Osteoporosis or low-density bone is a health problem that causes disability and various complications in the sufferers. It occurs when the normal bone becomes thin and porous due to poor nutrition or aging, which can decrease the ability of the bone to withstand the forces that are applied during daily activities.  This disease can be silent progressive with no prominent symptoms until complications like fracture occurs if left untreated or unidentified. Strategies to improve bone density and reduce the likelihood of falls are important in the prevention of osteoporosis. Physiotherapy plays an important part in treating this health problem. Certain exercises can help strengthen the bones when performed in a proper way and under the guidance of a well-trained professional. In this blog, we will discuss physiotherapy management for osteoporosis sufferers and the precaution to be taken to prevent the complications.


Role of Physiotherapy in the management of osteoporosis

Physiotherapists are trained professionals who treat osteoporosis by personalizing the treatment plan. There is no single exercise regimen for people suffering from Osteoporosis. Based on a medical evaluation of range of motion, muscle strength, fitness level, fracture risk, gait, and balance each regimen for the individual patient is specially tailored. They develop a specific program based on the individual’s need. The goal aims:


  • To help manage osteoporosis with minimal risk of complications.
  • To build or strengthen the bones and muscles to decrease the amount of bone loss and the risk of injury and help to stay independent.
  • Teaches proper postural alignment and body movement to protect the spine from fracture during daily activities, like lifting, forward-stooping, and bending.
  • Gives balance training and develops a program to help reduce the risk of falls.

Muscle grows when challenged by more than usual weight, same is the case with bone, bone grows when it is properly and sufficiently stressed.


Physiotherapy management

Exercising for bone-building or slowing bone loss is very specific and similar for all ages.  


  • Physiotherapist provides appropriate external devices, like bracing, to improve posture and promote healing.
  • Uses different modalities which help reduce pain


·    Range of motion (ROM) and strengthening exercises

Physiotherapists aim to improve the overall posture through a gentle range of motion and strengthening exercises. Gradual fractures and wedging of the vertebra are due to the increased flexion through the thoracic spine. These conditions worsen with poor posture. Maintaining a good posture with the help of exercises gentle range of motion and strengthening exercises can maintain the healthy mobility of the upper back and core.


·     Resistance exercises

As exercises lead to stronger bones, physiotherapist designs an appropriate exercise program, which can reduce the risk of falls and fall-related fractures. Exercise programs include the use of exercise bands, gravity resistance exercises e.g., squats, single-leg heel raises, prone trunk extension with cushion to protect lowest ribs, push-ups, lunges, sustained standing positions in neutral spine position.


·     Loading exercises

To increase the overall stability and bone strength lifting weights and lower impact exercise can decrease the risk of fracture. People with osteoporosis are afraid to perform strengthening exercises and other strenuous exercises. For any physiological system to improve its function load larger than normal must be exposed for strengthening.  Bones must meet forces greater than those it sustains to improve strength on a day-to-day basis. Weight lifting in the proper spine and lower-extremity alignment can be done. Weight-bearing exercises stomping, heel drops, dancing, jogging are also done under the guidance.


·     Balance and coordination exercises

Coordination and balance exercises also help in reducing fall risk. When walking on unstable surfaces or walking through narrow spaces, these exercises help to improve balance. Exercising on a bobath ball and placing challenges the whole walking can increase and maintain balance.

 As a part of an overall fitness program, exercises are performed 2 to 3 times a week.


Things to avoid: 

  • Avoid exercises that can put the greater risk for injury.
  • Avoid exercises that overstrain or under strain the bone or muscle.
  • Avoid exercises with any type of sit-up or crunch, and excessive spinal or hip twisting, forward or side bending.