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83 years old. Suffering from lower back pain. On zertaofim 50 and nurokind-gold 2ml inj. What to do?

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Orthopaedic Surgeon
Practicing since : 1994
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my grand mother is 83 years old,,suffering lower back pain..She is also getting pain,so that she is unable to stand.

on 27/10/2012..She had went to an Xray of LS Spine,both knees,Arthritic Profile. And our local orthopedist suggested for LOwer GI Endoscopy to consult Gastreoentrologist and for MRI of LS Spine to rule out secondaries.

He had also given Zertaofim 50 IM and suggested Nurokind-GOld 2ml inj for alternate days.
When she got back after todays injection,She was ok,but after climbing 3 stairs ,she was unable to stand and having pain at her right leg.We called 3 ppl from near by area made her sit on a chair and carried her to hers room.Now she is resting on Bed.

What advice can u give to us. or what help can i have from yourside.If u needed more details then please let me know that too..
Thank you
Posted Mon, 19 Nov 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 2 hours later
Thanks for posting your query.
As per the doctor's comments, her spine shows severe degenerative changes. The raised alkaline phosphatase levels are also indicative of bone degeneration may be due to secondaries in the bone.
An MRI of the spine is necessary for a better evaluation.
The pain in the legs is due to severe osteoporosis and weakness related to her age. She needs to continue with the medicines prescribed. The further medicines can be added after evaluation by MRI spine.
Medicines that may be used to treat her problem include:
Bisphosphonates like Alendronate (Fosamax) or Risedronate (Actonel, Atelvia) or Ibandronate (Boniva)
Raloxifene (Evista), a selective Calcitonin (Calcimar or Miacalcin), a naturally occurring hormone that helps regulate calcium levels in the body.
Parathyroid hormone - given in postmenopausal women with severe osteoporosis who are at high risk for bone fracture. It is given by injection.
Densumab- used to treat women who are past menopause and who are having severe osteoporosis. Given by injection, usually every 6 months.
Discuss with her doctor about these options for treating your mother.

In addition to these medicines, your mother will also need to get enough calcium and vitamin D, eat a healthy diet, and exercise regularly. A large part of treating or reducing the effects of osteoporosis is getting enough calcium and vitamin D.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
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