Tuesday, December 5, 2023
This activity is intended for primary care clinicians, gynecologists, geriatricians, endocrinologists, and other specialists who care for women at risk for or with osteoporosis.
The goal of this activity is to review the range and types of nonpharmacologic strategies for the treatment of osteoporosis, their mechanisms of action, and their potential effects on improving bone mineral density and preventing fractures.
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The traditional management of osteoporosis has focused on the pharmacologic aspects of treatment. Nonpharmacologic approaches, such as the use of orthoses, exercise programs, calcium and vitamin D supplementation, fall prevention, and kyphoplasty have largely been overlooked. Evidence for an essential contribution of nonpharmacologic treatments in the management of osteoporotic patients is increasing, particularly for patients who cannot, or will not, comply with medication regimens. This Review highlights the most important aspects of nonpharmacologic management of osteoporosis.
A comprehensive approach to the treatment of osteoporosis is essential to maximize bone density and minimize fracture risk. Although pharmacologic approaches represent the cornerstone of treatment, some patients cannot, or will not, comply with medication regimens. This is particularly true for regimens involving drugs with potential adverse effects, but also occurs in those who cannot afford certain medication options or are in conflict with taking any medications for prolonged time periods. For example, recent press about the possible connection between osteonecrosis of the jaw and the use of bisphosphonates has spurred a lot of skepticism about their use from many patients. Others are concerned about the long-term effects of these anti-osteoporotic therapies in patients, particularly given that there are limited data on the long-term use of these medications.
Nonpharmocologic therapies, such as orthoses, exercise programs, calcium and vitamin D supplementation, fall prevention and kyphoplasty, complement the traditional pharmacologic treatment of osteoporosis and can have a significant role in minimizing fracture risk. Management of osteoporosis should, therefore, involve a comprehensive approach encompassing both pharmacologic and nonpharmacologic treatment. This Review explores the various nonpharmacologic options available.
