Pharmacologic and Nonpharmacologic Treatment Modalities for Bone Loss in SCI - Proposal for Combined Approach

Rajiv S Dharnipragada, Uzoma Ahiarakwe, Ribhav Gupta, Abdiasis Abdilahi, Jack Butterfield, Anant Naik, Ann Parr, Leslie R. Morse

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Increased risk of bone fracture due to bone mineral density (BMD) loss is a serious consequence of spinal cord injury (SCI). Traditionally, pharmaceutical approaches, such as bisphosphonates, have been prescribed to prevent bone loss. However, there is controversy in the literature regarding efficacy of these medications to mitigate the drastic bone loss following SCI. Individuals with SCI are particularly at risk of osteoporosis because of the lack of ambulation and weight bearing activities. In the past two decades, functional electric stimulation (FES) has allowed for another approach to treat bone loss. FES approaches are expanding into various modalities such as cycling and rowing exercises and show promising outcomes with minimal consequences. In addition, these non-pharmacological treatments can elevate overall physical and mental health. This article provides an overview of efficacy of different treatment options for BMD loss for SCI and advocates for a combined approach be pursued in standard of care.

Original languageEnglish (US)
Article number101359
JournalJournal of Clinical Densitometry
Issue number2
StatePublished - Apr 1 2023

Bibliographical note

Publisher Copyright:
© 2023 The International Society for Clinical Densitometry


  • Bone mineral density
  • Functional electric stimulation
  • Spinal cord injury

PubMed: MeSH publication types

  • Journal Article
  • Review


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