Tips to Manage Osteoporosis Pain : Understanding, Medications, and Lifestyle Changes

Osteoporosis is a condition in which bone density and mass decrease increasing the risk of fractures. The pain is sharp, severe, and localized to the affected areas. It is mostly a dull ache, which is generalized.

Osteoporosis pain most commonly affects the bones of the hip and wrist. The pain experienced is mild to severe and resolves in 4-6 weeks.⁽¹⁾ However, in some cases, it may be lifelong.

Osteoporosis pain can be mild to severe and can have an impact on the quality of life of an individual. It is important to manage it for several reasons:

• Improves Quality of Life: Improving the quality of life of the patient is important as osteoporosis pain can be debilitating and make it challenging to perform daily activities.
• Prevent Further Injury: Osteoporosis pain can increase the risk of injury. Proper pain management can reduce this risk by reducing the chances of falls and fractures.
• Improves Mental Health: The inability to perform everyday tasks leads to depression and anxiety. Pain management can help in preventing depression and improve mental health.
• Improve Physical Activity: Osteoporosis can make it challenging to engage in physical activities. Physical activity is important for maintaining bone health. Pain management can enhance activity levels and improve health.

Seeking proper medical advice is essential and also is following the recommended treatment plan.

• A person with osteoporosis may experience pain due to weakened bones. These may lead to fractures and also aggravate pain.
• Nerve compression, joint inflammation, and muscular strains can also be a reason for pain due to osteoporosis.
• Osteoporosis may also increase the risk of fractures due to structural changes in the bone.⁽²⁾ A spinal compression fracture is the most common type affecting the bones of the spine.⁽³⁾ These occur commonly due to falls, coughing, twisting, or sneezing.
• Osteoporosis can affect the spinal alignment leading to poor posture. It can also increase the risk of osteoarthritis which may lead to joint pain and stiffness.

The pain of osteoporosis can be classified depending on the underlying cause. Some of the common types of osteoporosis pain include:

• Hip Pain: Hip fractures are the common type of fractures that occur due to osteoporosis. The pain in the hip is intense and can make it difficult for a person to stand, walk, or move the legs.
• Wrist Pain: Another common type of osteoporosis pain is wrist pain. It is associated with a wrist fracture and can be accompanied by swelling and tenderness.
• Vertebral Compression Fracture Pain: Vertebral compression fracture is the most common type of osteoporosis-related fracture and is localized to the back and can range from mild to severe.
• Joint Pain: The risk of osteoarthritis increases with osteoporosis and is accompanied by pain and swelling.
• Muscle Pain: As bones weaken due to osteoporosis they can lead to joint pain and muscle stiffness.
• Chronic Pain: There can be chronic pain due to osteoporosis that can be difficult to manage and affect the quality of life of a person.

It is important to identify the type of osteoporosis pain to determine the underlying cause and get appropriate treatment.

There are several medications that can be helpful in the management of osteoporosis pain depending on the underlying cause and severity.

• Prescription Medications: Several medications including biphosphates slow down bone loss.⁽⁴⁾ Medicines containing monoclonal antibodies can block proteins that promote bone loss and treat osteoporosis in postmenopausal women.⁽⁵⁾ Parathyroid hormones increase bone density and reduce the risk of fracture and help manage pain.⁽⁶⁾ Sometimes estrogen therapy is also useful in managing osteoporosis pain in post-menopausal women.
• Over-The-Counter Pain Relievers: Certain pain relievers such as Tylenol, Advil, Motrin, and topical pain relievers can be helpful in easing the pain and discomfort related to osteoporosis.⁽⁷⁾ These block the chemicals that cause pain and inflammation. The topical gels contain capsaicin which helps in managing localized pain.⁽⁸⁾ Even while taking over-the-counter medications, a doctor should be consulted to know about the side effects and their interaction with other medications. Also, they should not be consumed above the recommended dosage.
• Supplements for Osteoporosis Pain: Supplements including calcium, vitamin D, magnesium, and vitamin K2 can be helpful in improving bone health. Collagen is a protein that is important for improving bone health and providing structure and support to the bones. They can be availed in powder and capsule form. Supplements should also be consumed on the doctor’s advice.

Osteoporosis leads to weak and brittle bones prone to fractures. Lifestyle changes can help in reducing the risk of fractures. These include:

• Regular Exercise: Weight-bearing and resistance exercises can improve bone density.⁽⁹⁾ Walking, jogging, and weight training are other good options. It is better to consult a doctor before starting any exercise program for managing osteoporosis.
• Balanced Diet: A diet rich in calcium, vitamin D, and other nutrients can help improve bone health. Green leafy vegetables, fish, egg yolk, and fortified foods can be some good options for a healthy osteoporosis diet.
• Quitting Smoking and Limiting Alcohol Consumption: Smoking increases the risk of weakening of bones. Drinking alcohol increases the risk of falls. Limiting the consumption of both of these can help in osteoporosis pain management.
• Sleep and Stress Management: Chronic pain can affect sleep and increase stress. Establishing a sleep routine can help in managing stress due to pain.

Also, practicing relaxation techniques can help in reducing stress and improve sleep.

Alternative therapies can be a great help in managing the pain related to osteoporosis. However, it should be noted these therapies should not be used as alternatives to conventional treatment.

• Acupuncture: It works by inserting thin needles into specific points in the body. It effectively reduces pain and improves mobility.
• Massage Therapy: It works by improving circulation. Studies show that soft tissue massage and Tuina help in alleviating symptoms of pain in osteoporosis.^{(10, 11)}
• Chiropractic therapy: Chiropractic involves spinal manipulation that can be effective in managing pain and improving mobility. It is important to get it done by a qualified chiropractor.
• Mind-Body Therapies: Mind and body therapies including yoga, meditation, and guided imagery can be helpful in reducing stress due to osteoporosis pain and improving the overall quality of life.

Preventing osteoporosis is the best way to avoid suffering from pain due to osteoporosis. Following are the tips that can be helpful in achieving success in preventing osteoporosis:

Lifestyle changes to prevent osteoporosis include:

• Eating a well-balanced diet that is rich in vitamins and minerals needs to keep up bone health.
• Engaging in weight-bearing exercises can help in strengthening bones and improving balance. This can reduce the risk of falls and fractures.
• Avoiding smoking and consuming lesser alcohol
• Maintaining a healthy body weight as being underweight can bring in nutrient deficiency and increase the risk of osteoporosis.

Regular bone density scanning can be helpful in the early detection of osteoporosis and in preventing it from worsening or even occurring.

It is a simple painless test that measures the amount of calcium and other minerals in the bone.

Dual-energy X-ray absorptiometry (DXA) scan is the most common type of bone density test.

The frequency of bone density tests depends on the age, sex, and risk factor for osteoporosis in a person. A doctor can determine when or how often a person should be screened.

Bisphosphonates are medications that prevent the loss of bone density.⁽¹²⁾

Hormone therapy such as estrogen therapy can be helpful in preventing bone loss in postmenopausal women.

Calcitonin regulates calcium level in the body and reduces pain and improve bone density.⁽¹³⁾

Denosumab is a medication that helps in slowing down the bone breakdown and improves bone density.⁽¹⁴⁾

There are several ways to manage osteoporosis including lifestyle changes, medications, and alternative therapies. Weight-bearing and resistance exercises can also be helpful in alleviating pain associated with osteoporosis.

There are alternative therapies including acupuncture, chiropractic, and, massage therapies that can provide relief from pain. Regular bone density screening can be useful in the early detection and treatment of the condition.

All of these things can be helpful in managing osteoporosis and improving the overall quality of life.