Osteoporosis represents a growing global health challenge, affecting hundreds of millions worldwide with substantial morbidity, mortality, and healthcare costs [3]. Modern pharmacotherapy bisphosphonates, denosumab, anabolic agents offers effective fracture prevention but faces challenges of adherence, adverse effects, cost, and accessibility [4,5].

Ayurveda provides a coherent, preventive, and therapeutically rich perspective on bone health through the construct of Asthikshaya a Vata-predominant state of bone tissue depletion that demonstrates substantial conceptual overlap with modern understandings of osteoporosis [6,7]. Ayurvedic interventions including Panchakarma (particularly Basti), herbal formulations (Asthi Shrinkhala, Lakshadi Guggulu, Panchatikta Ghrita), Rasayana therapy, and Vata-pacifying dietary and lifestyle modifications offer multifaceted approaches to bone health that address not only the local skeletal pathology but also systemic factors including digestion, metabolism, stress, and inflammation [14,19].

Current preclinical and early clinical evidence supports the osteoprotective potential of specific Ayurvedic interventions [9,20,22]. However, high-quality, adequately powered clinical trials, standardization of formulations, and mechanistic studies are needed to translate these insights into evidence-based integrative care [10].

An integrative model combining pharmacological therapy with Ayurvedic principles offers a promising pathway for comprehensive osteoporosis management. Such an approach could leverage the strengths of both systems: the targeted, evidence-based efficacy of modern pharmacotherapy and the holistic, preventive, and symptom-management capabilities of Ayurveda. As the global burden of osteoporosis continues to rise with population aging, integrating traditional wisdom with modern science may provide the most effective and accessible solutions for bone health worldwide.