Osteoporosis: Understanding Symptoms, Treatments, and Proactive Management in NZ

Osteoporosis: Understanding Symptoms, Treatments, and Proactive Management in NZ

Osteoporosis, meaning "porous bone," is a progressive condition characterised by weakened bone structure and reduced bone mineral density. This silent disease often presents no osteoporosis symptoms until a fragility fracture occurs – typically in the hip, spine, or wrist – from minor stresses like bending or coughing 1. In New Zealand, osteoporosis affects thousands, particularly postmenopausal women and adults over 75, making understanding osteoporosis treatment NZ approaches vital for preventing devastating fractures 2. While daunting, severe osteoporosis can be managed effectively with modern medications and lifestyle adaptations. Let’s explore how you can protect your skeletal health.

Recognising Osteoporosis: Beyond the "Silent Disease"

Many mistakenly believe osteoporosis announces its presence. In reality, osteoporosis symptoms are frequently absent until significant damage occurs. Key indicators include:

  • Height loss (over 4cm/1.5 inches) due to vertebral compression fractures
  • Stooped posture (kyphosis), often called "dowager’s hump"
  • Persistent back pain from spinal microfractures
  • Fractures occurring unexpectedly from minimal trauma, like a minor fall

The organs most affected are bones themselves, particularly the hip, spine, and wrist. Spinal fractures severely impact posture, lung capacity, and abdominal function, while hip fractures dramatically increase mortality risk – up to 30% within a year in older adults 3. Early diagnosis via DEXA scans (bone density tests) remains critical, especially for high-risk groups: postmenopausal women, adults over 70, long-term steroid users, or those with family history 4.

Conventional Osteoporosis Treatments: From First-Line to Infusion Therapies

Osteoporosis treatment begins with foundational therapies and escalates based on severity:

  • First-Line Medications (Bisphosphonates):
    • Oral options: Alendronate (weekly), Risedronate (weekly/monthly), Ibandronate (monthly)
    • Osteoporosis infusion: Zoledronic acid (annual IV) – ideal for patients with gastrointestinal issues or adherence challenges
    • Mechanism: Slow bone breakdown by inhibiting osteoclasts
    • Key advantage: "After-effect" persists after stopping; typically used for 3-5 years
  • Alternative Antiresorptives:
    • Denosumab (Prolia): Subcutaneous injection every 6 months. Critical note: Requires ongoing treatment without gaps due to high spinal fracture risk upon discontinuation 5
    • Raloxifene (Evista): Selective Estrogen Receptor Modulator (SERM) that mimics estrogen’s bone benefits while reducing breast cancer risk. Unsuitable for those with blood clot history

Advanced and New Treatments for Severe Osteoporosis

What is the best treatment for severe osteoporosis? Bone-building (anabolic) agents are often recommended:

  • Teriparatide (Forteo) & Abaloparatide (Tymlos): Daily injections mimicking parathyroid hormone. Reduce vertebral fractures by 65-86% within 18-24 months – making them among the strongest medications available 6
  • Romosozumab (Evenity): The newest aggressive treatment for osteoporosis (approved 2019-2020). This monoclonal antibody blocks sclerostin, simultaneously increasing bone formation and decreasing resorption. Administered as monthly injections for 12 months, it reduces vertebral fractures by 73% 7

Post-Anabolic Transition: After completing 1-2 years of bone-building therapy, patients must switch to bisphosphonates or denosumab to maintain gains 8.

Lifestyle Adjustments: What to Avoid and Embrace

What makes osteoporosis worse? Smoking, excessive alcohol (>2 drinks/day), sedentary behaviour, and inadequate calcium/vitamin D intake accelerate bone loss 9. Activities to avoid with osteoporosis:

  • High-impact exercises: Running, jumping, intense aerobics (fracture risk)
  • Spinal flexion movements: Sit-ups, toe-touches, golf swings, certain yoga poses (e.g., forward folds, twists) – these increase vertebral fracture risk 10
  • Rapid/jerky motions: Quick twists or lifts without bracing core muscles
  • Contact sports: Football, hockey, skiing (high fall/collision risk)

Is walking bad for osteoporosis? No! Weight-bearing walking is highly beneficial, but use supportive footwear and avoid uneven terrain. Ideal activities include:

  • Strength training: Focused on back extensors and legs (using bands/weights)
  • Balance exercises: Tai chi reduces fall risk by 43% 4
  • Safe flexibility routines: Gentle stretches after warming up, avoiding spinal strain
Avoid Safer Alternatives Why
Sit-ups/Crunches Pelvic tilts, plank variations Minimises spinal flexion
Golf/Tennis Stationary cycling Eliminates forceful twisting
Running/Jogging Brisk walking, stair climbing Lowers impact stress on joints
Forward Bend Yoga Poses Wall slides, chest openers Prevents vertebral compression

Proactive Prevention: Keeping Osteoporosis from Worsening

Can anything be done for severe osteoporosis? Absolutely. Beyond medications:

  • Nutrition: Consume 1,200mg calcium daily (dairy, leafy greens, fortified foods) + 800–1,000 IU vitamin D. NZ sunlight (Oct–Mar) boosts vitamin D synthesis 6
  • Fall Prevention: Home safety checks (remove rugs, improve lighting), balance training, vision checks
  • Avoid Bone-Harming Substances: Limit caffeine, quit smoking, minimise alcohol
  • Medication Adherence: Critical for infused (e.g., osteoporosis infusion) and injectable therapies

Osteoporosis guidelines universally recommend weight-bearing exercise ≥30 minutes/day, 5 days/week, combined with muscle-strengthening twice weekly 2.

Conclusion: Take Control of Your Bone Health Journey

Osteoporosis management has evolved dramatically, offering hope even in severe cases. From foundational bisphosphonates to revolutionary anabolics like romosozumab – combined with intelligent lifestyle choices – you can significantly reduce fracture risks and maintain independence. Don’t let osteoporosis dictate your future.

👉 Discover personalised wellness strategies at betterness.nz. Explore our expert resources on nutrition, safe exercise routines, and holistic approaches to thriving with strong bones!

References

  • 1. Mayo Clinic. Osteoporosis treatment: Medications can help. 2024.
  • 2. Mayo Clinic. Osteoporosis - Diagnosis and treatment. 2024.
  • 3. Mayo Clinic. Osteoporosis - Symptoms and causes. 2024.
  • 4. Mayo Clinic. Exercising with osteoporosis: Stay active the safe way. 2023.
  • 5. Medical News Today. Exercises to avoid with osteoporosis. 2023.
  • 6. NHS UK. Prevention - Osteoporosis. 2022.
  • 7. Everyone.org. New Osteoporosis treatments 2025. 2025.
  • 8. Advancing care: optimizing osteoporosis treatment in the oldest old. PMC. 2025.
  • 9. Harvard Health. Osteoporosis drugs: Which one is right for you? 2024.
  • 10. NIAMS. Osteoporosis Causes, Risk Factors, & Symptoms. 2025.

Disclaimer: The information shared in this post is intended for general informational and educational purposes only. It does not constitute professional advice of any kind (including but not limited to medical, legal, financial, or lifestyle recommendations). Readers should always consult a qualified professional before making decisions based on any content presented here.

Originally published on Betterness.nz — empowering better living through insights, experiences, and natural wellness knowledge.

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