Nonpharmacologic therapies for osteoporosis
What nonpharmacologic therapies are available for patients with osteoporosis? When should pharmacological therapy be initiated for osteoporosis?
All patients should be on calcium and vitamin D. Patients should be advised on modifiable risk factor reduction (e.g., stop smoking), exercise (five times/week), and strategies to minimize fall risk. Pharmacological therapy should be advised for any patient who has osteoporosis based on any of the three criteria discussed earlier (see Question 5):
- • History of vertebral, hip, wrist, or humerus fragility fracture
- • T-score <–2.5
- • FRAX risk score (10-year): >3% for hip fracture or >20% for major osteoporosis fracture in drug-naïve patients aged >40 years with osteopenia by BMD testing.