Physical therapy, or physiotherapy, can help prevent and manage osteoporosis by strengthening bones and muscles, improving balance, and helping patients rehabilitate after injuries.

Osteoporosis can lead to losses in bone mass and density and increase your risk of fractures.

During physical therapy, a physical therapist creates a custom exercise program and guides you through exercises over weeks or months. They may also provide exercises for you to do at home. A physical therapy program helps improve your balance and decrease your risk 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 because it doesn’t often cause symptoms until it contributes to a bone fracture. The U.S. Preventive Services Task Force recommends regular screenings for females 65 and older and postmenopausal females with certain risk factors.

Anyone can get osteoporosis, and the 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.

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

During physical therapy, a trained physical therapist evaluates and treats irregularities in your movement caused by injuries or other health conditions. They customize the regimen just for you.

Physical therapy often involves stretches or exercises, usually in repetition or sets. However, physical therapists also use various other techniques to improve movement.

These include:

During your first appointment, your physical therapist typically assesses your symptoms and pain by asking questions and having you perform physical tests. The type of exercises assigned and the level of their difficulty or repetition depend on your specific injury and overall health. Often, exercises 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.

A doctor may recommend physical therapy for you 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 important for keeping bones strong and healthy. A 2019 review suggests that people with a moderate to high risk of fracture or functional limitations may benefit from working with a physical therapist. They can create a custom program to lower the chances of future injury.

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 receiving treatment 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 to 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.

Your physical therapist will likely recommend a combination of resistance and weight-bearing exercises for osteoporosis. This regimen will be individualized for your goals.

Your treatment plan may include:

Scottish physical therapy guidelines from 2022 recommend a varied physical therapy program to reduce the risk of fracture in people with osteoporosis. The recommended exercise types vary based on age and menopause status. Some recommendations might include:

  • static weight baring exercise, like standing on one leg
  • dynamic weight baring exercise, like walking or tai chi
  • non-weight baring exercise, like progressive resistance strength training

Resistance training aims to improve muscle mass and bone density. This type of exercise has also been associated with improving sleep quality 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 spine muscles 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. However, 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 should aim for the above and prioritize activities that help with functional balance and strength training 3 days per week.

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