Letter: Treating osteoporosis

Abstract

Osteoporotic fractures are common resulting in increased morbidity and mortality. Exercise can help prevent osteoporosis. It can also benefit patients with osteoporosis, but the exercises must be tailored to the patient.Most Australians should be able to obtain adequate calcium in their diet and vitamin D from the sun. Supplements may be needed in some patients and they are recommended for use with other drugs for osteoporosis.Bisphosphonates, and in some patients denosumab, are first-line drugs for osteoporosis. Raloxifene and strontium ranelate can be considered in patients who cannot take bisphosphonates or denosumab. Teriparatide is reserved for patients with severe osteoporosis and the use of strontium ranelate is declining because of cardiovascular safety concerns.to higher peak bone mass in adulthood. 7,8 Impact exercises are also beneficial for middle-aged and older adults for increasing or preventing age-related bone loss. Although the gains in bone mass are promising, there is insufficient evidence to suggest exercise might reduce fractures.The frequency and severity of falls may be reduced by exercises that maintain muscle strength, muscle mass, flexibility, mobility, balance and ease of movement. For people with established osteoporosis, any exercise that promotes these characteristics is recommended. The Box lists exercises according to their 'osteogenic' profile and more detailed information is available at www.osteoporosis.org.au/exercise. Specifically, weight-bearing aerobic exercises and progressive resistance training improve bone mineral density. [7][8][9][10][11] Any recommendation for exercise must be tailored to the individual. For example, in patients who have already sustained osteoporotic fractures, moderateto high-impact activities may be unsuitable. Patients