[Drug therapy of osteoporosis]

It has proved worthwhile to treat osteoporosis simultaneously in two ways. For symptomatic treatment of the pain, passive and active physiotherapy is important, backed up by treatment with analgesic and antirheumatic agents and calcitonin, while any other drugs are given mainly for treatment of the osteoporosis itself. For women in high-risk categories for osteoporosis long-term (10-12 years) preventative treatment with estrogens (plus progesterone) is indicated. When osteoporosis is already apparent on radiological examination, fluoride (+ calcium) is generally given over 3-4 years, while calcitonin therapy is appropriate in acute painful and rapidly progressive osteoporosis with fresh vertebral fractures. In this case both the antiosteoclastic and the analgesic effect of the hormone come into play. Calcium can be used for pre- and postmenopausal prophylaxis and as a supplement to fluoride therapy.