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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is terefrac right medication for severe pain in wrist after injury?

My wife aged 56 yrs having diabetes for 15 yrs,generally controlled.Menopause at age 45 yrs.For last 5 yrs has developed osteoporosis.Had trigger thumb, then frozen shoulder right side. 2 yrs back bone scan results were -2.5 to -3.5. For last one year had fractures 2 times on trivial fall of the wrist and ankle, the recovery from fractures took very long time. Doctors pointed out visible porosity in bones X-rays. latest bone scan result -2.0 to -3.5 i.e. -2.0 femoral,-2.5 left shoulder and -3.5 in spine.For last six months has very severe frozen shoulder-left. monr pain almost 24 hours gets very severe when going to sleep .Getting sleep gets difficult for hours.Pain is more in the left arm muscles just below the shoulder which goes simple to severe all through the day , much more while trying to sleep.Doctors say this muscle pain is due to frozen left sholder joint which is getting more frozen. pohisio therepy/diathermy treatment for 15-20 days had very little effect. One ortho specilist prescribed hyalgan 20 mg injection into the shoulder joint(hyaluronic acid sodium salt injection 20 mg-2 ml each time) 3-4 injections every 15 days. had two such injections but did not have even 10% benefit. With 1st injection ,for 15-20 days , she felt better shoulder movements. but problem relapsed with more severity on leaving injections treatment , in all two injections so far two months back. The same doctor also agressively prescribed terefrac ( parathyroid harmone)subcutaneos injections to be administered daily for 18 months. WSe are now very apprehensive if this injection - parathyroid is really required, and will it not cause any untoward side effects that may prove quite detrimental after taking this treatment.Today, Her parathyroid harmone test reasult 70.2 against the higher limit of the range to be 68.Her all other tests TSH , Sugar,Urin microalbumin,HBA1C,Lipid profoile and LFT all are normal. Kindly advise what to do now? Rakesh Kumar
Mon, 22 Jun 2020
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Orthopaedic Surgeon 's  Response
Hi,

Your wife is suffering from severe osteoporosis which is quiet common for the females of her age. Parathyroid hormone is considered the best medication that actually increase the bone mass, and is considered the last resort. These parathyroid supplements don't cause side effects usually, in case if there are any they are reversible. You can start it without giving a second thought.

Another option is denosumab injection which need not to be taken daily, you can consult your doctor regarding it as well, as it is very effective and is free from side effects. As far as frozen shoulder is considered, she can have steroid injections into her joint. Even if steroid does not proves to be effective, the only options left are either arthroscopy or manipulation under anesthesia.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Rohan Shanker Tiwari, Orthopedic Surgeon
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Is terefrac right medication for severe pain in wrist after injury?

Hi, Your wife is suffering from severe osteoporosis which is quiet common for the females of her age. Parathyroid hormone is considered the best medication that actually increase the bone mass, and is considered the last resort. These parathyroid supplements don t cause side effects usually, in case if there are any they are reversible. You can start it without giving a second thought. Another option is denosumab injection which need not to be taken daily, you can consult your doctor regarding it as well, as it is very effective and is free from side effects. As far as frozen shoulder is considered, she can have steroid injections into her joint. Even if steroid does not proves to be effective, the only options left are either arthroscopy or manipulation under anesthesia. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Rohan Shanker Tiwari, Orthopedic Surgeon