Osteoporosis afflicts millions of Americans, and proven medical therapies have brought great relief for this painful illness. But recent reports have examined the risk of developing an unusual fracture of the femur (thigh bone) in patients who are prescribed long-term use of bisphosphonate medications, the common first-line defense for treatment of osteoporosis.

These fractures are characterized by an almost straight-line break of the femur, which can occur either spontaneously or following minor trauma. In a study published in the Journal of Bone and Mineral Research, researchers reported that these unusual fractures were much more common in patients taking Fosamax, the brand name for alendronate. This is the second serious and rare side effect of Fosamax, which leaves many patients confused and fearful of the drug's complications.

As a result of these studies, some doctors have advised their patients that the bisphosphonate medications could have side effects that make continued use questionable. And some patients taking these osteoporosis medications have spontaneously stopped treatment for fear of fracture. However, the evidence is compelling that the benefits of using bisphosphonates for managing osteoporosis far outweighs the potential side effects.

To complicate matters, some research now shows that bisphosphonates are not the cause of these unusual fractures of the femur. In a recent paper published in the prestigious New England Journal of Medicine, the prevalence of this fracture was shown to be very rare. And compared to subjects not taking the bisphosphonates, it was no more common in patients taking either oral alendronate or the intravenous zoledronic acid (Reclast). Of the 14,195 women followed over a 10-year period, only 10 developed this unusual fracture and less than a third of them were taking a bisphosphonate.

Osteoporosis is a truly devastating disease, which weakens bone and can cause a wide array of fractures, including collapsed vertebra and hip fractures. As many as 50 percent of women over the age of 50 will have at least one osteoporosis-related fracture during their lifetime. The incidence of osteoporosis-related fractures is also common in men over the age of 70. Serious bone fractures later in life can have major consequences. For example, following a hip fracture, 50 percent of patients are never able to walk without assistance, 25 percent are admitted to nursing homes and one-year mortality is increased by 25 percent.

Because the effects of osteoporosis are so devastating, appropriate treatment is very important. Like any other medications, bisphosphonates come with side effects. In addition to the rare femur fractures, there is also risk of damage to the jaw and difficulty healing after dental surgery. But the benefits of taking a bisphosphonate are quite significant. These medications not only build bone strength, but they also reduce the risk of vertebral fractures by 50 percent to 70 percent, hip fractures by 40 percent to 50 percent and fractures of the wrist by 25 percent to 50 percent. In terms of reducing overall fracture risk, this information clearly indicates that advantages of taking these drugs far outweigh the risks.

Though prevention is the best way to manage osteoporosis, screening for the disease is an important component to baby boomer health. Women should be screened initially at age 50 and men at age 60. Thereafter, screening should be done every three years. If significant osteoporosis is diagnosed, exercise and adequate intake of calcium and vitamin D are critically important. For most patients, alendronate (the generic form of Fosamax) should be the first medication considered. The only real difference between this therapy and the non-generic medications is that it must be taken weekly rather than monthly, and the cost is currently $10 for a three-month supply, far cheaper than the brand-name alternatives.

When an oral agent cannot be tolerated due to indigestion, heartburn or the presence of esophageal disease, patients should consider the intravenous form of osteoporosis therapy. There is some evidence indicating that adverse effects on the jaw could be higher in the intravenous bisphosphonates compared to those taken orally.

Whether you suffer from osteoporosis or not, there is an important lesson to be learned from these reported health concerns about a highly effective therapy: Do not panic. Become as educated as possible about the adverse effect and discuss the problem in detail with your physician prior to stopping treatment. No medication is without risk of side effects.

Dr. David Lipschitz is the author of the books, "Breaking the Rules of Aging" and "Dr. David's First Health Book of More Not Less." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.DrDavidHealth.com.