Published: 2009-11-03 01:05:41
Author: Jasper Sidhu | Dynamic Chiropractic | November 4, 2009
It hasn't been that long since the arthritis drug Vioxx was taken off the shelves for producing adverse side effects. Merck stopped selling Vioxx in September 2004 after a clinical trial showed it increased the risk of strokes and heart attacks in some patients.1
In recent news, the drug Fosamax, used in the treatment or prevention of osteoporosis, is being put on trial in a class-action lawsuit. Approximately 800 cases have been brought into a mass lawsuit that alleges the drug causes osteonecrosis of the jaw.2
As the risk of drug side effects continues to take the spotlight, consumers are increasingly looking for alternatives to drugs to manage their conditions. Osteoporosis is no exception. As primary health care professionals who prescribe drug-free therapy, we are well-positioned to expand our practice into the education and treatment of osteoporosis. Let's look at what research says about osteoporosis treatment and discuss how to combine nutrition, exercise and education into a comprehensive program that can be effectively implemented in your practice and community.
Statistics alone show the magnitude of the osteoporosis epidemic. Thirty thousand hip fractures occur each year, with 70 percent to 90 percent caused by osteoporosis.3 However, treatment of osteoporosis has always been suboptimal, often the result of a lack of knowledge and/or compliance by the patient.4
Key Components of Osteoporosis Management
Nutritional supplementation is an ideal illustration of the need for a proper education program. Calcium and vitamin D supplementation has been shown to reduce rates of bone loss and fracture rates in older adults and the elderly.5-7 Proper nutrition is also essential for those who show up in your clinic with an osteoporotic fracture. Poor nutritional status can limit recovery and increase susceptibility to further fractures.8-9
Although vitamin D and calcium are perceived to be important for bone health by health professionals and patients alike, a study found that use of these supplements was suboptimal.10 However, when personal knowledge of dual-energy X-ray absorptiometry (DEXA) results were known, there was a significant increase in calcium intake in postmenopausal women.11Other studies have shown that use of baseline and appropriate follow-up DEXA scans, and ongoing reinforcement of nonpharmacologic measures, can improve osteoporosis care.12-13
Patient perception and knowledge affects not only their compliance with nutrition, but also with exercise. Perceived risk of osteoporosis may lead to decreased activity levels, hence resulting in an increased risk of bone damage.14
All of this emphasizes the need to include ongoing education as part of a comprehensive osteoporosis management program, while understanding and accepting each patient's current view on osteoporosis. If this part of the program is not instituted, compliance with even the best osteoporosis program will always fall short.
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