Walking Aids for Osteoporosis and Fragile Bones

Why falls matter more with osteoporosis

Fractures from osteoporosis most often affect the spine, wrist and hip. Spinal (vertebral) fractures can happen with little or no fall, from a cough, a lift or a bend, and cause back pain, loss of height and a stooped posture. Hip fractures usually follow a fall and need surgery. Preventing the fall prevents the fracture. Falls are not random; they are often caused by weak muscles, poor balance, poor vision, medicines, dizziness and hazards at home. The more of these you fix, the lower the risk.

Walking aids reduce falls only when they are the right type, fitted well and used properly. A stick that is too long, a worn tip or a frame used on a slippery floor can cause a fall. See stick or walker: which one does your parent need.

Choosing the aid

With osteoporosis, many physiotherapists prefer more stability rather than less, because the cost of a fall is high.

Single stick. Suitable for someone who is steady with mild unsteadiness. Choose a stick with a good tip and the right height; a pivot-base stick improves grip; see pivot-base walking sticks. Do not lean heavily on a stick, which can slip.

Two sticks or Nordic poles. Some people with good balance use two poles to improve posture and walking pattern. Only with a physiotherapist's guidance.

Walking frame or two-wheeled walker. For people who are unsteady or have had fractures; see walking frame buying guide and two-wheeled walkers.

Rollator. For people who are steady but tire, with a seat for rests. A rollator also encourages an upright posture, which can ease the stooped position caused by spinal fractures. See rollator buying guide. Be sure the brakes are used correctly; see rollator brakes and seat safety.

Wheelchair for outings. If long distances are risky, a wheelchair or transit chair for outings keeps the person active without exhausting them.

A physiotherapist can assess balance and choose. See what to expect from a physiotherapist's walking assessment.

Posture and the stooped back

Vertebral fractures can cause a forward curve of the upper back, called kyphosis. This shifts the centre of gravity forward and can reduce balance. Walkers and rollators with handles at the right height encourage a more upright posture, whereas a stick may lead to leaning. Standing tall, exercises to strengthen the back extensors and good seating help. A physiotherapist can teach safe posture and movement. Avoid heavy lifting, deep forward bending and twisting, which can strain fragile vertebrae; ask your doctor for specific advice.

Making the home safer

Most falls happen at home. Reduce hazards.

• Floors. Remove loose rugs, cables and clutter; fix uneven thresholds; use anti-slip mats and tape; see anti-slip tape and coatings.
• Lighting. Bright lights, night lights on the way to the toilet and light switches within reach; see motion-sensor night lights.
• Bathroom. Grab bars, a shower chair, a non-slip mat and a raised toilet seat; see bathroom safety checklist for seniors.
• Stairs. Handrails on both sides and visible step edges.
• Furniture. Stable chairs with arms at a good height; a bed at the right height.
• Pets and objects. Keep walkways clear.
• Footwear. Non-slip, supportive shoes; see walking aids and footwear.
• Emergency help. A phone or alert device within reach; see panic pendants.

For a self-check, see falls risk assessment you can do at home and home safety for seniors living alone.

Exercise: the other half of the plan

Exercise helps bones and balance. A programme for osteoporosis usually includes:

• Weight-bearing exercise, such as walking and stair climbing as safe, to stimulate bone.
• Strength training, with light weights or bands, for muscles around the hips and spine; see resistance bands guide.
• Balance training, such as standing on one leg with support and tai chi; see balance exercises for seniors.
• Posture exercises, to strengthen back muscles.

Avoid high-impact or twisting exercise, and forward bending such as toe touches and sit-ups, unless a professional says it is safe. See exercise for osteoporosis and osteoporosis at home.

Nutrition, medicines and the doctor's role

Bone health needs calcium, vitamin D and protein; see calcium and vitamin D after 60 and bone health after 50. Many people also need prescription medicines that slow bone loss or build bone. Take them exactly as prescribed, and ask about side effects. Review other medicines that cause dizziness, drowsiness or low blood pressure with the doctor; see polypharmacy and deprescribing. Check eyesight and hearing yearly.

After a fracture

If your parent has had a hip, spine or wrist fracture:

• Follow the surgeon's and physiotherapist's instructions on weight bearing and aids; see hip fracture recovery at home and walking frame after hip or knee surgery.
• Start the aid they recommend, not an old one from the cupboard.
• Manage pain so that movement is possible.
• Aim to keep moving. Staying in bed too long weakens muscles, thins bones and risks pressure sores and clots.
• Treat the osteoporosis, because a fracture is a signal of a high risk of another. Ask about a bone density test and treatment.
• Review the home, and consider an alert device.
• Watch mood. Fear of falling is common after a fracture.

Common mistakes

• Delaying an aid because of pride.
• Using the wrong aid or height.
• Skipping exercise for fear of fractures.
• Heavy lifting or twisting.
• Stopping osteoporosis medicines early.
• Ignoring back pain that suddenly appears, which may be a spinal fracture.
• Rugs and clutter left in place.

Living confidently, not fearfully

Fear of fracture can become a problem in itself. Some people with osteoporosis stop going out, give up walking and stay in a chair, which weakens muscles, thins bones further and increases the risk of the very fall they dread. The aim is to be careful, not afraid. Use the right aid and set up the home well, then get on with life. Short daily walks, light gardening, social visits and gentle classes are good for bones, balance and mood. Plan routes with rests and benches, wear supportive shoes and carry a phone. If a fall happens, review what caused it and fix the cause, whether it was a rug, a medicine, a dizzy spell or poor light. Ask the doctor about the whole plan, including medicines for bone strength, vitamin D and calcium, and a review of anything that could cause dizziness. Share the plan with the family so that everyone supports independence, rather than restricting it. Small steps taken regularly protect both bones and confidence.

When to see a doctor

See a doctor urgently for severe pain after a fall, inability to bear weight, a shortened or twisted leg, sudden severe back pain, new numbness or weakness in the legs, loss of bladder or bowel control, or a head injury. Ask the doctor about bone density, treatment and fall prevention. Our care advisors can arrange a home safety check and a physiotherapist visit.