Osteoporosis physiotherapy focuses on reducing fracture risk, improving bone strength through safe loading, and building balance and muscle strength so falls are less likely. The condition itself—Osteoporosis—means bones become less dense and more fragile, so the key principle in physio is “strong but safe loading” rather than rest or avoidance.

Main goals of physiotherapy

1. Improve bone loading (to slow bone loss)
2. Strengthen muscles supporting the spine and hips
3. Improve balance and coordination (fall prevention)
4. Correct posture and reduce spinal fracture risk
5. Teach safe movement strategies for daily life

Nutrition plays a major role in preventing and managing Osteoporosis. While diet alone cannot cure osteoporosis, it helps maintain bone strength, reduce bone loss, and lower the risk of fractures.

Key nutrients for bone health

Calcium

• Adults generally need about 1,000 mg/day, increasing to 1,200 mg/day for most women over 50 and men over 70.
• Good sources include:
  • Dairy products (milk, yogurt, cheese)
  • Calcium-fortified plant milks
  • Calcium-set tofu
  • Canned salmon or sardines with bones
  • Leafy greens such as kale and bok choy (spinach contains calcium but is less well absorbed)

Vitamin D

• Vitamin D helps your body absorb calcium.
• Sources include:
  • Sunlight exposure (varies by season, location, skin tone, and sunscreen use)
  • Fatty fish like salmon, trout, and mackerel
  • Fortified milk and cereals
  • Supplements, if recommended by a healthcare professional

Protein

• Adequate protein supports bone and muscle health, which also helps prevent falls.
• Good sources include:
  • Fish
  • Poultry
  • Eggs
  • Beans and lentils
  • Dairy products
  • Soy foods
  • Lean meats

There is also evidence that some mental health conditions and treatments can affect bone health:

• People with depression may have an increased risk of developing osteoporosis due to a combination of biological factors and lifestyle changes.
• Some medications, including certain antidepressants (especially some Selective serotonin reuptake inhibitors), have been associated with lower bone density or a higher risk of fractures in some studies. This doesn’t mean they should be stopped, but it’s worth discussing risks and benefits with a healthcare provider.

Supporting both bone and mental health

Many strategies benefit both:

• Regular weight-bearing and strength-training exercise, as appropriate for your health.
• Adequate calcium and vitamin D intake.
• Good sleep habits.
• Staying socially connected.
• Learning safe movement techniques to reduce fear of falling.
• Seeking treatment for anxiety or depression if symptoms develop.

Osteoporosis and mental health are closely connected. Living with osteoporosis can affect emotional well-being, and mental health can also influence bone health and recovery.

Here are some of the main connections:

• Anxiety and fear of falling: After an osteoporosis diagnosis or a fracture, many people become worried about falling or breaking another bone. This fear can lead them to avoid physical activity, which may actually weaken muscles and bones over time.
• Depression: Chronic pain, reduced mobility, changes in independence, or concerns about aging can contribute to depression. Depression may also make it harder to stay active, eat well, or take medications consistently.
• Social isolation: If someone limits activities because of pain or fear of fractures, they may become isolated, which can negatively affect mood and quality of life.
• Stress: Long-term stress can make it harder to maintain healthy habits such as exercising, sleeping well, and eating a balanced diet—all of which are important for bone health.