Osteoporosis: What it is and how physiotherapy can help manage it
Osteoporosis is a common condition that weakens bones, making them more fragile and increasing the risk of fractures. It is estimated that around 3 million people in the UK are living with osteoporosis, with fractures commonly affecting the spine, hip and wrist.
These fractures can significantly affect mobility, independence and quality of life — particularly in older adults.
The good news is that there are effective ways to manage osteoporosis, and physiotherapy plays a key role in helping people maintain strength, mobility and confidence.
In this article, we’ll explore what osteoporosis is, who is most at risk, and the best evidence-based strategies for managing the condition.
What is osteoporosis?
Osteoporosis is a condition where bone density and bone quality decrease over time, causing bones to become weaker and more prone to fractures.
Bone is living tissue that is constantly being broken down and rebuilt. As we age, bone breakdown can occur faster than bone formation, leading to reduced bone strength.
The most common fracture sites include:
Spine (vertebral fractures)
Hip
Wrist
Spinal fractures can lead to symptoms such as:
Back pain
Loss of height
Changes in posture such as increased rounding of the upper back (kyphosis)
These fractures may occur with minimal trauma or even everyday movements.
Who is most at risk?
Several factors can increase the risk of developing osteoporosis, including:
Increasing age
Post-menopausal women
Family history of osteoporosis
Low body weight
Smoking
Excess alcohol intake
Low calcium or vitamin D intake
Long-term steroid use
Physical inactivity
Because osteoporosis often develops gradually without obvious symptoms, many people only discover they have it after sustaining a fracture.
Physiotherapy management for osteoporosis
Physiotherapy plays an important role in helping people with osteoporosis remain active and reduce their risk of fractures.
A physiotherapist can assess an individual’s mobility, strength, balance and posture, and provide personalised treatment and exercise programmes to support bone health and improve function.
Individualised exercise programmes
Exercise is one of the most effective non-pharmacological treatments for osteoporosis.
A physiotherapist can design a programme tailored to the individual’s:
Bone density
Fracture risk
Fitness level
Pain levels
Medical history
Effective exercise programmes often include:
Strength (Resistance) training
Strength training helps stimulate bone formation and improve muscle support around joints.
Guidelines commonly recommend:
Resistance training 2–3 times per week
Exercises targeting major muscle groups
Progressive loading over time
Examples include:
Squats
Sit-to-stand exercises
Step-ups
Resistance band exercises
Weight training
Research supports resistance training as an important strategy for maintaining bone health.
Weight-bearing activity
Weight-bearing exercises place healthy stress on the bones, which can help stimulate bone strength.
Examples include:
Brisk walking
Stair climbing
Dancing
Low-impact jogging
Balance and stability training
Falls are a major cause of osteoporotic fractures.
Improving balance and coordination can significantly reduce fall risk. Physiotherapy programmes often include:
Single-leg balance exercises
Functional strength movements
Tai chi or stability training
These exercises help improve confidence and reduce the likelihood of falls.
Postural training
Osteoporosis — particularly when spinal fractures occur — can lead to increased curvature of the upper back (thoracic kyphosis).
Physiotherapy may include:
Spinal extension exercises
Postural strengthening
Movement education
Improving posture may help reduce pain and support spinal health.
Education and movement advice
Education is another important part of physiotherapy management.
Physiotherapists can advise on:
Safe lifting techniques
Movement strategies for daily activities
Exercises that may need modification
Nutrition and bone health
Nutrition also plays a key role in maintaining bone health.
Calcium
Calcium is essential for maintaining bone strength.
Adults typically require 700–1000 mg of calcium per day, ideally from dietary sources such as:
Dairy products
Leafy green vegetables
Fortified foods
Vitamin D
Vitamin D helps the body absorb calcium effectively.
It can be obtained through:
Sunlight exposure
Diet
Supplements when required
Healthcare professionals may recommend supplements if vitamin D levels are low.
Medical management
For some people, medication may be recommended to reduce fracture risk and strengthen bone.
Common medications include bisphosphonates, which slow the rate that bone is broken down in your body.
Medication decisions are usually made by a GP or specialist following assessment and bone density scans (DEXA).
When should you see a physiotherapist?
You may benefit from physiotherapy if you:
Have been diagnosed with osteoporosis or osteopenia
Have experienced a fracture
Feel unsteady or concerned about falling
Want guidance on safe exercise
Experience back pain related to spinal changes
Early support can help you stay active and reduce your risk of fractures.
How physiotherapy can help you stay active with osteoporosis
With the right support, many people with osteoporosis can remain active and independent.
Improve strength and bone health
Reduce fall risk
Improve posture and mobility
Exercise safely and confidently
If you are based in Bristol and would like personalised advice or support with osteoporosis management, AgeWise Physio can help you develop a safe and effective plan tailored to your needs.
Book a physiotherapy assessment to discuss your symptoms and create a personalised plan designed to support bone health and reduce fracture risk.
