Osteoporosis is a chronic condition characterized by bone mass and density loss, leading to an increased risk of fractures.

Anyone can get osteoporosis, and risk increases with age. According to the National Institutes of Health (NIH), you’re more likely to develop the condition if it runs in your family. Treatment usually includes medication, diet and lifestyle changes, and physical therapy.

Physical therapy, also known as physiotherapy, can help to both prevent and manage osteoporosis. A physical therapist creates a custom exercise program to strengthen your bones and muscles over weeks and months. This helps improve your balance and decrease your chance of falling.

Physical therapy can also help rehabilitate an injury due to osteoporosis, and improve your quality of life if you’re experiencing chronic pain.

We’ll give an overview of how physical therapy works, what types of exercises are commonly used, benefits, and more.

Osteoporosis screening

Osteoporosis is called a “silent” disease, as it doesn’t often cause any symptoms until it contributes to a bone fracture. The U.S. Preventive Services Task Force recommends regular osteoporosis screenings for women 65 years and older, and postmenopausal women with certain risk factors.

Find out who should get osteoporosis screening and what to expect.

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During physical therapy, a trained physical therapist evaluates and treats irregularities in your movement caused by injuries or other health conditions. Your regimen will be customized just for you!

In the United States, physical therapists earn a doctorate in physical therapy and pass a national licensing board exam. The American Physical Therapy Association (APTA) says most physical therapy programs last 3 years and require an undergraduate degree for entry. Physical therapists have to be licensed in each state they practice in, and these requirements vary by state.

Physical therapy often involves performing stretches or exercises, usually done in repetition or sets. But physical therapists also use a variety of other techniques to improve movement.

These include:

During your first appointment, your physical therapist will assess your symptoms and pain levels by asking you questions and performing physical tests. The type of exercises assigned, and the level of their difficulty or repetition, will depend on your specific injury and overall health. Often, exercises will change or increase in difficulty as you get stronger.

They may have you perform these exercises in their clinic, but it’s also common for physical therapists to assign you exercises to do daily on your own.

Physical therapy may be advised if:

  • You have a diagnosis of osteoporosis.
  • You recently had a fracture due to osteoporosis.
  • You are an older adult with a history of osteoporosis in your family.
  • You have another health condition affecting bone health.

Regular exercise is an important part of keeping your bones strong and healthy. A 2019 review suggests people with a moderate to high risk of fracture or with functional limitations may benefit from working with a physical therapist. They can create a custom program to lower the chances of future injury.

For preventing osteoporosis and osteoporotic fractures, the authors of a 2017 study recommend a long-term exercise program designed to improve postural stability, mobility, and movement efficiency. This goes alongside increasing vitamin D and calcium intakes.

Physical therapy can also help people with osteoporosis recover from fractures. Treatments such as ultrasound and electric stimulation may help manage chronic pain. Pain medications and drugs specifically used to treat osteoporosis can also be useful in tandem with physical therapy.

The exercises a physical therapist will assign depend on several factors, such as:

  • what specific injury or health condition you are being treated for
  • your overall wellness and how any preexisting conditions may affect your care
  • the level of activity in your daily life or job
  • your own goals for physical therapy

Physical therapy exercises are usually straightforward, don’t require expensive equipment, and can be done at home, according to a 2019 study.

It’s important you pay close attention to your physical therapist’s guidance to make sure you’re doing exercises correctly. They may also give you charts or videos to reference.

If you’re worried you’re not doing an exercise right, or if it’s causing pain, stop and talk with your physical therapist.

For osteoporosis, the APTA says your physical therapist will likely recommend a combination of resistance and weight-bearing exercises. This regimen will be highly individualized.

Your treatment plan may include:

A 2018 research review identified the two most effective types of exercise for increasing bone density in people with osteoporosis. These were weight-bearing aerobic exercises, such as stair climbing or walking, and resistance training exercises, such as lifting weights.

Resistance training aims to improve muscle mass and bone density. This type of exercise has also been associated with improving quality of sleep and reducing mortality, among other health benefits.

Regular and targeted exercise is important for preventing and managing osteoporosis.

Working with a physical therapist can help you:

A 2019 study suggests that people with osteoporosis who perform exercise have a higher quality of life than those who don’t.

A 2021 review of studies found a moderate amount of quality evidence that physical exercise can improve balance, strength, and the endurance of muscles of the spine in people with osteoporosis, while reducing pain and fear of falling.

The researchers also found that starting physical therapy was generally associated with positive outcomes. But more research is needed to understand which specific treatments are best, and how long and often they should be performed.

In a 2020 study, researchers found a 12-week exercise program supervised by a physical therapist helped improve muscle strength, balance, and fear of falling in women with osteoporosis and a history of vertebral fractures.

Exercise recommendations

The World Health Organization (WHO) offers guidelines on recommended activity levels for each age group.

Experts suggest:

  • Adults ages 18 to 64 should do at least 150 to 300 minutes of moderate intensity aerobic physical activity throughout the week, or 75 to 150 minutes of vigorous intensity aerobic physical activity.
  • This recommendation also applies to adults with chronic conditions.
  • Adults over 65 years old should aim for the above and prioritize activities that help with functional balance and strength training 3 days per week.
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To find a physical therapist in your area, you can ask your doctor for a recommendation. A doctor’s note isn’t always necessary to visit a physical therapist, but your insurance provider may require it for coverage.

You may also be able to find a list of in-network providers from your insurance company by calling or using their website.

The APTA has a free online directory, so you can search for clinics and physical therapists in your area.

Osteoporosis is a common bone disease, especially among postmenopausal and older women. However, anyone can get osteoporosis. It causes decreased bone density and mass, and can lead to fractures.

Physical therapy, in combination with other treatments, may help strengthen your bones and muscles. It can help you improve your balance to lower your risk of falling.

It’s important to talk with your doctor about screening for osteoporosis as you age, especially if you have a history of the disease in your family or are over 65 years old. Your doctor may recommend working with a physical therapist if screening reveals you’re at moderate or severe risk of breaking a bone.