In our physio practice, more of our patients are telling us they have osteoporosis, or are coming to see us because physiotherapy has been recommended to help with their osteoporosis diagnosis.
Often people associate this condition with their bones crumbling away. They think they need to be extremely careful about applying pressure to their bodies because their bones are fragile. But osteoporosis can be prevented in many cases, or its impact significantly reduced, and exercise plays an important role in this.
In this article, we explain what osteoporosis is, how you can reduce your risk of getting it, and what treatment can help you to reverse osteoporotic changes in your bones.
Osteoporosis causes the density of your bones to decrease. It happens when the enzymes in your body that remove ‘old’ bone are working quicker than the processes that replace ‘old’ bone with ‘new’. This decreased bone density raises the risk of bone fractures.
Often you will be unaware that your bone density is changing until you fall and fracture something. At that stage, the doctor may recommend that you have further investigations because they’re concerned that the fracture might be related to osteoporosis.
What causes it?
Things that can make you at higher risk of osteoporosis include:
There are 2 stages of osteoporosis:
If your doctor suspects that you could have osteoporosis they will send you for a bone density scan, also known as a DEXA. This will typically look at the bone density in your hip and lumbar spine.
From the scan you will be given a T-score that lets you know what your bone density is:
If you have a below normal score, further investigations may be needed to understand why. For example, you may need blood tests to assess your vitamin D levels.
You need to understand what is causing the osteoporosis to determine what treatments are required.
The growth of new bone is stimulated by stress being put through the bone. This can be done by weight-bearing or loaded movements, such as walking, running and resistance training.
But you also need to have the components in your body to make the new bone.
Often your doctor will prescribe medication to stimulate bone growth or reduce how fast your body breaks down ‘old’ bone. These could include drugs such as:
Your doctor may also send you to a rheumatologist who specialises in osteoporosis to help with managing your symptoms and improving your bone density.
There are also lifestyle changes you can make to help maintain or improve your bone density.
If your loss of bone density is not too severe, or if you have adverse effects from the medication, your doctor may suggest that you start with changes in lifestyle to help improve your bone density before trying an alternative medication.
If you have reduced bone density levels, you will require follow up scans every 2 to 5 years to check whether the medication and lifestyle advice is helping.
Yes, it can. A physiotherapist can help guide you with appropriate weight bearing and loaded exercises for your bone density and fitness level. They can put together a safe exercise programme for you to perform at home or in the gym and aid with progressing the programme as you become stronger.
Guidelines for adults when performing strengthening exercises:
Physiotherapy can also help if you’ve had a fall, you have spinal fractures causing pain, or you have other symptoms that mean that you’re struggling to get the exercise you need to help with your osteoporosis.