Osteoporosis Management Strategies
Strategies for the prevention and treatment of osteoporosis in people with rheumatoid arthritis are not significantly different from the strategies for those who do not have the disease.
Nutrition
A diet rich in calcium and vitamin D is important for healthy bones. Good sources of calcium include:
Calcium supplements can also help ensure that the calcium requirement is met each day.
Vitamin D
Vitamin D plays an important role in calcium absorption and bone health. It is synthesized in the skin through exposure to sunlight. While many people are able to obtain enough vitamin D naturally, older individuals are often deficient in this vitamin due, in part, to limited time spent outdoors. Such individuals may require vitamin D supplements in order to ensure an adequate daily intake.
Exercise
Like muscle, bone is living tissue that responds to exercise by becoming stronger. The best exercise for your bones is weight-bearing exercise that forces you to work against gravity. Some examples include:
Exercising can be challenging for people with rheumatoid arthritis and needs to be balanced with rest when the disease is active.
Regular arthritis-friendly exercises such as walking can help prevent bone loss and, by enhancing balance and flexibility, can reduce the likelihood of falling and breaking a bone. Exercise is also important for preserving joint mobility.
Healthy Lifestyle
Smoking is bad for bones as well as the heart and lungs. Women who smoke tend to go through menopause earlier, triggering earlier bone loss. In addition, smokers may absorb less calcium from their diets.
Alcohol can also negatively affect bone health. Those who drink heavily are more prone to bone loss and fracture, both because of poor nutrition as well as increased risk of falling.
Bone Density Tests
Specialized tests known as bone mineral density (BMD) tests measure bone density in various sites of the body. These tests can detect osteoporosis before a fracture occurs and predict one's chances of fracturing in the future. Rheumatoid arthritis patients, particularly those receiving corticosteroid (glucocorticoid) therapy for two months or more, should talk to their doctors about whether they might be a candidate for a bone density test.
Osteoporosis Medications
Like rheumatoid arthritis, there is no cure for osteoporosis. However, there are medications available for the prevention and treatment of osteoporosis. Several medications and drug options are approved by the Food and Drug Administration (FDA) for the prevention and/or treatment of osteoporosis in post-menopausal women these include:
Alendronate is also approved for use in men. For rheumatoid arthritis patients on corticosteroid (glucocortiocoid) drugs such as prednisone, alendronate (for treatment) and risedronate (for prevention and treatment) are approved for glucocorticoid-induced osteoporosis.
Related Resources - Osteoporosis
Related Resources - Rheumatoid Arthritis
Related Resources - Juvenile Rheumatoid Arthritis
Source: NIH Osteoporosis and Related Bone Diseases ~ National Resource Center, What People with Rheumatoid Arthritis Need to Know About Osteoporosis, Rev Date: 1/2003
