Osteoporosis

Physiotherapy and hydrotherapy for osteoporosis

Physiotherapists can help people with osteoporosis to reduce pain and improve mobility, improve posture and prevent falling and fractures. People receive physiotherapy after spinal, hip and wrist fractures and some people we talked with had physiotherapy after spinal surgery to help them recover strength and movement. Physiotherapy can be provided as an inpatient and outpatient. Hydrotherapy (gentle exercise in warm water), was received by several people afflicted with spinal fractures to help relax their muscles.
 
A maximum number of sessions are allowed under the NHS but most of the people we talked to did not comment on this issue and appeared to be satisfied with the amount and quality of the physiotherapy received. A few people would have preferred more physiotherapy sessions, especially when they could not afford to pay for it privately.

Physiotherapists were often described as ‘good’, ‘helpful’ and ‘encouraging’. Similarly, waiting lists was an issue that few people remarked about maybe because many have had physiotherapy and hydrotherapy as inpatients or they received it following a fracture. Several of the people we talked to required more regular physiotherapy sessions to help them cope with pain or immobility provoked by osteoporosis and/or other conditions such as arthritis or hemiplegia.
After their allocated physiotherapy sessions are over, people are expected to continue at home with the exercise routine learnt at hospital.
But not everyone who was sent home with a booklet of exercises managed to do them regularly. The one to one interaction with the physiotherapist was an important motivating and reassuring factor, especially for people who experienced pain on an ongoing basis. Sarah said that she is ‘lazy’ but when she does her exercises she still experiences pain. Many people explained that after a fracture they lost confidence and were fearful of falling and breaking another bone or doing a bad movement and going into spasm (see also Feelings and thoughts about osteoporosis).
A few people we talked to paid to see a private physiotherapist. People’s experience of private physiotherapy varied. Jane said that during her pregnancy before she was diagnosed she spent ‘an absolute fortune’ on private sessions because she couldn’t understand why she was having so much backache.
A few people thought that physiotherapy should be a long-term rather than a short-term treatment. They argued that in some cases help may be needed not just to help people to deal with the after effects of a fracture but to restore confidence as well.
There may be times when someone with osteoporosis is advised not to have physiotherapy due to the fragility of the osteoporotic area or severity of pain, so it is always a good idea to tell your GP that you are having private physiotherapy or any other treatment such as osteopathy. The best person to seek advice from is the GP or the physiotherapist. But an individual’s knowledge of his/her own body should also help to make that decision. Several people were referred by their GP to see a physiotherapist that specialised in spinal injuries.
In several cases very gentle and minimal exercises were recommended. Heavy manual work can sometimes be seen as replacing the need for physiotherapy but it can also aggravate the level of pain experienced by the person.

Sarah describes her last physiotherapy as a more vigorous and painful session and she is unsure if it is the physiotherapy or the length of time that has passed since her fracture that have improved her symptoms.

Having to travel to have physiotherapy or to go to a rehabilitation centre is not always easy particularly if you are disabled and/or unable to take public transport. Several of the people we talked to commented on how uncomfortable it was for them to travel on public transport. Jane said that being in pain during the journey to the hospital diminished the benefits of physiotherapy. Several would find it useful to have facilities nearer to home which they could walk to (see summary Osteoporosis, mobility, driving and transport).
Elderly patients are sometimes confused or forget relevant information regarding their treatment. Beryl is seventy-two years old and has restricted neck movement and following an x-ray her GP decided she would benefit from physiotherapy. But she forgot about the x-ray and therefore her session was postponed until the physiotherapist was able to confirm this information.
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Exercise classes by physiotherapists
One thing that some of those we talked to would welcome is exercise classes designed/guided by physiotherapists. Some people would like more information and guidance regarding weight bearing exercises or any other type of exercise that is good for osteoporotic bones. Several said that ordinary gyms do not have the proper expertise to help them and so they are wary of doing weight bearing exercises in case they fracture (see also Osteoporosis and exercise).

Irene took part in a twelve week exercise programme specially designed by a physiotherapist for people with osteoporosis. The programmes aim was to measure the benefits of exercise for people with the condition. Her local hospital continues running this programme. According to Irene the exercise programme for people with the condition has expanded beyond the hospital premises as leisure centres in the city also became interested in implementing such a programme. Sports staff are trained by hospital physiotherapists.

Hydrotherapy
A few people had hydrotherapy. Some had it when they were staying in hospital. Cressida, who over the years had many spells in hospital, said that physiotherapy and hydrotherapy was offered ‘automatically’. One support group organised its own sessions and regularly hired the pool at the local hospital under the supervision of a physiotherapist. Several people said that the experience of weightlessness allowed them to be pain-free and they found it very relaxing. Many people also see swimming as a good alternative and either swim lengths or do gentle exercises (see also Osteoporosis and exercise).
Physical activities and ‘weight bearing exercises’ such as walking, jogging, climbing stairs and push-ups, which improve bone strength are beneficial for people with osteoporosis. 

See resources for more information.



 

Last reviewed April 2011
Last updated April 2011

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