Treatment of Osteoporosis
Once the diagnosis of osteoporosis is made, it is up to the doctor and the patient to decide if the treatment plan should be preventative or curative in respect to the fracture risk. Many different interventions can then be conducted to achieve your treatment or preventative plan – both are equally effective at preventing fracture.
In order to understand the treatment option, it is important to first understand the anatomy of the bone and the functioning of the cell types. The three major cells which are involved in bone growth and remodeling are osteoblasts, osteoclasts, and osteocytes. The osteocytes are the mature bone cells found in the body, which undergo cell death from time to time and new cells replace them. Just before being destroyed, these cells send signals to cell structures for the production of bone-forming cells known as Osteoblasts. Hence when an individual undergoes trauma or is put through a certain degree of stress, the osteocytes send signals to the bone-forming cells known as Osteoblasts to increase their production. Osteoblasts then produce certain factors which cause the production of another cell known as Osteoclasts. Osteoclasts are bone-resorbing cells and are necessary for bone remodeling. The resorbed area of the bone is then refilled by the osteoblasts, which do this by filling the gaps with hydroxyapatite crystals. In case of a disturbance of the balance between osteoclasts and osteoblasts production, more bone will start to be dissolved as compared to the bone that is getting formed. Hence the major target for osteoporosis treatment is to decrease the activity of the bone-resorbing cells known as osteoclasts and increase the activity of the bone-forming cells known as Osteoblasts.
This may be achieved in two ways: Anabolic and Anticatabolic Treatment. The anabolic treatments include Physical Activity, Vitamin D administration, Steroid therapy, growth hormone therapy, parathyroid hormone therapy, and administration of Calcium and Calcitriol. On the other hand, the anti-catabolic interventions include the ways in which the activity of bone-resorbing cells can be prevented. This may include Estrogen Therapy, Hormone Replacement Therapy, giving bisphosphonates, and Osteoprotegerin and Strontium Ranelate therapy.
1) Exercise
One of the first things recommended by experts for osteoporosis is physical therapy, which may act as a preventative therapy and as a co-adjuvant treatment form. Bone mass that has been lost due to osteoporosis can be regained by undergoing exercises that involve weights and speed activities. This is because physical activity causes the stimulation of Osteocytes and Osteoblasts, which cause the formation of new bone.
An added benefit of regular exercise will also lead to an increase in muscle mass and a general improvement of neuromuscular coordination. This will prevent unnecessary falls and lower the risk of fractures associated with the condition. This is also proven by studies conducted to evaluate the effectiveness of exercise in the elderly. Results of one such study showed that those elderly individuals who undergo regular exercise are at a lower risk for osteoporosis-related fracture as compared to the elderly individuals who practice a more sedentary lifestyle.
