Complementary and
alternative therapies
and osteoporosis
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What is osteoporosis?
Osteoporosis occurs when the struts
which make up the mesh-like structure
within bones become thin causing them
to become fragile and break easily
following a minor bump or fall. These
broken bones are often referred to as
fragility fractures. The terms ‘fracture’
and ‘broken bone’ mean the same thing.
Although fractures can occur in different
parts of the body, the wrists, hips and
spine are most commonly affected. It is
these broken bones or fractures which
can lead to the pain associated with
osteoporosis. Spinal fractures can also
cause loss of height and curvature of the
spine.
Strong
dense
bone
Fragile
osteoporotic
bone
This leaflet covers specific information on
complementary and alternative therapies. If
you would like more general information on
osteoporosis, please ask us for a copy of our
publication All about Osteoporosis.
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Complementary and
alternative therapies
and osteoporosis
Complementarytherapyisanareaofhealth
carethatisgrowinginpopularityandmany
peoplefindsuchtherapiesbeneficialin
offeringrelieffrompainandimprovingtheir
qualityoflife.
Atpresentthereisnoevidencethat
complementarytherapiesincreasebone
densityorreducetheriskofbrokenbones.
Mostofthesetherapieshavenotundergone
thevigoroustestingandtrialsexpectedof
conventionalmedicinesoyouareunlikely
tofindproofthattheyworktoreduce
pain.However,for
thosepeoplewho
havesustained
fractures as a result
of osteoporosis,
thisapproachmay
offeradditionalrelief
frompainandother
symptoms.
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Complementarytherapyisincreasinglybeing
usedalongsideconventionalmedicineas
partofaperson’spainmanagementplanand
manyhospitalsrunpainclinicswhichoffer
awiderangeoftreatmentoptionsincluding
complementaryapproaches.Inallsituations,
itisimportantthatthetherapistismadefully
awareofanindividual’smedicalhistorybefore
commencingtreatmentanditisimportant
thatyouexplainthatyouhaveosteoporosis
and may be at a higher risk of breaking bones.
Some of the most commonly used therapies
are described on the following pages. A list of
useful organisations and their contact details is
included at the back of this leaflet.
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Acupuncture
The word acupuncture comes from the Latin
acus meaning ‘needle’ and punctura meaning
‘to prick’. Certain strategic areas on the body
are pierced with fine needles or stimulated
with massage, heat or electricity, which can
bring relief of symptoms both close to the
needles and in distant parts of the body.
Acupuncture has been found to be helpful
in treating musculoskeletal disorders like
rheumatoid arthritis, chronic pain and many
other conditions. The needles used by
acupuncturists are often disposable and,
if not, should be carefully sterilised before
use to avoid the risk of HIV or hepatitis.
Most people feel no pain with acupuncture,
although some may experience a heavy,
dull, aching sensation. Symptoms may be
relieved immediately or over a period of time.
However, others experience no relief with
this therapy. Acupuncture may, for some
people, relieve the pain associated with
spinal fractures but this may only last while
treatment is undertaken and can reoccur
once treatment has stopped.
The cost of acupuncture and the number of
sessions needed will vary according to the
condition being treated. Your own doctor
may offer acupuncture or may be able to
refer you to a physiotherapist, nurse or other
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health professional who offers this service.
Acupuncture can also be performed by nonmedically qualified acupuncturists and by lay
practitioners.
When choosing an acupuncturist it is
recommended that you find out about the
practitioner’s qualifications and experience,
and to ask whether they are certified with a
recognised body.
A doctor qualified in acupuncture will
be registered with the British Medical
Acupuncture Society, and physiotherapists
with the Acupuncture Association of
Chartered Physiotherapists. The British
Acupuncture Council represent the largest
group of practitioners and hold a nationwide register. At present, the practice of
acupuncture is not statutorily regulated;
however, there are proposals for both
acupuncture and herbal medicine to have
statutory status in the near future.
The National Institute for Health and Clinical
Excellence (NICE), the independent body that
advises NHS doctors on best clinical practice,
has released evidence-based guidelines
regarding the management of persistent,
non-specific low back pain. The guidelines
recommend acupuncture among the first line
treatments for those with back pain that has
lasted more than six weeks.
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Massage therapy
Thepracticeofmassagetherapyisan
ancientformofphysicalmedicineand
continuestobeusedwidelyandinmany
settings.Massagecanhelptoincrease
relaxation,alleviateanxietyandstress
associatedwithillnessandimproves
generalwell-being.
Massageinvolvesthestroking,pressing,
kneadingandwarmingoftheskinand
muscles.Themasseurwillusuallyusebare
handsandmayuseoilstomakeiteasierto
slidetheirhandsacrosstheskin.
Researchstudieshavesofarnotgivena
clearpicturehowmassageworksbutitis
thoughtthatitcanstimulatethebloodand
lymphaticcirculationandhelptoremove
toxinsandwasteproductsfromthebody.
(Thelymphaticsystemdrainswateryfluid
fromtissuesofthebodyandreturnsittothe
blood.)Massagecancontributetotherelief
ofpainthroughthestrokingactionofthe
massageonthenerveendingsintheskin,
>>
Massage can help to
alleviate anxiety and
stress associated
with illness.
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whichmayhelptolessenthesensationof
painduetothereleaseofendorphins–the
body’snaturalpain-reducingchemicals.
There are many different massage techniques.
Some therapies are more rigorous than others
andmaynotbesuitableforthosepeopleat
riskofbrokenbonesduetoosteoporosis.
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Aromatherapy and
aromatherapy massage
Aromatherapyaimstocreateasenseofwellbeingbyusingtheessentialoilsofplants.
Theycanbeinhaledasavapouror,indiluted
form,massagedintotheskin.Essentialoils
havebeenusedmedicinallyforcenturies
andclinicaltrialshaveindicatedeffectiveness
forbowelconditions,woundhealingand
relievinganxiety.Oilswhichareassociated
withhavingapain-relievingeffectinclude
camomile,lavenderandrosemary,while
bergamotandrosecanhelpdepression
andirritabilityalongwithvaporisedessential
oilsoflavender,orange,geranium,lemon
andgrapefruit.
Remember,oilsshouldneverbetaken
internallyorappliedundilutedtotheskin.
Gentlemassagewithdilutedoilscanhelp
easemusclespasmandpain.Aromatherapy
asatreatmentisusuallyarrangedprivately
butsomedoctor’spracticesandhospital
trustsdoreferwithintheNHSsystem.Ifyou
aretakingregularmedication,checkwith
yourdoctorortheAromatherapyCouncil.
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Reflexology
Reflexologyfocusesonthefeetandhasbeen
adoptedfromeasternmedicine.Itworks
onthetheorythatcertainareasonthefeet
correspondtodifferentpartsofthebodyand
thehealthandwell-beingofanindividual
dependsuponfree-flowingenergywithin
thebody.Ifthisflowisimpeded,ill-health
willfollow.Bymassagingthecorresponding
pointsonthefeet,theenergyisallowedto
flowfreelyagain.
Reflexology
canbeusedfor
relaxationthat,in
turn,allowsforthe
uninterruptedflow
ofenergywhich
may,inturn,help
reducepain.
Reflexologymay
alsoincreasebloodandlymphaticcirculation,
helpdigestionandalsotheimmunesystem.
Thefeetaremassaged,usingoilsin
somecases,bythetherapistwho,after
consultationwiththeclient,willconcentrate
ontheappropriateareasofthefeet.
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Ifyouhavehadbrokenbonesinyourfeet
duetoosteoporosis,informthetherapist
accordinglyatthefirstappointmentandthey
willthendecideiftreatmentisappropriate.
Themassageuseddoesnothavetobe
vigorousordeep,andgentlemassagemay
bemorehelpfulinaidingrelaxation.
Homeopathy
Homeopathyisthoughttobeameans
ofstimulatingthebody’sownhealing
mechanism.Itwasestablishedinthelate
18thcenturyandthenamehomeopathyis
derivedfromtheGreekhomoiosmeaning
‘like’andpathosmeaning‘suffering’.Itis
baseduponthetheorythatsubstances
which,inhighdosescauseoverdose,in
smalldoseswillcure.Homeopathyaimsto
stimulateourbody’snaturaldefencesystem.
Itmaybeusefulforbothchronicand
acutepain.
Homeopathyshouldonlybeundertaken
withtheadviceofaqualified,registered
homeopath,particularlyinthecasesof
pregnantwomenandyoungchildren.
Pleaseconsultyourpharmacistbefore
purchasingover-the-counterproducts
andlethim/herknowifyouaretaking
anyprescribedmedicines.
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Herbs such as lemon
balm may have an
anti-spasmodic effect
on the muscles.
Herbal medicine
Herbalmedicineisoneoftheoldestforms
ofmedicine,havingbeenusedinallcultures
andcivilisationsforcenturies.Herbal
preparationsformthebasisformanyofour
moderndrugs:aspirinisbaseduponan
extractofwillow,whichwasusedbythe
AmericanIndiansforthereliefofpain,and
theheartdrugdigoxinisderivedfromextract
offoxglove.
Devil’sclawandwillowbarkmayhave
anti-inflammatoryandpain-relieving
properties,andherbssuchaslemonbalm,
camomile,passionflowerandvalerian
mayhaveananti-spasmodiceffectonthe
muscles.Therearesomeplantsthatshould
beavoidedbecausetheyarepotentially
harmfulsoitisimportanttoseekexpert
help.Medicinalherbalpreparationsshould
be used with care during pregnancy or when
taking other medications and only under the
supervision of a herbalist. Further information
and a list of practitioners can be obtainedfrom
the National Institute of Medical Herbalists.
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Natural progesterone
Themainingredientinnaturalprogesterone
creamcomesfromanextractfromwild
yamsandisclaimedtobesimilartothe
naturalhormone,progesterone,produced
inthebody.Thisisthenmixedwithother
ingredientstomakeitacreamthatcan
berubbedintoskinandabsorbed.There
areclaimsmadethatnaturalprogesterone
creamscanbeusedtohelpwithmenopausal
symptomsandtopreventosteoporosisand
strengthenbones.
Medicalresearchhasshownthatthe
hormoneoestrogen,giventopostmenopausalwomeninhormone
replacementtherapy(HRT),reducesthe
riskofosteoporosisandfracture.However,
givenonitsowntowomenwhohadnot
hadahysterectomy,itincreasedtheriskof
endometrial(womb)cancer.Progestogen,a
syntheticformofprogesteroneis,therefore,
givenaswellasoestrogentoreducethisrisk
ofcancer.Progesterone,inanaturalform,
israrelyusedinHRTbecauseitisusedup
quicklybythebodyand,atthedoseneeded
toprotectthewomblining,seemstomake
womensleepy.
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Naturalprogesteronecreamwasdeveloped
becauseitwasbelieved,bythosewho
claimeditsbenefit,thatitwasprogesterone
ratherthanoestrogenthatreduced
menopausalsymptomsandprevented
osteoporosisinpost-menopausalwomen.
Itwasalsobelievedthatinthis‘natural’form
itwouldnotcausesideeffectsorharm.
Historically,HRThasplayedakeyroleasa
treatmentformenopausalsymptomsand
topreventosteoporosis.However,with
drugtreatmentsdevelopedspecificallyfor
osteoporosisoverthelastdecadeorso
andtheknowledgeofpotentialhealthrisks
associatedwithlonger-termuseofHRT,itis
nowmuchlesscommonlyused.
Naturalprogesteronecreamisoften
marketedasanaturalalternativeto
HRTand,therefore,appealstowomen
seekinganalternativeoptiontodrug
treatmentsforosteoporosis.
The main ingredient in
natural progesterone
cream comes from an
extract from wild yams
and is claimed to be
similar to the natural
hormone, progesterone.
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Althoughtherearesomesideeffects
associatedwiththeuseofthesynthetic
progestogensinvariousHRTpreparations,
asnaturalprogesteroneisanunlicensed
product,anypossiblesideeffectsarenot
officiallydocumented.
Therehasbeensomescientificresearchinto
theeffectofprogesteroneonbonedensity,
althoughnoneofthesestudieshavelooked
atwhetherornotitreducesaperson’s
fracturerisk(likelihoodofbreakingabone).
Furtherresearchisneeded.
OneAmericanstudyinvestigatedtheeffects
ofnaturalprogesteronecreamonboth
menopausalsymptomsandbonedensity.
Althoughitseemedeffectiveincontrolling
hotflushes,therewasnoeffectonbone
densityobservedinthefirstyear.Thishas
beenconfirmedbyasmallBritishtrialwhich
showednochangesinbonedensityover
twoyears,butatrendtowardsimproved
menopausalsymptoms.Thisstudyby
SouthamptonUniversityhasbeenpresented
atmajorosteoporosisconferencesbutis,as
yet,unpublished.
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Osteopathy and chiropractic
Althoughosteopathyandchiropracticaretwo
separate disciplines they have many similarities;
both therapies consist of a number of different
techniques, one of which includes manipulation
ofthebonesoftheskeleton.Chiropractors
tendtofocusonthejointsofthespineand
nervoussystemandosteopathsplacemore
emphasisonsofttissuesandmusclesand
mobilisationofjoints.Theaimofthese
therapiesistohelptoimprovethefunctionof
joints,easepainandreducemusclespasm.
Therehasbeensomeclinicalevidenceto
suggestthatspinalmanipulationtechniques
canhaveapositiveeffectonchroniclow
backpain.Itisveryimportantthatpeople
withosteoporosisdonotundergoany
skeletalmanipulationduetotheriskof
fracture. However, since both osteopathy and
chiropractics use a wide range of approaches,
theycanstillbeconsideredasasourceof
painreliefaslongasthepractitionerismade
fullyawareofanindividual’smedicalhistory
beforecommencingtreatment.
IntheUKbothpracticesarestatutorily
regulated.Osteopathsmustberegistered
withtheGeneralOsteopathicCouncil
andchiropractorswiththeGeneral
ChiropracticCouncil.
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Exercise and
movement therapies
The Alexander Technique
Thisisamethodofbreathingandexercise
thatfocusesonimprovingpostureand
mobility.FrederickMatthiasAlexanderfirst
developedthetechniqueinthe1890s.
Alexanderhadacareerinthetheatreandas
ayoungactorkeptlosinghisvoiceduring
stageperformances.Herealisedthatthe
functioningofhisownvoicewasdependent
onacorrectpostureandbalanceoftension
inhisbody.Helaterwentontodevelophis
methodsandteachothers.
TheAlexander
Techniqueaims
toimprovethe
alignmentofthe
head,neckand
back,toimprove
co-ordinationand
balanceandtohelp
withbodyfunctions
suchasbreathing
anddigestion.Some
peoplewithpostural
changescausedby
spinalfractureshave
foundthisahelpful
techniquetolearn.
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Pilates
Thisisanexercisetechniquewhichalso
concentratesoncorrectbodyalignment.It
wasoriginallydevelopedbyJosephPilates
inthe1920sandpractisedbydancersto
improvefitness.
Pilatesconsistsofaspecificprogrammeof
exercisestohelptoimproveflexibilityand
strength;italsofocusesonusingthebody’s
deepcoremusclesinthetrunkandpelvis.
Thesearemusclesthathelptosupportthe
body’sskeletalstructure.
Thistypeofexercisemaybehelpfulfor
peoplewhohavefracturesinthespine
asaresultofosteoporosis.However,it
isimportanttoavoidanymovementor
stretchingexercisewhichinvolvesbending
forwardortouchingyourtoesorundertaking
neckexerciseswhereyourollyourhead
backwardsorcircleyourhead,whichcould
bepotentiallydangerousforthosepeopleat
riskofbrokenbones.
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Tai Chi
TaiChiisanancientformofChinesemartial
arts;itusestheprinciplesofdeepbreathing
andrelaxationcombinedwithslowcontrolled
movements. Tai Chi is good as an intervention
tohelptoreducetheriskoffallingand,
therefore,breakingaboneifyouhave
osteoporosis.Thisisbecauseitimproves
postureandbalanceinolderpeople.
Yoga
YogaoriginatesfromIndiaandhasbeen
practisedforover5,000years.Itisbasedon
Hinduphilosophyandfollowsasystemof
exercisestoencouragephysicalandmental
well-being.Itinvolveslearningaseriesof
differentmovements,physicalpostures,
breathingtechniquesandmeditation.There
aremanydifferenttypesofyogabeing
practised;however,themostcommonyoga
techniqueisHathaYoga.
Pilates,TaiChiandYogaareexercise
methodswhichusecontrolledandfocused
movementsandcanhelptoimproveposture
anddevelopmusclestrength.Forsome
peopletheymayactuallyhelptoalleviatepain
symptomsresultingfromspinalfractures.As
longasspecialcareisfollowedwithregard
tothepotentiallydangerousmovements
>>
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whichhavealreadybeenmentioned,these
approachesmayprovideanalternative
exerciseactivityforolderpeopleandthose
withosteoporosis.
Itisalwaysrecommendedthatyoucheck
withahealthcareprofessional(suchasyour
GP)whohasaknowledgeofyourmedical
historyandriskoffracturebeforetakingup
anynewexercise.Additionally,aswithany
organisedexerciseclass,
itiswisetoinformyour
instructorifyouhave
osteoporosissohe/she
canadaptthe
movementsto
suityou.
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Factors which can help to maintain healthy
bones are a well-balanced diet with
adequate calcium-rich foods; regular weightbearing exercise; avoiding smoking and
keeping alcohol consumption within the
recommended limits.
Join the National Osteoporosis
Society today
Become a member and support the only UK-wide
charity dedicated to improving the diagnosis,
prevention and treatment of osteoporosis.
To join today, either call us or visit our website:
01761 473287
www.nos.org.uk
Our publications are free of charge
but we would welcome a donation
You can support the work of the National
Osteoporosis Society by making a single
or regular donation:
01761 473111
www.nos.org.uk
For osteoporosis information and
support contact our Helpline:
0845 450 0230
[email protected]
53621_NOS_ Complementary amended pages.indd 1
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Useful contacts
British Medical Acupuncture Society
Royal London Hospital for Integrated Medicine
60 Great Ormond Street
London WC1N 3HR
Tel: 020 7713 9437
www.medical-acupuncture.co.uk
The British Acupuncture Council
63 Jeddo Road
London W12 9HQ
Tel: 020 8735 0400
www.acupuncture.org.uk
Aromatherapy Council
www.aromatherapycouncil.co.uk
The Society of Teachers of the
Alexander Technique
1st Floor Linton House
39-51 Highgate Road
London NW5 1RS
Tel: 0207 482 5135
www.stat.org.uk
General Chiropractic Council
44 Wicklow Street
London WC1X 9HL
Tel: 020 7713 5155
www.gcc-uk.org
British Reflexology Association
Monks Orchard
Whitbourne
Worcester WR6 5RB
Tel: 01886 821207
www.britreflex.co.uk
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The Institute for Complementary
Medicine and Natural Medicine
ICNM
Can-Mezzanine
32-36 Loman Street
London SE1 OEH
Tel: 020 7922 7980
www.i-c-m.org.uk
British Homeopathic Association
Hahnemann House
29 Park Street West
Luton LU1 3BE
Tel: 01582 408675
www.britishhomeopathic.org
National Institute of Medical Herbalists
Clover House,
James Court,
South Street,
Exeter EX1 1EE
Tel: 01392 426022
www.nimh.org.uk
General Osteopathic Council
176 Tower Bridge Road
London SE1 3LU
Tel: 020 7357 6655
www.osteopathy.org.uk
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Other leaflets in this range:
• Anorexia nervosa and osteoporosis
• Anti-epileptic drugs and osteoporosis
• Breast cancer treatments and osteoporosis
• Clothing, body image and osteoporosis
• Coeliac disease and osteoporosis
• Complex regional pain syndrome and osteoporosis
• The contraceptive injection (Depo Provera)
and osteoporosis
• Drug treatments for osteoporosis
• Exercise and osteoporosis
• Glucocorticoids and osteoporosis
• Healthy bones – facts about food
• Healthy living for strong bones
• Hip protectors and osteoporosis
• Hormone therapy in men and women and osteoporosis
• Living with broken bones (includes information on
welfare benefits)
• Osteoarthritis and osteoporosis
• Osteogenesis imperfecta and osteoporosis
• Osteoporosis in children
• Parathyroid disease and osteoporosis
• Percutaneous vertebroplasty and balloon
kyphoplasty and osteoporosis
• Pregnancy and osteoporosis
• Scans and tests and osteoporosis
• Thyroid disease and osteoporosis
• Transsexualism and osteoporosis
• Vibration therapy and osteoporosis
0845 130 3076 (General Enquiries)
0845 450 0230 (Helpline)
www.nos.org.uk
Camerton, Bath BA2 0PJ
President: HRH The Duchess of Cornwall
National Osteoporosis Society is a registered charity no. 1102712 in England and Wales
and no. SC039755 in Scotland. Registered as a company limited by guarantee in England
and Wales no. 4995013
New breast cancer pages JUNE 2012.indd 2
Last updated November 2012
NOS/00200
11/8/2012 12:37:35 PM