affects about 20% of aging men and can be caused by other conditions like rheumatoid arthritis and certain medications, such as steroids.
Often referred to as a “silent disease,” osteoporosis can be detected with a DXA (Dual-energy X-ray Absorptiometry) scan before any fractures occur. It’s important not to confuse osteoporosis with osteoarthritis, which is a type of degenerative arthritis, or a DXA scan with a bone scan, which measures blood flow to bones to assess for inflammation.
At ASC, a DXA scan is usually accompanied by additional assessments such as the TBS (trabecular bone score) to evaluate bone connectivity and VFA (vertebral fracture assessment) to check for prior silent spinal fractures. The radiation exposure from these tests is minimal, comparable to the amount received during a flight from New York to Los Angeles.
Using a comprehensive medical history along with results from DXA, VFA, and TBS, ASC providers can accurately determine your future fracture risk and recommend a personalized treatment plan. This often includes a daily intake of 1000-1200 mg of calcium from food and/or supplements, daily vitamin D3, and regular weight-bearing exercises such as walking and balance training to prevent falls.
Osteoporosis treatments fall into two main categories:
1) Anti-resorptive medications, which prevent bone loss. These include:
- Oral medications: Fosamax (alendronate), Actonel (risedronate), and Boniva (ibandronate), taken weekly or monthly.
- Intravenous medications: Zoledronate, administered annually in-office for 1-5 years, and Prolia, given as a biannual in-office injection
2. Anabolic (bone-building) drugs, which include:
- Forteo (teriparatide) and Tymlos (abaloparatide), injected at home nightly for 18-24 months.
- Evenity (romosozumab), administered as a monthly injection in the clinic for 1 year.
If you think you may have osteoporosis, consult with the providers at ASC to discuss your symptoms and explore the most effective treatment options. With proper management, you can significantly reduce your risk of fractures and maintain healthier bones.