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Osteopenia: Treatment, Procedure, Cost and Side Effects

Last Updated: Apr 25, 2024

What is the treatment?

The condition of bone loss is known as osteopenia in medical terms.

How is the treatment done?

Osteopenia is a medical condition that occurs when the body does not make new bones as quickly as it reabsorbs the old bones and thus, causes the bone mineral density to be lower in the patient than normal. This decreased bone density leads to bone fragility and an increased chance of breaking a bone (bone fracture). The condition of low bone density can be caused due to a low-calcium diet, smoking, age-related hormone changes and certain diseases and medication. Women and people above the age of 50-60 are at a greater risk.

Unless the medical condition progresses to osteoporosis, usually, there are no symptoms,. The bone begins to lose its mineral density and gradually becomes weak. The bone weight also decreases.

Treatments include medications to protect the patient’s decreasing bone mass and bring improvement, dietary changes and routine exercise. Physical exercises include aerobic activities for 20–30 minutes. This helps to improve the cardiovascular health. Medications involve dietary supplements that help in promoting overall health and also helps to strengthen and build bones.

Who is eligible for the treatment? (When is the treatment done?)

Osteopenia is diagnosed by the doctors using measures of bone mineral density (BMD). Depending on the patient’s age, doctor’s use a special machine to measure the bone density of the patient and determine if the bones are weaker than expected. Dual energy X-ray absorptiometry, known as DEXA or DXA, is the most common way to measure BMD. It uses X-rays that emit lower radiation than a typical X-ray. The test is painless and the result is a T-score which determines whether the patient suffers osteopenia.

Treatment of osteopenia mainly involves medications and proper healthy diet in order to prevent the progression of this condition to osteoporosis. In the early stages of this condition, patients are given exercises like prone leg lifts, toe raises and heel raises, hip abductors to strengthen the body muscles and bones and a proper improved life style order which includes a healthy diet. If the BMD level is very close to the osteoporosis level, then medicines are prescribed. These medications mainly involve high calcium and Vitamin D (vitamin D2, vitamin D3, cholecalciferol) supplements. Commonly used drugs with a wide range of actions in this condition are bisphosphonates including alendronate, risedronate, and ibandronate; selective estrogen receptor modulators (SERMs) such as raloxifene; estrogen; calcitonin; and teriparatide.

Who is not eligible for the treatment?

Women who are elder than 65 years and men 70 years and older can develop osteopenia. Postmenopausal women are at an increased risk for osteopenia and osteoporosis. Adults who have a bone fracture and a medical condition associated with bone loss (such as rheumatoid arthritis) are eligible for treatment. Also, people being considered for prescription treatment for osteopenia or osteoporosis are eligible for osteopenia treatment.

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Are there any side effects?

As bone loss or osteopenia do not have any symptoms, people do not recognise this. People with healthy bones and properly functioning bones are not eligible for the treatment. If the bone mineral density of the person is appropriate on the basis of his or her age, then there is no need for an osteopenia treatment.

What are the post-treatment guidelines?

There are some yet rare side effects of the medicines used for the treatment of osteopenia. Side effects of alendronate (Fosamax) and other bisphosphonates (risedronate, zoledronic acid and ibandronate) drugs prescribed for osteoporosis and osteopenia are a subject of indepth medical research and media scrutiny. The adverse risks for consumption of these medicines noted in patients with osteopenia mainly include unusual hip fractures and a jawbone problem known as avascular necrosis of the jaw. Also, overconsumption of calcium can cause decay of the bone materials. Thus it is always important to keep a balanced intake of medicines according to the prescription.

How long does it take to recover?

Osteopenia does not require treatment with prescription medications when in detected in the early stages. The bone density test may be repeated every two years to monitor the bone mineral density (BMD). This will help to detect the condition of the patient and note for improvements. There are no alternative post treatment guideline apart from taking medicines as prescribed and doing the recommended exercises. Patients should remember not to overdo their physical exercises or work load as that may cause bone fracture. Even exposure to sun is beneficial for the bone development but should only be performed after doctor’s recommendation depending on the overall health conditions.

What is the price of the treatment in India?

Recovery from osteopenia treatment does not take a huge time. As this condition does not have any symptoms unless progressed to osteoporosis, and the DEXA test is also painless, people recover within first few weeks. Medicines and proper intake of food can strengthen the bones. Thus, recovery ranges from the fifth to eight month of consumption of medicines. People start to show signs of betterment.

Are the results of the treatment permanent?

Treatment of osteopenia does not involve a huge amount because the primary treatment mainly aims at improving the bone conditions and bone mineral density. This is mainly done by right consumption of food rich in calcium and vitamin D supplements and getting the necessary exercises. Medicines are also provided, if needed by the patient. The cost for the treatment of osteopenia ranges between Rs 100- Rs. 800/-

What are the alternatives to the treatment?

In order for the treatment to be permanent, people should maintain a healthy lifestyle. Consuming food rich in vitamin D and calcium can increase the bone density and help in preventing the progression of osteopenia to osteoporosis. Avoiding alcohol, smoking and getting plenty of exercises can help prevent osteopenia. Osteopenia can not be reversed usually, but with the bones getting better and stronger, the risks of having bone fracture or joint pain or fracture reduces.

References

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Written ByDr. Kailash Kothari MD - Anaesthesiology,MBBSOrthopaedics
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