Treatment for osteoporosis typically involves lifestyle changes to diet and exercise, as well as medication that slows down the rate of bone breaking down (called bone resorption), increases bone formation, or both.

If a patient experiences a painful vertebral compression fracture from osteoporosis, they may be a candidate for surgeries such as kyphoplasty or vertebroplasty.

This page provides information on diet, exercise, and fall prevention that can help reduce the risk of complication from osteoporosis.

Diet and Nutrition

It is important for patients with osteoporosis to receive adequate calcium and vitamin D through a healthy, balanced diet. A doctor, nutritionist, or other health professional can educate patients on the amounts of calcium and vitamin D they should receive each day, as well as easy ways to work these nutrients into a daily diet.

Calcium

Most patients are advised to initially increase calcium intake through their diet. Dietary calcium can be found in dairy products such as milk, cheeses, and yogurt. If a patient has restrictions to dairy, a supplement is typically recommended. Other sources of dietary calcium include dark leafy greens (such as spinach, broccoli, and kale) and calcium-fortified foods and juices.

See Sources of Calcium in Food

It is not advised to take more calcium than is recommended, either through diet or supplements. Excess calcium may increase the risk for other health problems, such as kidney stones, cardiovascular disease, or stroke. 1 Cosman F, de Beur SJ, LeBoff MS. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014;25(10):2359–2381. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176573/. doi:10.1007/s00198-014-2794-2.

Vitamin D

Adequate vitamin D intake is necessary for the body to absorb calcium. Because high levels of vitamin D are not found in many foods, supplements may be advised. The amount of supplemental vitamin D recommended may vary from one osteoporosis patient to another depending on their dietary needs.

It is not uncommon for a doctor to advise vitamin D intake higher than the daily recommended amount of 15 mcg (600 IU) to 20 mcg (800 IU). 1 Cosman F, de Beur SJ, LeBoff MS. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014;25(10):2359–2381. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176573/. doi:10.1007/s00198-014-2794-2. Taking up to 100 mcg (or 4000 IU) per day is considered the safe upper limit. 2 Vitamin D Fact Sheet for Health Professionals. National Institutes of Health. Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Updated November 9, 2018. Accessed April 2019.

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Exercise and Fitness

Regular exercise is important to help maintain bone density and provide overall muscle strengthening that can reduce the risk of falls. Weight-bearing exercise and muscle strengthening are especially important for bone health and fall prevention.

See Exercise and Back Pain

Examples of exercises that may be recommended for osteoporosis patients include:

  • Exercise walking
  • Jogging
  • Going on a short, easy hike
  • Climbing stairs
  • Tai Chi
  • Yoga
  • Pilates
  • Tennis, if able
  • Dancing, if able

Patients with osteoporosis should talk with their doctor before beginning a new exercise program to ensure exercises are safe. If a person already has a fracture, exercise options are usually limited in order to prevent further injury.

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Reducing the Risk of Falling

Because osteoporosis causes bones to be thinner and weaker, it is important to reduce the risk of high-impact injuries as much as possible, including falls. There are a few methods that can help reduce the risk of falling:

  • Exercise to strengthen muscles and improve balance and coordination.
  • Make modifications to home safety, such as by installing a handrail in the shower, using a shower stool, or relocating everyday items to the ground floor to reduce the use of stairs.
  • Correct visual impairments that may cause a person to trip and fall.

Additionally, a patient with osteoporosis may work with an occupational therapist for more individualized advice for fall prevention.

Dr. Scott Curtis is a sports medicine specialist at Princeton Spine and Joint Center, where he serves as the center’s Director of Sports Medicine, specializing in sports-related injuries and general musculoskeletal care.

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