@kdickerson I have always been told that osteoporosis does not cause pain- until we fracture. Have you had an x-ray to see if you have any hidden fractures? If not your back pain may have another cause. Have you been to PT? Had any imaging?

Evenity works quickly. My friend went from -4 something to borderline in a year.

When you finish, you might want to research Prolia vs Reclast as a follow-up. You are young so you will have to, at some point, transition to Reclast from Prolia and that can be very tricky.

Many of us benefit from Keith McCormick's book "Great Bones" which explains Prolia rebound, which is a scary problem that happens when stopping. One year might be helpful then Reclast, according to McCormick's latest opinions. I also watch Dr. Ben Leder on YouTube for info! But your own doctor is probably the best resource!