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Osteoporosis Treatment: Cost and Side Effects

Last Updated: Mar 25, 2024

What is the Osteoporosis Treatment?

Osteoporosis is the disease of the bones wherein they become weak resulting in increased chances of fractures and broken bones. The normal functioning of the bones involve continuous breakdown and rebuilding with new material. But in case of osteoporosis the breakdown of bones occur in a faster rate and take a lot of time to rebuild. Due to this, the bones remain weak, become less dense and brittle leading to more fractures. Osteoporosis occurs more in women than in men. Strong and healthy bones are present in human body especially during their twenties. As people age, bones tend to become weaker and weaker. Hence, older people have higher risk of getting osteoporosis. Women are more prone to osteoporosis because the hormone estrogen which protects bones decreases in level in the body in menopausal women. Several other factors that increase the risk of the disease are smoking, malnutrition, certain medications like barbiturates, steroids and proton pump inhibitors and some diseases like multiple myeloma and rheumatoid arthritis. On getting diagnosed with osteoporosis, your healthcare practitioner may prescribe you calcium and vitamin D supplements and ask you to stop smoking and reduce alcohol consumption. Several other medications and injections may also be recommended like hormone therapy, antibodies, bisphosphonates and selective estrogen receptor modulators (SERMs).

How is the Osteoporosis Treatment done?

Osteoporosis cannot be cured completely. The weak bones can only be made stronger with medications so that the bones are no more susceptible to fractures and breakages. To have healthy and strong bones it is important that you maintain sufficient levels of vitamin D and calcium in the blood. To maintain the healthy levels it is important that you take proper diet and supplements. There are several medications that aid in strengthening of bones. Doctors may prescribe you with Bisphosphonates either in the form of oral supplements or via injections which slow down the breakdown rate of the bones which in turn is used in maintaining the bone density in the body. Bisphosphonates used in maintaining bone density in the body are etidronate, ibandronate, zolendronic acid, risedronate and alendronate. Another medication prescribed by doctors is strontium ranelate which is taken by dissolving its powder in water. This drug helps both in the creation of bone cells and in the prevention of fast breakdown of bone cells. Selective oestrogen receptor modulators (SERMs) are medication that helps in maintaining bone density like oestrogen. Teriparatide or parathyroid hormone medication is used to stimulate bone cells production in the body. In certain cases hormone replacement therapy may also be prescribed to maintain bone density. Osteoporosis in men can be treated with testosterone treatment if their bone density decreases due to insufficient male hormone production.

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

Most women after their menopause, that is, in the age group of 48-55 years are more likely to develop osteoporosis due to decreases levels of oestrogen. Oestrogen is important for maintaining bone density in the body. Women who experience frequent fractures and breakage of bones especially starting from their thirties are eligible for osteoporosis treatment. Men also above 65 years of age may experience weak bones due to osteoporosis and hence may be eligible for treatment.

Who is not eligible for the treatment?

In certain cases infants too may experience brittle bones due to a disease called osteogenesis imperfect. But they cannot be subjected to same treatments as that of osteoporosis because the underlying cause of brittle bones is production of poor quality of collagen due to a genetic mutation. The disease can be observed in adults too since it is a genetic disease. Also, if fracture of bones happen due to sudden injury or fall or any accident, such condition cannot be due to osteoporosis and hence, such patients are not eligible for osteoporosis treatment.

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Are there any side effects?

Medication and drug treatment also come with their share of side effects. Side effects due to bisphosphonates can be stomach ache, dysphagia or problems in swallowing or irritation in the oesophagus. A long-term therapy with bisphosphonate may affect your bones causing your thighbone to crack and break called atypical femoral fracture. A rare side effect called osteonecrosis also occurs wherein the jaw bone cells die and wither causing dental problems. Side effects of strontium ranelate can cause nausea and diarrhoea and skin rash too. Side effects due to SERMs are leg cramps, hot flushes and potential risk of forming blood clots. Teriparatide have some common side effects like nausea and vomiting. Hormone Replacement Therapy is not prescribed often because of its associated side effects like stroke, ovarian cancer, breast cancer, venous thromboembolism and endometrial cancer. So, before you get HRT for osteoporosis it is recommended to discuss the benefits and disadvantages to your doctor.

What are the post-treatment guidelines?

It is recommended not to rely only on medication to treat your osteoporosis. You must also make some behavioural and lifestyle changes like limit alcohol consumption, quitting smoke, getting a good nutrition so that you get sufficient vitamin D and calcium and working out regularly. Foods that help making bones stronger are more fruits and vegetable intake, low-fat dairy products like milk is rich in calcium and fish like tuna, salmon, mackerel and sardines which are rich in vitamin D help in making stronger bones. Regular exercise improves posture and balance of the body, strengthening bones. Exercises like strength training helps in making your bones in the arms and upper spine stronger. Jogging, low-impact aerobics, elliptical training and biking have been proven beneficial in strengthening of bones.

How long does it take to recover?

Osteoporosis cannot be cured completely because it requires regular practice of maintaining bone density in the body with medicines, appropriate nutrition and exercise. With the help of these steps it takes at least 6-18 months to have strong bones and maintain bone density.

What is the price of the treatment in India?

The price for osteoporosis treatment ranges from Rs. 500 and can go up to Rs. 2,000 or more based on the time and type of medications required.

Are the results of the treatment permanent?

No, the results cannot be said to be permanent because osteoporosis cannot be cured completely. The medication, exercises and other treatment options are just to maintain the bone density in the body. For maintaining the density regular efforts are required so that proper formation of bones take place.

What are the alternatives to the treatment?

Osteoporosis can also be managed by getting sufficient vitamin D and calcium through your diet. Calcium rich foods like dairy products, fresh fruits and green vegetables, soy products and enriched grains. Regular physical exercise, jogging, walking, practicing low-impact aerobics, biking and elliptical training can be helpful in strengthening your bones.

References

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Written ByDr. Rohit Chakor Fellowship in Joint Replacement & Arthroscopy,Fellowship in Knee and Hip Replacement,MBBS,Fellowship in Trauma and Arthroplasty,Fellowship in Minimally Invasive Joint Replacement Surgery,DNB (Orthopedics),DNB - Orthopedics/Orthopedic SurgeryOrthopaedics
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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