Rapid and profound bone loss is a well-known secondary complication following spinal cord injury (SCI), occurring primarily below the level of neurological lesion due to mechanical disuse. The greatest loss of bone is experienced during the acute phase of injury, and established osteoporosis often persists into the chronic phase, with no current standard of care plan for patients. The main goals of this thesis were to:​ (1) explore patient knowledge and awareness regarding bone loss, fracture risk and treatment options following SCI, and (2) to investigate pharmaceutical treatment options to prevent bone loss in acute SCI, as well as treat established osteoporosis in chronic SCI. Three independent studies were carried out and are presented in Chapters 3-5, respectively. Survey results demonstrated that while more than half of participants with SCI were able to correctly answer knowledge-based questions regarding bone health, less than one-fifth had received education on the topic, and approximately three-quarters were interested in learning more about treatment options. Our clinical trials demonstrated the efficacy of zoledronic acid (antiresorptive therapy) to mitigate loss of bone mineral and strength at the hip in acute SCI, regardless of one’s ability to regain ambulation following injury, and the efficacy of romosozumab (anabolic and antiresorptive monoclonal antibody therapy) to increase bone mineral and strength at the hip, but not the knee, in women with chronic SCI. These findings add to the existing body of literature suggesting zoledronic acid is a strong candidate for standard of care to mitigate bone loss during acute SCI, and indicating that further investigation is required to find a treatment that can increase bone mineral, and reduce fracture risk, at both the hip and knee during chronic SCI for those with established osteoporosis.