Current osteoporosis prevention and management

This review presents a clinical approach to osteoporosis prevention and treatment. Initially, a medical history, including assessment of factors predisposing to bone loss, the impact of osteoporosis on activities of daily living and psychological function, physical examination, and appropriate laboratory evaluation is necessary. Subsequently, the goals of osteoporosis prevention and treatment are pain control, maximization of function, maintenance of bone mass, and fracture prevention. An individual clinician or a multidisciplinary team may meet these goals. In brief, it is essential to evaluate nutritional status with emphasis on optimization of calcium and vitamin D intake. Physical activity to maintain muscle strength and bone mass and reduce falls risk is addressed elsewhere in this issue. Use of one of the increasing armamentarium of pharmaceutical agents that preserve or increase bone mass may be indicated on the basis of bone mass and other factors. Patient education regarding osteoporosis in general, and falls risk and body mechanics in particular, plays an important role in osteoporosis prevention and treatment. Finally, controversies in the medical management of osteoporosis are addressed.