These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.
Osteoporosis
Question: What is the latest information on Fosamax as a treatment for
Osteoporosis? I am an active 52 year old woman whose bone
density test shows bone deterioration in the spine and hip.
What are the side effects and long term effects of the drug?
Answer: Fosamax is an effective treatment for women(or men) with osteoporosis. The drug is
poorly absorbed (10% or so) and must be taken on an empty stomach and with no other food or
medicines for 30 minutes or so. Side effects are mainly GI. Some patients experience severe
inflammation of the esophagus and/or stomach. It is critical to take this with a large amount
of water to avoid any slowing of transport through the esophagus. Some patients experience
abdominal gas, diarrhea and other GI side effects. About 90% of my patients have absolutely
no side effects what so ever.
Osteoporosis
Question: Which is more effective for treating osteoporosis – fosomax or calictonin?
Answer: It’s not really clear since they haven’t been compared in a head to head study. We have used calcitonin for years and fosamax for about one year. I’m so far more impressed by the bone density numbers of fosamax. However, these drugs need to be compared in a head to head study of bone fractures before any meaningful comparison can be made. In the meantime, I favor fosamax unless the woman has GI problems. If this is the case use nasal calcitonin.
The “Tens Unit”
Question: My 76 yr old mom has Osteoporosis. She also has 3-4 compression fractures of the vertebrate. She is a widow & lives by herself. She has help during the week and I (who lives 50 miles away & have Fibromyalgia)try to help as much as I can on the weekend when I am not at work. I have heard of TENS units and wonder if this device would be of help to my mom for her pain. She has heart disease, Diabetes(not Insulin dependent), and has had 2 heart attacks (which were not detected at the time of occurance). She is on Fosomax and for pain- Tylenol with Codiene. Her Dr. does not want her on anything stronger as she lives alone. That is why I have wondered if the TENS unit might be of help but wanted to get an expert’s opinion before getting her hopes up.
Answer:Compression fractures of the spine and hip are a common source of pain and disability to women-especially, post-menopausal women. There are several things to try and relieve pain from compression fractures.
1.Tens units. These emit an electrical signal that somehow blocks the pain fibers by literally overloading the system so fewer signals get through. In my experience, this is helpful about 20% of the time. But, they’re relatively cheap and non-invasive.
2.Calcitonin. Injections of calcitonin or more recently inhalation of calcitonin in a nasal spray will sometimes help the pain. Presumably by “healing” the fracture.
3.Local measures. Do not overlook such tried and true remedies as heat, ice, Ben Gay and other salicylate creams and Zostrix cream. Zostrix was initially used to treat the pain from shingles-but, often helps any local pain such as arthritis or fractures. It will need to be used at least three or four weeks before you can determine if it is of help.
4.Braces. Truncal support braces to decrease the weight of the body on the fracture area are of occasional use.
Last but not least. Ensure that your grandmother’s physician has checked her vitamin D levels and her parathyroid levels. Disorders of either(a common problem) will impair the
healing and lead to other fractures and subsequent disability.
