The Emotional Weight of Osteoporosis

For many, an osteoporosis diagnosis comes as an unwelcome surprise, and its implications can leave people reeling, at least short-term. Example patient reactions Joanne has heard over the years: "I was already feeling a little down... you're getting older, your body is changing. It felt like a downward spiral. I left the doctor's office and just cried." / "I feel fragile now... like I'm already broken." / "I'm worried, scared, and completely overwhelmed." / "I'm so afraid of breaking a bone that I've stopped doing everything." Joanne recalls her own disbelief when diagnosed almost twenty years ago: "How could this have happened to me? I've been exercising, eating well..."

What must be avoided is letting worry and anxiety lead to "fear-avoidance behavior" — a psychological response where people avoid activities, movements, or situations for fear of pain, injury, or worsening their condition. This can develop after pain/injury or simply after a diagnosis perceived as risky, and the resulting inactivity often causes muscle deconditioning and decreased flexibility — ironically becoming the cause of the very fracture that was feared. The worst thing to do is nothing.

Dispelling Fears and Misunderstandings — three common fears people experience with an osteoporosis diagnosis:

• Fear of Falling and Fractures: research is clear that adults who exercise regularly (including walking) are far less likely to fall and experience fractures; a review of 16 meta-analyses showed consistent evidence that exercise significantly reduces fractures in community-dwelling adults over 60.
• Fear of Stooped Posture: abundant evidence shows back-strengthening exercises improve posture, reduce hyperkyphosis, and prevent the vertebral fractures that often lead to "stooped" posture.
• Fear of Loss of Independence: many research studies demonstrate the correlation between maintaining even modest physical fitness and remaining safely in one's home.

When Osteoporosis Makes You Feel Old. Staying active, especially in joyful ways, is one of the most important habits to nurture — engaging in social activities, hobbies, or new learning is fun and enriching. Joanne rejects negative aging stereotypes and posts uplifting counter-examples to a personal "vision board," such as a woman who took up track and field in her seventies because she was "bored" — while having osteoporosis. Another example: watching "The Pacemakers" dance group perform at a Physical Therapy convention in Boston after a lecture on aging well. Osteoporosis may be part of aging, but it doesn't have to define how we feel about ourselves — proactive, safe, consistent exercise, an overall healthy lifestyle (imperfection included), and a positive mindset are key.

References

1. Stubbs B, et al. What Works to Prevent Falls in Community-dwelling Older Adults? Umbrella Review of Meta-analyses of Randomized Controlled Trials. Physical Therapy 2015 Aug;95(8):1095-1110.
2. Katzman WB, et al. Targeted Spine Strengthening Exercise and Posture Training Program to Reduce Hyperkyphosis in Older Adults: Results from the Study of Hyperkyphosis, Exercise, and Function (SHEAF) Randomized Controlled Trial. Osteoporosis International 2017;28(10):2831-2841.
3. Liu CJ, et al. Progressive Resistance Strength Training for Improving Physical Function in Older Adults. Cochrane Database System Rev. 2009 July 8;(3):CD002759.
4. Lousuebsakul-Matthews V, et al. Non-sedentary Lifestyle Can Reduce Hip Fracture Risk Among Older Caucasian Adults: The Adventist Health Study-2. British Medical Journal 2015;8(3):220-229.
5. Grierson, B. What Makes Olga Run? Henry Holt and Company, LLC, NY, 2014.