How does physical therapy help with osteoporosis?

Physical therapy can help osteoporosis patients build bone density, slow down bone loss, correct posture, and learn ways to do daily activities that reduce the risk of getting a fracture.

Osteoporosis is a disease in which the body loses more bone material than it builds up. Over time, the bones weaken and become prone to fractures from simple activities and mild stresses such as minor falls, lifting, and bending. In severe cases, even coughing can cause a fracture. The most common fractures in osteoporosis are sustained in the hip bones, spinal vertebrae, and wrist bones. The disease can lead to painful disability in the elderly.

10 million older adults in the US have osteoporosis, while 44 million more have low bone density. The disease typically impacts many post-menopausal women and older men, although it is possible to get it younger.

Combined with a good diet rich in calcium and vitamin D, exercise can help suppress bone loss and relieve osteoporosis. However, individuals with osteoporosis may feel pain exercising, and wrong exercises and postures could do more harm than good. Working with a physical therapist can help osteoporosis patients learn how to safely perform exercises that are most beneficial for their particular symptoms.

Goals of physical therapy in osteoporosis

Build bone material and slow down bone loss with exercise

Exercise puts strain on the bones that stimulates deposition of calcium and activates bone-forming cells. A physical therapist helps patients work on exercise routines that help strengthen the bones based on the patient’s existing condition and provides recommendations to increase difficulty or intensity with time. 

Physical therapists often recommend the following exercises for osteoporosis patients:

• Resistance exercises. These include weightlifting, balance exercises, or using exercise bands.
• Weight-bearing exercises. These include walking, running, dancing, heel drops, stomping, and racquet sports.

Improve posture in daily tasks

Physical therapists can instruct patients on how to walk and get around daily tasks such as getting out of bed or lifting things in a way that their overall posture improves and the chance of getting fractures reduces. If the patient is suffering from pain, or arthritis that makes it hard to exercise, physical therapists can help demonstrate exercise positions that relieve the pain. In cases of injury, they may provide patients with structures such as braces to maintain a healing posture.

Does insurance cover physical therapy for osteoporosis?

Most health insurance companies cover physical therapy if it is deemed medically necessary by a medical care provider. The amount the patient has to pay depends on individual plans. Medicare Plan B also covers medically necessary physical therapy if it has been prescribed by a medical provider such as a doctor, nurse practitioner, clinical nurse specialist, or physician assistant.

Most insurance companies pay for physical therapy for only as long as needed, generally 4 weeks. For example, Aetna generally covers a maximum of 12 sessions in 4 weeks during which the patient is taught how to do the exercise routines on their own.

Lifestyle changes that can prevent osteoporosis

Osteoporosis can be prevented to an extent by taking care of bone health. As we age, it is natural to lose more bone material than we gain. But we can take precautions to keep our bones as strong as possible.

• Getting enough calcium and vitamin D. Eating a well-balanced diet with sufficient calcium and vitamin D provides the body with enough resources to make more bone material. If you do not get enough calcium and vitamin D through food, talk to your doctor about using supplements. In general, for people with post-menopausal osteoporosis, a daily consumption of 1,200 mg of calcium and 800 IU of vitamin D is recommended.
• Reducing alcohol use. Excess long-term alcohol consumption can negatively impact bone growth and remodeling. Limiting or avoiding alcohol use can help prevent osteoporosis.
• Avoiding tobacco products. Nicotine from tobacco products prevents the body from producing bone-making cells which results in poor bone regeneration. Nicotine also reduces how much calcium the body absorbs from the diet. Avoiding products containing nicotine can help keep bones strong for longer.
• Getting daily exercise. Regular weight-bearing exercises and strength training can keep bones and muscles strong for longer.