Effect of Zoledronic Acid on Pain and Bone Mineral Density in Osteoporosis: A 2-year Longitudinal Study

BACKGROUND: Osteoporosis is a common metabolic bone disorder associated with reduced bone mineral density (BMD) and increased risk of fractures and chronic pain. Zoledronic acid (ZA), a bisphosphonate, is widely used in the management of osteoporosis because of its antiresorptive properties. AIMS AND OBJECTIVES: To evaluate the effect of zoledronic acid on pain levels and bone mineral density in patients with osteoporosis over a 2-year follow-up period. MATERIALS AND METHODS: A hospital-based observational pre-post study was conducted among 120 diagnosed osteoporosis patients. Each participant received a single dose of zoledronic acid and was followed for 2 years. Pain levels were assessed using the Visual Analog Scale (VAS), and BMD measurements were recorded at baseline and at structured 6-monthly intervals up to 2 years. RESULTS: Participants demonstrated higher pain scores at baseline, followed by a progressive decline at 6 months, 1 year, 1.5 years, and 2 years. This decreasing trend was statistically significant (P = 0.001). Similarly, BMD was lowest at baseline and showed a consistent increase across all follow-up intervals, with the upward trend also reaching statistical significance (P = 0.001). CONCLUSION: Zoledronic acid effectively reduces osteoporosis-related pain and significantly improves bone mineral density over time in patients with osteoporosis.