Osteoporosis and Your Bone Health: What You Need to Know

Osteoporosis is common, often silent and is widely misunderstood. A great many people who are told their bones are thinning, conclude that they are now fragile and have to stop doing things, which is almost always the wrong response.

The modern evidence for osteoporosis is far more encouraging: the right kind of activity strengthens bone, steadies you on your feet and lowers the chance of the fractures that matter.

As a chiropractor, I do not treat osteoporosis. It is a medical condition, diagnosed and managed by your GP and specialist. But two questions come up in my clinic often. The first is how to keep bones strong as the years go by. The second is whether it is safe to see a chiropractor for treatment all for other musculoskeletal conditions following your osteoporosis diagnosis. This page answers both those questions.

What is osteoporosis and how is it diagnosed?

Bone is living tissue that is constantly broken down and rebuilt. You build to a peak of bone mass in your late twenties and hold that steady for a time, then you lose a little each year, with a faster drop in women around the menopause as oestrogen falls. Osteoporosis is the point at which bone density and quality have declined enough that bones break more easily than they should, sometimes from a minor knock or a fall from a standing height.

Osteoporosis is usually measured on a DEXA (or DXA) bone-density scan, with a T-score of minus 2.5 or lower defining osteoporosis and the milder range above it called osteopenia. The important feature of this condition is that it is silent, with no symptoms at all until a bone breaks. That is why doctors assess fracture risk using tools such as FRAX or QFracture, typically in women from sixty-five and men from seventy-five, or younger where there are risk factors.[3] Osteoporosis causes around half a million fractures a year in the United Kingdom.[3]

 

What affects your bone health

 

Some of what governs bone strength is outside your control and some is very much within it. The factors you cannot change include getting older, being female, going through an early menopause and a family history of osteoporosis or a poor diet. Long-term use of steroid medication and certain medical conditions also raise the risk, which is one reason to keep your GP informed.

The factors you can influence are the very encouraging part of the story: being physically active, eating nutritionally dense food rich in Vitamin D, calcium and protein, not smoking and keeping alcohol moderate. These habits  all support bone health. Conversely, inactivity, being significantly underweight, heavy drinking and smoking all work against your bone health.[3][5] Bone responds to being used, which is precisely why staying active matters so much.

Keeping your bones strong

 

The evidence-based approach to bone health was set out in the UK consensus statement as strong, steady and straight.[1]

Strong means loading the skeleton through weight-bearing activity, resistance or strength work and some impact, because bone is laid down in response to being worked.

Steady means the balance and strength training that reduces the risk of falls, since most fractures follow a fall.

Straight means looking after posture, particularly the muscles that support the spine.

Perhaps the most reassuring finding of recent years is that even people with low bone mass can, under proper supervision and a gradual build up, undertake progressive resistance training safely and see their bone density and strength improve.[2]

Alongside activity, aim for enough calcium in the diet and consider a daily vitamin D supplement, especially through the autumn and winter, as national guidance advises.[5]

The single most important message is to keep going: the emphasis should be on continuing to be active, not on stopping.

a lady cycling on a busy street because it is important to maintain exercise for good bone health and to try to prevent osteoporosis

Is it safe to see a chiropractor if I have osteoporosis?

It can be, provided the approach is adapted to you. I do not treat osteoporosis itself, this is managed by your GP and or your specialist through monitoring and specific medication where appropriate.

What I can do is help with a musculoskeletal problem while taking full account of your bone health. The single most important thing you can do is tell me at your first visit, if you have been diagnosed with osteoporosis, osteopenia or if you think you may be at risk. This changes how I approach your treatment plan. This is also the reason why I take a full and detailed medical history at your first full chiropractic appointment and choosing chiropractic techniques to suit your bones.

In this case I favour gentle, low-force methods and I would not use forceful high-velocity thrust techniques on a spine where there could be a risk of loss of bone density. I am also cautious with loaded or repeated forward-bending of the spine, which the national consensus advises treating with care in people with osteoporosis.[1] If at any point I have a concern or if I judge that hands-on treatment is not suitable for you, I will say so and refer you back to your GP.

You can read more about how I assess suitability on my page about whether it is safe to see a chiropractor.

Headshot of Leslie Budzynski DC, BCA registered Bournemouth Chiropractor at Bournemouth Chiropractic

Related guides

These pages cover the areas most closely connected to bone health and staying independent:

If osteoporosis getting in the way of things you love doing, come and talk it through. I offer a free 15-minute consultation, you can come in for a short no-obligation chat with no examination or treatment.

Book a free consultation

Or call for a chat on 01202 937568

Red flags

A few situations need a doctor rather than any hands-on therapy. If you break a bone from a minor fall or a knock that would not normally cause a fracture, that is a fragility fracture and should prompt a medical assessment of your bone health, including a fracture-risk assessment or a DEXA scan.

Sudden new back pain, particularly if it comes with a loss of height or a developing stoop, can be a vertebral fracture and should be checked by your GP, especially if you already know you have osteoporosis. It is worth knowing that most spinal fractures of this kind do not come from a fall at all, but happen during ordinary activity or even spontaneously.[3] In these situations your GP is your first port of call.

Your first visit to Bournemouth Chiropractic

Your first appointment begins with a full and very detailed medical history and this is the moment we discuss any bone-health issues, the medicines you take and any previous fractures. Followed by an examination and an honest discussion of what I can and cannot help together with and a treatment plan adapted to your bones. You can read more about what to expect at your first visit before you come in. If I can not help you or if it is not safe to do so, I refer you back to your GP.

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Frequently Asked Questions

No. Osteoporosis is a medical condition managed by your GP and specialist, usually through bone-density monitoring and where appropriate, medication. A chiropractor does not treat osteoporosis. What I can do is help with a musculoskeletal problem while adapting my approach to your bone health and offer advice on bone-healthy activity.

It can be safe to have chiropractic treatment with osteoporosis, with the right precautions. Techniques are chosen to suit your bones, favouring gentle, low-force methods and some techniques are modified or will be avoided altogether. This is why it is so important to tell me about any diagnosis of osteoporosis or osteopenia at your first visit, so I can work safely or refer you on to your GP or a specialist.

Yes. Research shows that even people with low bone mass can improve bone density and strength through appropriate, progressive and supervised exercise, rather than needing to avoid activity. The key words are “supervised” and “gradual”: the aim is to build up sensibly, not to leap into heavy loading unguided.

A combination, summed up by the phrase ‘strong, steady and straight’: weight-bearing and resistance work to load the bones, balance training to prevent falls and posture work for the spinal muscles. Building up gradually, ideally with guidance at first, is safer and more effective than doing too much too soon.

Speak to your GP, who can assess your fracture risk using a tool such as FRAX or QFracture and where appropriate, arrange a DXA bone-density scan. It is particularly worth asking if you have broken a bone easily, lost height or have risk factors such as a family history or long-term steroid use.

Questions about osteoporosis and your bones?

If you have osteoporosis and want to know whether chiropractic care is right for you, come and talk it through. If you would like to ask questions before committing to anything, I offer a free 15-minute consultation. This is a short, no-obligation chat to talk through what is going on and whether I am the right person to help you. It is not an examination or treatment. A first appointment is different: it includes a full history, a physical examination and treatment. Whichever you choose, you will leave knowing more than when you arrived. I see patients from all across Bournemouth and you do not need a GP referral.

References

[1] Brooke-Wavell K, Skelton DA, Barker KL, et al. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. British Journal of Sports Medicine. 2022;56(15):837-846. doi:10.1136/bjsports-2021-104634

[2] Watson SL, Weeks BK, Weis LJ, et al. High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: the LIFTMOR randomized controlled trial. Journal of Bone and Mineral Research. 2018;33(2):211-220. doi:10.1002/jbmr.3284

[3] National Institute for Health and Care Excellence. Osteoporosis: assessing the risk of fragility fracture. Clinical guideline CG146, 2012 (updated 2017). Available at: nice.org.uk/guidance/cg146

[4] Royal Osteoporosis Society. Strong, Steady and Straight: physical activity and exercise for osteoporosis. Available at: theros.org.uk

[5] Scientific Advisory Committee on Nutrition. Vitamin D and Health, 2016; and Public Health England vitamin D recommendation. Available at: gov.uk (search “vitamin D SACN”)

Medical Disclaimer: The information on this website is for general informational purposes only and does not constitute medical advice, nor is it a substitute for diagnosis, treatment, or guidance from a qualified healthcare practitioner. If you have any health concern, please consult your GP or another appropriately qualified clinician. Chiropractic treatment isn’t suitable for everyone. Suitability is assessed at your initial consultation, with referral to another healthcare professional made where appropriate. Treatment outcomes vary between individuals, and no guarantee of results is made or implied.

Practitioner: Leslie Budzynski D.C. | Doctor of Chiropractic | GCC registration: 00043 | BCA membership number: 0072