Osteoporosis

How can physiotherapy help with osteoporosis?

Physiotherapists can help you improve your muscle strength, advise on exercises that improve your bone density results and, if you are at risk of falling, how you can improve your balance.

Bone is a living tissue that can be built up through exercise, so a physiotherapist will work with you to design a personal programme that suits your needs and advise on suitable physical activities.

Exercise is recommended as part of a programme to prevent falls. Physiotherapists are experts at assessment and delivery of exercise programmes to help you improve movement, strengthen muscles, and maintain mobility.

Ask your physio or GP about osteoporosis exercises and falls prevention programmes in your local area.

What will happen when I see a physiotherapist?

Your first session with a physiotherapist will usually include a detailed assessment. Everything you tell the physiotherapist will be confidential. They may ask you questions about your: 

• current symptoms, including pain
• medical history and bone density scores
• any problems you may have with daily tasks
• health, fitness levels and lifestyle

The physiotherapist will assess your falls risk and check your balance, posture and strength. They will watch how you move and find out how this problem is affecting your life, including how it is affecting your ability to be physically active.

Your physio may ask you to remove some clothing so that they can have a look at individual joint movements and test muscle strength. It’s a good idea to wear loose fitting, comfortable clothing to your appointment.

At this first appointment, the physio may discuss and agree achievable treatment goals and a management programme. They may arrange follow-up appointments, and link closely with other healthcare professionals who may be involved in treatment.

Your consultation is likely to include:

• advice about how to manage your pain
• advice about maintaining or improving your posture
• strengthening and flexibility exercises
• balance and co-ordination exercises
• low impact weight bearing exercises for osteoporosis, targeting the hip, spine and wrist

• advice on making exercise safe for you and tips on preventing falls

If you have had a fall or are at risk of falling it may also include:

• referral for a group exercise class or a falls prevention programme
• advice on which exercises are appropriate, how to complete them and appropriate ongoing exercise
• teaching you how to get up off the floor if you fall, or how to keep warm and safe on the floor if you are unable to rise from the floor

• advice about walking inside and outside which may include the supply of an appropriate walking aid
• if you have broken a bone, your physio will offer advice on pain relief and help you improve your movement, including getting back to optimum fitness and physical activity

Where can I get more information on osteoporosis and physiotherapy?

All physiotherapists have the skills and knowledge to manage the physical problems associated with osteoporosis.

Physiotherapists with a particular interest in osteoporosis and the care of older people might be members of a Professional Network. Follow the links for more information: 

• Chartered Physiotherapists working with older people (AGILE)
• Association of Chartered Physiotherapists in the Community (ACPC)

The National Osteoporosis Guideline Group (NOGG) offers guidelines for the diagnosis and management of osteoporosis in postmenopausal women and men over 50 years.

They also sets out recommended practice for osteoporosis prevention and treatment of the condition. This recommends that general management should include an assessment of the risk of falls and their prevention.

• Information for healthcare professionals
• Information for patients

The Scottish Intercollegiate Guidelines Network (SIGN) offers guidelines for the management of osteoporosis.

These recommend high-intensity strength training and low-impact weight bearing exercise to manage osteoporosis.

• SIGN guidelines: Osteoporosis

Meanwhile, how can I help myself and find useful advice?