Lifestyle Weight-bearing endurance exercise and/or exercises to strengthen muscles improve bone strength in those with<unk> . Aerobics, weight bearing, and resistance exercises all maintain or increase BMD in postmenopausal women. Fall prevention can help prevent<unk>  complications. There is some evidence for hip protectors specifically among those who are in care homes. Pharmacologic Therapy The US National<unk>  Foundation recommends pharmacologic treatment for patients with hip of spine fracture thought to be related to<unk> , those with BMD 2.5 SD or more below the young normal mean (T-score -2.5 or below), and those with BMD between 1 and 2.5 SD below normal mean whose 10-year risk, using FRAX, for hip fracture is equal or more than 3%. Bisphosphonates are useful in decreasing the risk of future fractures in those who have already sustained a fracture due to<unk> . This benefit is present when taken for three to four years. They do not appear to change the overall risk of death. Tentative evidence does not support the use of bisphosphonates as a standard treatment for secondary<unk>  in children. Different bisphosphonates have not been directly compared, therefore it is unknown if one is better than another. Fracture risk reduction is between 25 and 70% depending on the bone involved. There are concerns of atypical femoral fractures and osteonecrosis of the jaw with long-term use, but these risks are low. With evidence of little benefit when used for more than three to five years and in light of the potential adverse events, it may be appropriate to stop treatment after this time. One medical organization recommends that after five years of medications by mouth or three years of intravenous medication among those at low risk, bisphosphonate treatment can be stopped. In those at higher risk they recommend up to ten years of medication by mouth or six years of intravenous treatment. The goal of<unk>  management is to prevent osteoporotic fractures, but for those who have sustained one already it is more urgent to prevent a secondary fracture. That is because patients with a fracture are more likely to experience a recurrent fracture, with marker increase in morbidity and mortality compared. Among the five bisphosphonates, no significant differences were found for a secondary fracture for all fracture endpoints combined. That being said, alendronate was identified as the most efficacious for secondary prevention of vertebral and hip fractures while zoledronate showed better performance for nonvertebral non-hip fracture prevention. For those with<unk>  but who have not had a fracture, evidence does not support a reduction in fracture risk with risedronate or etidronate. Alendronate decreases fractures of the spine but does not have any effect on other types of fractures. Half stop their medications within a year. When on treatment with bisphosphonates rechecking bone mineral density is not needed. There is tentative evidence of benefit in males with<unk> . Fluoride supplementation does not appear to be effective in postmenopausal<unk> , as even though it increases bone density, it does not decrease the risk of fractures. Teriparatide (a recombinant parathyroid hormone) has been shown to be effective in treatment of women with postmenopausal<unk> . Some evidence also indicates strontium ranelate is effective in decreasing the risk of vertebral and nonvertebral fractures in postmenopausal women with<unk> . Hormone replacement therapy, while effective for<unk> , is only recommended in women who also have menopausal symptoms. It is not recommended for<unk>  by itself. Raloxifene, while effective in decreasing vertebral fractures, does not affect the risk of nonvertebral fracture. And while it reduces the risk of breast cancer, it increases the risk of blood clots and strokes. While denosumab is effective at preventing fractures in women, there is not clear evidence of benefit in males. In hypogonadal men, testosterone has been shown to improve bone quantity and quality, but, as of 2008, no studies evaluated its effect on fracture risk or in men with a normal testosterone levels. Calcitonin while once recommended is no longer due to the associated risk of cancer and questionable effect on fracture risk. Alendronic acid/colecalciferol can be taken to treat this condition in post-menopausal women. Certain medications like alendronate, etidronate, risedronate, raloxifene, and strontium ranelate can help to prevent osteoporotic fragility fractures in postmenopausal women with<unk> . Tentative evidence suggests that Chinese herbal medicines may have potential benefits on bone mineral density.
Osteoporosis
Osteosclerosis
Osteopathy
Dysosteosclerosis
Osteodystrophy
Osteopoikilosis
Osteopenia
Osteolysis