Learn about Osteoporosis, what treatments exist and get helpful tips to help form your musculoskeletal pain co-management plan

painHEALTH Osteoporosis

Osteoporosis is a condition that affects the strength and quality of bones causing weakness in the skeleton. Osteopenia is a milder form of osteoporosis where the extent of bone fragility is less than osteoporosis. It has been estimated that 66% of Australians aged over 50 have Osteoporosis or Osteopenia.

Osteoporosis is not an inevitable part of ageing; it can be treated and prevented! Osteoporosis affects 13% of women aged 50-69 years and 43% of women aged 70 years and older1. However, it may also occur in men and younger people (e.g. female distance athletes and people with medical conditions). The most common outcome of osteoporosis is a bone break or “fracture”. A fracture (broken bone) usually occurs from a fall or simple impact. Most often this affects the hip, pelvis, spine, rib, or arm and wrist. Once you have had one fracture, the risk of sustaining more fractures increases. So that’s why preventive strategies become very important. Many people experience pain and difficulty doing everyday life activities like work and recreation (ongoing disability) after they fracture a hip or have a spine fracture. The good news is that you can get help.

Osteoporosis is usually managed with a combination of medication, exercise and lifestyle modifications, including focusing on optimal nutrition.

What can I do for my Osteoporosis?

There is a lot you can do to manage your Osteoporosis and reduce the risk of fractures. Such as:

  • weight bearing exercise including Tai Chi, (e.g. walking (including power walking, pole walking), lifting weights under the direction of your health professional, dancing)
  • adopt a diet rich in calcium and vitamin D (to help absorb calcium)
  • maintain a healthy lifestyle by keeping physically active (e.g. take a daily walk with your dog or partner or a friend)
  • avoid smoking and excess alcohol (> 2 standard drink/day) or caffeine (>5/6 cups/day)
  • participate in balance training if you feel unsteady or fall over often
  • have your vision checked

Your health professional team can advise you on the most appropriate exercise and diet choices to improve your bone health. For further information about recommended intake of calcium, Vitamin D and exercise, refer to the Osteoporosis Australia website. To calculate your calcium intake, you could also try the new International Osteoporosis Foundation App.

What about pain and Osteoporosis?

Many people experience persistent pain after a spinal fracture: usually neck pain, mid-back pain, and lower back pain. It is important to talk to your health professional team about your pain to make sure you are getting the best advice and treatment. The principles of managing pain in osteoporosis are the same as those described throughout our pain management modules. This is usually not just one thing, but what you as a whole person, might need to better treat your pain and stay active. You may also need more specific exercise and posture training, supports or other interventions to help manage your pain. For example, new exercise guidelines for people who have sustained osteoporotic spinal fractures have recently been released2,3. You can ask your physiotherapist about these guidelines and they can advise on exercises suitable for your situation. For general guidance about exercise and osteoporosis, see the Too Fit to Fracture recommendations from Osteoporosis Canada.

Vertebroplasty is a procedure that has been used to treat painful spinal fracture due to osteoporosis. The procedure involves injecting medical-grade cement into a fractured vertebra through a needle. The cement hardens in the bone space to stabilize the fracture site. Recent scientific trials, and a Cochrane Review have concluded that available evidence does not support the use of this procedure for reducing pain or disability or improving quality of life 4. Importantly, serious adverse events have been reported. If you are considering this procedure, it is critical that you discuss this current evidence with your doctors.

Want further information?

For more information about Osteoporosis and and to access community support groups, visit Osteoporosis Australia and the Cochrane Summaries. The Primary Health Network in your area and your state/territory Council of the Ageing (COTA) may also have further information about community-based programmes for osteoporosis.

To check your risk of osteoporosis visit the Osteoporosis Australia Risk Factors website. Alternatively, if you wish to contact a Health Professional, we recommend you seek further assistance.

Movement with pain

Pacing and goal settings

Approaching Pain

Chronic and Non-Cancer pain management plan

Exercise | Prevent Osteoporosis

Calcium | Prevent Osteoporosis

Vitamin D | Prevent Osteoporosis

Medications for Osteoporosis

  1. Watts JJ, Abimanyi-Ochom J, Sanders KM. Osteoporosis costing all Australians. A new burden of disease analysis 2012-2022. Sydney: Osteoporosis Australia; 2013. [PDF]
  2. Giangregorio LM, McGill S, Wark JD, et al. Too Fit To Fracture: outcomes of a Delphi consensus process on physical activity and exercise recommendations for adults with osteoporosis with or without vertebral fractures. Osteoporos Int 2015;26:891-910. [PubMed]
  3. Giangregorio LM, Papaioannou A, Macintyre NJ, et al. Too Fit To Fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporos Int 2014;25:821-35. [PubMed]
  4. Buchbinder R, Golmohammadi K, Johnston RV, et al. Percutaneous vertebroplasty for osteoporotic vertebral compression fracture. Cochrane Database of Systematic Reviews 2015. [PubMed]

This module has been developed by Assoc Prof. Andrew Briggs, BSc(Phty)Hons, PhD, Senior Research Fellow in the School of Physiotherapy and Exercise Science, Curtin University, WA; Senior Advisor, Arthritis and Osteoporosis Victoria; and Clinical Advisor, Victorian WorkSafe Authority.