Osteoporosis, which is a thinning of the bones as we age, can cause significant back pain if it causes vertebral body fractures. Recently, several drugs have been approved for use in the treatment of osteoporosis to reduce the risk of fractures. Osteoporosis medications work by reducing the bone loss and increasing mineral deposition in the bones.

One well-known medication used to treat osteoporosis, alendronate (e.g. Fosamax), helps strengthen bones by encouraging mineral deposition in the vertebral bodies. This in turn can lower the risk of compression fractures. Fosamax is taken orally and it can be very irritating to the esophagus, so it should be taken with water and the patient should avoid lying down for 30 minutes after taking the drug to keep it from refluxing back into the esophagus.

Another common medication is calcitonin (e.g. Miacalcin), a hormone that improves bone strength by favoring the bone-forming cells and inhibiting the bone-destroying cells. This medication serves to lower the risk of vertebral fractures, and has the added benefit of reducing low back pain in those who already have had a compression fracture. Miacalcin is administered by a nasal spray once a day.