Osteoporosis: Overmedicalized Fracture Prevention

In a recent study published in the Journal of Internal Medicine, issues surrounding osteoporosis were targeted. Essentially the preconceived notion is that “Current prevention strategies for low-trauma fractures amongst older persons depend on the notions that fractures are mainly caused by osteoporosis (pathophysiology), that patients at high risk can be identified (screening) and that the risk is amenable to bone-targeted pharmacotherapy (treatment). However, all these three notions can be disputed.”

The article claims that, “Prevention of any medical condition is naturally appealing, but it is essential to strike the right balance between benefits and harms with any intervention. …the most obvious weaknesses in the prevailing general reasoning about osteoporosis to highlight the fact that there is yet the possibility for improvement in our existing paradigms for osteoporosis and fracture prevention.”

Osteoporosis is treated primarily by pharmaceuticals because it “relatively simple” to do so. However, the “bone-targeted pharmacology has, at best, minimal effect on the incidence of fractures.”  There is no doubt that many people, particularly older people, suffer from hip and other bone related injuries. But “key facts about hip fracture patients should be noted: they are generally old (mean age around 80 years) and undeniably frail.”

Is this just another health concern that is is over-medicated? The article actually states, “should ‘osteoporosis’ be added to a long list of diagnoses for which doing less, or even nothing, is better than our contemporary practice?”

The article keeps it simple and succinct with, “despite the burden of illness related to hip fractures, the main ways to prevent these fractures have not changed in nearly 25 years: stop smoking, be active and eat well. This advice is appropriate for anyone whether or not they are worried about osteoporosis and has advantages for the entire human body, including the brain, heart, skin and bones.”

 

Click here to read more.

 

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