Article by Shane Armfield

Osteoporosis: A Physiotherapist’s Insight

What is Osteoporosis?

Osteoporosis thins and weakens bones, making them prone to fractures. This condition occurs when bones lose more calcium than they absorb, leading to reduced bone density and a honeycombed structure.

The Root Causes of Osteoporosis

Disrupted bone renewal processes often lead to osteoporosis. As people age, their ability to replace old bone with new diminishes. Factors like reduced physical activity, menopause, chronic diseases, and lifestyle choices such as smoking and poor diet significantly contribute.

Osteoporosis Osteopenia physiotherapy treatment
Physiotherapy Treatment To Assist Osteoporosis And Osteopenia

Key Risk Factors

Several factors impede the development of strong bones, including:

  • Insufficient weight-bearing exercise
  • Menopause
  • Chronic conditions like rheumatoid arthritis and coeliac disease
  • Hormonal imbalances
  • Lifestyle choices such as smoking and excessive alcohol consumption
  • Dietary deficits in calcium and vitamin D

Physical activities, especially weight-bearing and resistance exercises, play a crucial role in maintaining bone health at all ages.

Recognising Symptoms of Osteoporosis

Osteoporosis typically remains undetected until frequent fractures occur. Regular check-ups and discussions about bone health with your GP are essential for early detection.

Diagnosing Osteoporosis

A bone densitometry scan, comparing bone density against age-matched norms, usually diagnoses osteoporosis.

Osteopenia: A Warning Before Osteoporosis

Osteopenia, a condition with lower-than-normal bone mineral density, often precedes osteoporosis. It marks a critical stage for taking action to prevent further bone density loss.

Identifying Osteopenia

Regular bone density screenings are vital, as osteopenia usually shows no symptoms. Age, menopause, certain medications, and lifestyle choices are common risk factors.

Managing Osteopenia: Physiotherapists’ Role

Physiotherapists manage osteopenia through:

  • Exercise programmes focused on weight-bearing and muscle-strengthening activities
  • Dietary guidance rich in calcium and vitamin D
  • Support for lifestyle modifications like reducing alcohol and quitting smoking

The Necessity of Early Intervention

Early action against osteopenia can significantly slow or prevent its progression to osteoporosis.

Treating Osteoporosis

Treatment strategies include lifestyle and dietary changes to boost calcium and vitamin D intake. Medications like bisphosphonates, denosumab, and hormone replacement therapy often supplement these efforts.

Exercise: A Pillar in Managing Osteoporosis

Exercise plays a crucial role in preventing falls, especially for those with osteoporosis. It enhances quality of life by improving physical function, reducing pain, and boosting muscle strength and balance. Exercise programs plus moderate to vigorous walking has been shown to lower the risk of hip fractures.

For those with osteoporosis or at risk of it, resistance training and weight-bearing aerobic exercises are recommended. Individuals who have had vertebral fractures should engage in exercises to enhance core stability and compensate for weakness or postural issues. Those at risk of falls should consider balance-focused exercises like tai chi or balance and gait training. (Pinheiro MB and Naganathan V 2024)

Preventing Osteoporosis: A Young Start

Beginning prevention efforts early in life is the most effective strategy. Increasing bone mass during youth can delay osteoporosis onset and reduce fracture risks.

Conclusion: Proactively Safeguarding Bone Health

Both osteopenia and osteoporosis demand proactive management. Engaging in regular exercise, maintaining a balanced diet, and making lifestyle changes are key to their prevention and treatment. For personalised advice and a tailored treatment plan, consulting a physiotherapist is essential. Taking active steps today ensures stronger bones and a healthier future.


Pinheiro, M. B., & Naganathan, V. (2024). Appraisal of clinical practice guideline: Clinical practice guideline for management of osteoporosis and fracture prevention in Canada: 2023 update. Journal of Physiotherapy. https://doi.org/10.1016/j.jphys.2024.05.002

Moayyeri, A. (2008). The association between physical activity and osteoporotic fractures: A review of the evidence and implications for future research. Annals of Epidemiology, 18(11), 827-835. https://doi.org/10.1016/j.annepidem.2008.08.007

Effective Management of Upper Back Pain and Injury

Physiotherapy Insights


Upper back pain and injury, predominantly affecting the thoracic spine, are prevalent issues causing significant discomfort and impacting daily activities. This article, infused with physiotherapy insights, aims to enlighten the general public about the causes, symptoms, and treatment options for upper back pain.

managing upper back pain
Managing Upper Back Pain

Managing Upper Back Pain

Upper back pain stems from various sources, including thoracic spine conditions, joint injuries, muscle strains, nerve irritations, and systemic diseases. Recognising these causes is vital for appropriate treatment.

Common Causes of Upper Back Pain

  • Joint Injuries: Facet joint pain is a frequent issue.
  • Muscle-Related Injuries: This includes back muscle pain, side strains, whiplash, muscle cramps, and DOMS (Delayed Onset Muscle Soreness).
  • Bone-Related Injuries: Conditions like Scheuermann's Disease, Scoliosis, and others.
  • Disc-Related Injuries: Including bulging, slipped, or herniated discs.
  • Nerve-Related Pain: Such as thoracic outlet syndrome and pinched nerves.
  • Systemic Diseases: These include Ankylosing Spondylitis, Fibromyalgia, and arthritis types.

Posture and Upper Back Pain

Poor posture is a significant contributor to upper back pain. Understanding and correcting sitting, standing, and sleeping postures can prevent and alleviate pain.

Physiotherapy Perspective

A physiotherapist's approach to treating upper back pain involves assessing the individual's condition and tailoring a treatment plan. This may include exercises, manual therapy, and advice on posture correction.

Latest Research and Techniques

Recent advancements in physiotherapy have introduced innovative methods for treating upper back pain. These include targeted exercises, advanced manual techniques, and utilisation of posture-improving products.

What to Do?

If you experience upper back pain, it's crucial to consult a physiotherapist for a professional assessment and personalised treatment plan.


Upper back pain, though common, can be effectively managed with the right approach. Understanding its causes and seeking professional physiotherapy advice are key steps towards recovery.

For more information, explore articles at PhysioWorks.

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Joint Injuries

Muscle-Related Injuries

Bone-Related Injuries

Disc-Related Injuries

Nerve-Related / Referred Pain

Systemic Diseases

Posture Information

Sitting Posture

Standing Posture

Sleeping Posture

Posture Products

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