There are different medical treatment options available. The most common of these being bisphosphonates. Bisphosphonates prevent bone from being broken done. However, this may lead to less new bone formation as it prevents old bones from being broken down. In addition to this, this class of medications has lots of side effects- muscle aches, esophageal ulceration, osteonecrosis of the jaw, seizures and atypical fractures of the femoral shaft and even esophageal cancer. Other treatment options include estrogen and estrogen agonists like raloxifene. While it decreases the chance of osteoporosis, there are many individuals that are not good candidates for this type of treatment because of the increased risk of blood clots and even strokes.
While we always recommend weight bearing exercises to prevent osteoporosis, recent studies have shown that exercise really bolsters bone mass in the hip and femoral neck decreasing the chance of developing hip fractures. Studies showed that increases in body mass density at the hip and femoral neck were particularly noticeable in women age 65 or older if exercise training lasted more than 200 days. Basically, exercise has a huge protective effect on bone mineral density and can prevent fractures without all the side effects that traditional medications like bisphosphonates and estrogen agonists can have. The thought is that as we age, our bodies produce cytokines that are inflammatory and destroy bones. Exercise prevents the production of these bone destroying inflammatory cytokines and increases growth factors that help produce new bone. In women particularly, exercise has also been shown to have a positive effect on estrogen concentrations which helps with bone remodeling.
With all the innovations of modern society- dishwashers, washing machines, Alexa to turn on our lights and delivery of everything from groceries to dinner, we have become very sedentary. Unfortunately, our bodies were not built for this. Our bodies were meant to be active. Movement and exercise promote the resorption of old bone and the formation of new bone. This is vital to preventing fractures, back pain from fractured or collapsed vertebra, loss of height over time and stooped postures.
While it’s important talk to your provider about your risk of bone loss and osteoporosis as you get older to see what options are best for you, don’t discount the importance of lifestyle choices like exercise to help prevent bone loss and fractures.