What Is The Treatment For Osteoporosis ?

Posted on Wed, 8 Jun 2011

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Wed, 8 Jun 2011 Answered on

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Question : I am 45, female, 5'4", 122 pds., exercise and am in good muscular shape. I'm having regular pain in my left elbow for close to 10 months now and in the last 2 months my shoulder on other arm. As of the last 4 days terrible pain in my upper right ribs under my right breast. I have pins and needles in both hands constantly now. I have also been bruising for simple non painful injuries from my arms to my legs. And I am curently fighting an infection in between my last 2 toes which will not seem to heal, for 2 weeks now.(extreme itching, swollen with blisters and pus, skin breaking open turning very white.) I was diagnosed with osteoporosis recently, last month, but I think I need to see not just my spine and hip but perhaps a full scan or x-ray. Do you agree? Perhaps to rule out any bone tumors or possible cancer. My bone pain is all day and I am unable to sleep in one position for very long. My GP has not been much help and I wonder who should I now make an appointment with, a specialist or another GP? I'm a liitle scared and just would like some answers and good advice. Thank-you.

Answered by Dr. Sangeet (1 hour later)

Hello,

Thanks for your query.

Osteoporosis is a treatable disorder.

I would like to rectify a few things first. I doubt if your DEXA scan result says "severe osteoporosis", because this can happen only if you have a fracture of your spine. Else it just reads "Osteoporosis".

Vitamin D is essential for your bones, but your bone strength is equally regulated by your hormones.

I would like top know a few things before jumping to the treatment aspects.
- Have you attained menopause lately?
- Have you checked your blood sugar levels. This is with respect to the numbness and itching you have in your limbs as it could be a sign of Diabetes.

Blood calcium levels are not an exact indicator of Osteoporosis and 8 - 11 mg% is normal for your age.

DEXA scan of the spine and hips is an approximate and self sufficient indicator of osteoporosis of your whole body. You needn't go for any whole body scan to check that.

Multiple joint pains and bone pains could also be an indicator of Menopause.

You would need to visit either an Orthopedician or an Endocrinologist to deal with Osteoporosis.

The treatment of Osteoporosis includes:
- Hormone replacement or mediators.
- Adequate Calcium and Vitamin supplements.
- Prevention of fractures.
- Daily exercises
- Serial testing of your bone density (scan) once every year.

You need to know that it's a treatable disorder and please stop worrying about it.

Hope I have answered your queries. I would be expecting a reply from you to my two questions to be able to serve you better.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sangeet (18 hours later)

In regard to your first question concerning "menopause" the answer is no. I am still regular with my cycles every 27 days and lasting 5 to 7 days and showing no signs of slowing. My grandmother and mother both did not begin to enter menopause until their early 50's. Both were very active in their 40's with no such problems similiar to mine. I'm not so worried about Osteoporosis, the diagnosis, as I am as to how and why at my age and activity. I was an aerobic instructor and did weight training to stay toned, NOT "body-building" by any means. I never drank or smoked. I've taken great pride in staying fit and healthy. My bone pain and extreme fatigue is what brought me to the doctor in the first place 5 years ago. I am in daily pain and aspirin and naproxin sodium (Aleve) is no longer helping to curve that pain. I work in the yard, etc. I just want to be at least somewhat pain-free. Afterall, I am not 75 but rather 45. The answer to your second question is "No". I have not have my blood suger levels tested in a while but will do so. However, there is no "Diabetes" in my family on either my father or my mother's side. Would I benefit from 'physical therapy"? I will do anything to get rid of this pain just NOT major narcotics. Thank-you for your help and concern. XXXXXXX

Answered by Dr. Sangeet (4 hours later)

Hello XXXXXXX and thanks again,

Pardon me, but my answers would have been more convincing if I could examine you.

If you haven't attained menopause yet, these symptoms wouldn't be related to it obviously, contrary to what I thought - Osteoporosis, aggravated by menopause could have similar symptoms.

Hence, in my opinion, you should go for either an Xray or MRI scan of your cervical (neck) spine as your symptoms mimic cervical spondylosis too. It's a condition wherein the bones in your neck degenerate and start impinging on your nerves supplying the shoulders, elbows and fingers.

The pain in cervical spondylosis typically radiates from your neck or shoulder down your arm. It could be associated with numbness. However you wont notice any pain on moving your joints or when pressing against them. Please let me know if it does so.

If its cervical spondylosis, as evidenced by Xrays or MRI scan, you need to learn spine exercises from a Physiotherapist and continue them at home. Nerve protective drugs, like those containing long period of time.

Aerobics and other less strenuous exercises would be of help if you have either of the two- Osteoporosis/ Spondylosis. So you can start with them.

Easy bruisability is a side effect of Aspirin. However, if its occurring very frequently, you need to get your Platelet count checked.

I would advise you to visit an Endocrinologist to get the cause of osteoporosis sorted out. Its uncommon for a physically fit person like you and whose not attained menopause to get osteoporosis. He would accordingly advise Hormone replacement or calcium supplements. Try not to be dependent on pain killers for long term.

I hope your doubts have been cleared. If not, I will be always available to sort them out.

Wish you good health, XXXXXXX

Regards

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar