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Nonpharmacologic management of osteoporosis to minimize fracture risk

Nature Clinical Practice Rheumatology volume 4, pages 20–25 (2008)Cite this article

Abstract

The traditional management of osteoporosis has focused on the pharmacologic aspects of treatment. Nonpharmacologic approaches, such as the use of orthoses, exercise programs, calcium and vitamin D supplementation, fall prevention, and kyphoplasty have largely been overlooked. Evidence for an essential contribution of nonpharmacologic treatments in the management of osteoporotic patients is increasing, particularly for patients who cannot, or will not, comply with medication regimens. This Review highlights the most important aspects of nonpharmacologic management of osteoporosis.

Key Points

  • Osteoporosis is a condition that should be treated using a comprehensive approach, focusing on both pharmacologic and nonpharmacologic treatment

  • Orthoses, such as back braces and hip protectors, can help in the prevention and treatment of fractures

  • Exercise programs, such as tai chi and physical therapy programs, are essential for improving balance and building strength

  • Calcium and vitamin D are critical supplements; vitamin D deficiency has been recognized as an epidemic

  • Fall prevention requires environmental modifications and minimization of potentially hazardous medications

  • Kyphoplasty is a minimally invasive spine procedure that can decrease pain and improve kyphosis in patients with painful vertebral compression fractures

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Figure 1: Orthoses often prescribed for osteoporotic patients.
Figure 2: Sun exposure allows conversion of 7-dehydrocholesterol to previtamin D3 in the skin, which is then quickly converted to vitamin D3 (cholecalciferol).

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Acknowledgements

Désirée Lie, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. JT Lin is an Assistant Professor of Rehabilitation Medicine and JM Lane is Professor of Orthopedic Surgery and Assistant Dean of Medical Students at the Weill Medical College of Cornell University, New York, USA.,

    Julie T Lin & Joseph M Lane

  2. JT Lin is also an Assistant Attending Physiatrist and JM Lane is also an Attending Orthopedist and Chief of the Metabolic Bone Service at the Hospital for Special Surgery, New York.,

    Julie T Lin & Joseph M Lane

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  1. Julie T Lin
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Correspondence to Julie T Lin.

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The authors declare no competing financial interests.

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Lin, J., Lane, J. Nonpharmacologic management of osteoporosis to minimize fracture risk. Nat Rev Rheumatol 4, 20–25 (2008). https://doi.org/10.1038/ncprheum0702

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  • DOI: https://doi.org/10.1038/ncprheum0702

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