Osteoporosis is a disease of the bone that leads to increased risk of fracture. This occurs due to reduced bone density and structural deterioration of bone tissue. It occurs primarily in post menopausal women, but may also occur in elderly men and in persons with certain chronic disease processes such as renal failure and in persons who have been on long term prednisone therapy for diseases such as COPD.

In the United States, it is estimated that 10 million individuals have osteoporosis and another 18 million have low bone density which places them at risk for osteoporosis.

Typically, osteoporosis has no "symptoms" and is usually diagnosed when a person sustains a fracture where it is found on X-ray. As the bones become less dense and weaken further, pathological fractures can occur. A pathological fracture is a fracture that occurs without any type of injury such as a fall. In severe osteoporosis, fractures of the spine or the hip can occur without warning. Spinal fractures can cause debilitating pain which impairs a person’s mobility.

If an individual becomes less mobile they will have increased bone loss. An individual who sustains a pathological hip fracture may fall, thinking that they fractured their hip falling, when in reality, the fracture occurred spontaneously causing them to fall. Having a hip fracture and repair increases the risk of mortality in elderly individuals.

It is recommended that all women over the age of 65 undergo a bone mineral density test (BMD). A diagnosis of osteoporosis is made when a BMD test is 2.5 standard deviations below that of a normal healthy young adult. If you are post menopausal and over 65 years of age, then you should request that your physician order a bone mineral density test.

If you are diagnosed with osteoporosis, you will initially be treated with a "biphosphonate" drug, such as Fosamax, Actonel, or Boniva. Fosamax and Actonel are taken daily or weekly on an empty stomach and require that you remain upright for at least 30 minutes after taking your dose to allow for better absorption. Boniva is taken once monthly. Common complaints with oral biphosphonates are indigestion and esophagitis. Therefore, persons who have gastroesophageal reflux disease (GERD) don't always tolerate these medications.

Yearly infusions of Zoledronic acid can decrease the risk of fracture significantly but facilities that perform this may not always be available. Another option that is available for persons with osteoporosis is Forteo. Forteo is used primarily in persons with established osteoporosis who have sustained a fracture in the past, have multiple risk factors for fracture, or in those who cannot tolerate the oral dosing of biphosphonates.

Forteo is administered daily as a subcutaneous injection. If a caregiver is not available to administer the injection or you cannot administer the injection yourself, you may qualify for a visiting nurse to administer the injection or teach you how to administer it yourself. Forteo should not be used if you have had previous radiation therapy, Pagets disease or in young individuals.

In addition to the above medications, other things that you can do to improve your osteoporosis is to ensure that you have an adequate intake of calcium and vitamin D, stop smoking, limit your consumption of alcohol, and participate in weight bearing exercise.