need advice

PMR is polymyalgia rheumatica.  it literally means "pain all over".  The only effective treatment is with steroids like prednisone, which can contribute to bone thinning.  Unfortunately there are still doctors who routinely prescribe osteoporosis meds without checking on the person's bone status, or prescribing them to people like Karen on the basis of "osteopenia".   My doctor wanted to do the same, but we held off and at my suggestion I had a DXA scan.  Diagnosed with "low bone mass" which I believe is the current term for "osteopenia" which originally was never meant to describe a disease condition.  She then wanted me to go on the meds but by then I'd done so much reading I decided I would never take them.  Also I had found out that two of my friends had been osteoporotic and both had just used natural means, diet, supplements, exercise, to move themselves back into the "osteopenia" range.  One of them has slacked off and become osteoporotic again, but the other sticks to her regimen and her bone density continues to improve - she said her scans have proven this. I find that quite encouraging.  

My feeling is holding off the bisphosphonates would be the conservative treatment.  There's too much evidence that nutrition and exercise can be effective treatments for that not to be tried first.

I agree with Anhaga, if your current exercise and nutrition can be improved to a lifestyle choice that supports bone health then that would ( and is) my first choice.This would also support more effective medical interventions should you choose that direction in the future....in the meantime let's hope that better treatment options become available to us in the future

Handbrake, I agree that better treatment options are the best hope for future. Unfotunately, our future is now -- and not much seems to be happening, other than nearly identical osteo drugs being rolled out but given different names. Though exercise and nutrition choices probably contribute to overall health, I am very dubious that, once osteoporosis has developed, either one of these approaches is going to reverse the process. Perhaps the type of exercise that may improve balance in order to help prevent falls has some merit.

It's true that some people are in far more dire straits than others.  My feeling is that a relatively young person who is really only borderline should be guided to the non-pharmaceutical treatment first.  The real thing that should happen, though, in all our various countires, is for us to be given a much bigger heads-up when we are younger emphasizing the importance of maintaining good bone health, instructing us how to do it, and also a baseline scan at a reasonable age, say 50 for women, somewhat older for men.  There is so much emphasis on smoking, heart health and cancer that it seems bones are forgotten and yet poor bone health is the cause of measureless suffering of older people and huge costs to the health care system.