Physical Therapy for Osteoporosis

Osteoporosis is a condition in which your bones begin to lose density, becoming weaker, more fragile, and more likely to fracture. This condition is common among middle-aged and older adults. Women are up to four times more likely to develop the disease than men. Currently, approximately 54 million people are estimated to have osteoporosis in the United States.

Fortunately, a host of treatment options, including physical therapy (PT), can help to strengthen bones and ease the disease’s effects. This article discusses ways that you can treat your osteoporosis with PT.

Osteoporosis Overview

The bones in your body contain microscopic pores, or holes, that help accept any forces that travel through them. In people with osteoporosis, however, these pores become bigger, causing the bone to become thinner, more brittle, and more likely to fracture.

Bones are living organisms and the body must constantly “remodel” them with calcium and other nutrients to keep them strong. In people with osteoporosis, this bone remodeling is outpaced by bone deterioration or breakdown, and a loss of bone mass occurs over time.

Some people are at a higher risk of developing osteoporosis than others, including:

• People over age 50
• Postmenopausal women (due to the loss of estrogen)
• Smokers
• People with celiac disease or irritable bowel syndrome (due to nutrient malabsorption)
• Caucasian and Asian women
• Thin or petite individuals
• People with thyroid, parathyroid, or kidney problems
• Patients treated with long-term steroid medication, hormone treatments,
  or radiation therapy

Commonly referred to as the silent disease, osteoporosis frequently causes no symptoms at all. In fact, many people are unaware they have a problem when they are first diagnosed. Unfortunately, as the condition progresses, it can cause many different symptoms including:

• Loss of height as you age
• Kyphotic, or slumped, posture
• Difficulty breathing (due to postural changes restricting your lung capacity)
• Frequent bone fractures
• Pain

Diagnosis

Because osteoporosis is so prevalent, most physicians begin to screen for it as people approach middle age. This evaluation typically includes a routine bone mineral density test (also known as a DEXA scan). This test utilizes X-rays to visualize your bones and measure their relative strength.

A blood draw and comprehensive review of your medical and medication histories are also commonly performed to identify any factors that could contribute to bone fragility.

Finally, your height and overall posture are assessed each year to monitor for any changes that may be due to osteoporosis. Early diagnosis of this disease is crucial in preventing further bone loss from occurring and in avoiding a life-altering fractures down the road.

Physical Therapy

Once you have been diagnosed with osteoporosis (or its precursor osteopenia), your doctor may refer you to a physical therapist as part of your intervention treatment plan.

It may seem counterintuitive to go to therapy when you are not experiencing any pain or limitation of mobility, but PT has been shown to provide several valuable osteoporosis-related benefits. The sections below detail specific treatments that can help you lessen the effects of this condition.

Resistance Training

One effective way to combat bone deterioration is to begin a resistance training program. Bones remodel, or build up, in areas where stress occurs, so this type of exercise can help provide bones with the resistance needed to strengthen.

Your physical therapist can assist you in designing a strengthening routine that is appropriate for your condition and fitness level. The therapist can also teach you how to safely progress in the program as you get stronger. Evidence has shown that this type of activity not only improves bone health but also increases your overall function.

Weight-Bearing Exercise

Like resistance training, weight-bearing exercises are a good way to put positive stress on your bones and trigger bone remodeling in weaker areas in the spine, hips, or legs. Activities like walking, using an elliptical machine, or stair climbing are all positive ways to help maintain (and potentially improve) the density of your bones.

Your physical therapist can outline daily activity guidelines and monitor your status as you begin an aerobic regimen. Therapists can also provide you with safe progression exercises as you adapt to your new routine.

Balance Training

If you have osteoporosis, your bones are more fragile and, therefore, more apt to fracture than those without the disease. Because of this, fall prevention is crucial for individuals with this condition.

Your physical therapist can help improve your balance and reduce the chances of a fall by focusing on balance training activities. These exercises simulate unpredictable or uneven surfaces in an effort to make them less challenging to navigate. PT will also help build strength in leg, ankle, and foot muscles to help you maintain your stability.

Body Mechanics Education

Several types of movements, including rapid rotation, forward bending of the trunk, and heavy lifting, can put an increased amount of strain on osteoporotic bones and leave you more at risk of a fracture. Unfortunately, many daily tasks like unloading the dishwasher or putting on shoes can require these potentially harmful movement patterns.

Your physical therapist can help educate you on alternative strategies that can be used to carry out your daily tasks in a safer way. Therapists will also monitor your posture as you lift or exercise and provide cueing to reduce your risk of harm.

Other Treatments

As previously mentioned, physical therapy is just one component of a multifaceted approach to treating osteoporosis. Depending on your individual situation and bone density, your physician may also suggest one of several other interventions.

Prescription medications, including one group called bisphosphonates, also can help increase the strength in your bones and lower your risk of a fracture. Other options, like biologics, anabolics, or hormone replacement therapy, may also be considered depending on your unique circumstances.

In addition to PT and prescription drugs, nutritional interventions, including taking supplements like vitamin D or calcium, may also be encouraged. These nutrients play an important role in maintaining bone health.

Finally, your physician may recommend lifestyle changes like quitting smoking, increasing your protein intake, and reducing your intake of caffeine and alcohol.

A Word from Verywell

While extremely common, osteoporosis is a disease that also can be effectively treated, especially when it's caught early. While it can be scary to discover that your bones have lost density, physical therapy, along with other treatments, can help you take control of your bone health and reduce the chances of a fracture.

If you have any risk factors for osteoporosis, be sure to speak to your primary doctor about monitoring your bone density as you age. Following a comprehensive screening protocol, your doctor will be able to monitor your progress and point you in the direction of treatments that are appropriate for you.