Mental Health & Wellbeing

Living with osteoporosis — especially after a fracture — can affect your emotional wellbeing as well as your physical health. Fear of falling, anxiety about activity, and concerns about independence are all common and understandable responses. Addressing these emotional aspects is an important part of living well with osteoporosis.

Fear of Falling (Kinesiophobia)

Fear of falling is extremely common after a fracture and in people with osteoporosis. Technically known as “kinesiophobia” (fear of movement or activity due to anticipated pain or injury), this fear can lead to:

• Avoidance of physical activity, social situations, and going outdoors
• Further deconditioning (weakening of muscles from inactivity)
• Increased isolation and loneliness
• Paradoxically, greater fall risk — because muscle weakness and reduced balance increase with inactivity
• Depression and anxiety

Fear of falling is not irrational — fractures are serious and the fear of another one is understandable. But when fear starts limiting daily life significantly, it is important to address it actively.

What can help?

• Physiotherapy: A physiotherapist can work with you to gradually and safely build your activity and confidence, addressing specific movement fears
• Structured falls prevention programmes: Group programmes (many available through the HSE and local authority sports partnerships) build balance and confidence alongside peers
• Cognitive behavioural therapy (CBT): CBT techniques can help challenge and reframe unhelpful thoughts about falling and activity
• Tai chi: Has been shown not only to reduce falls but also to reduce fear of falling in older adults
• Personal alarm systems: Knowing you can summon help if needed can give confidence to be more active

The Emotional Impact of Diagnosis

Receiving a diagnosis of osteoporosis, or being told you have had a fragility fracture, can bring a range of emotions: shock, anxiety, sadness, anger, or a sense of vulnerability. Some people feel that their body has “let them down”, or worry about becoming a burden on family members.

These responses are completely normal. It is important to give yourself time to process the diagnosis. Some things that can help include:

• Talking to someone you trust about how you are feeling — a family member, friend, or GP
• Learning more about osteoporosis (as you are doing now) — understanding the condition can reduce fear of the unknown
• Focusing on what you can do to help yourself, rather than what you cannot control
• Connecting with others who have similar experiences — peer support can be invaluable

Maintaining Independence and Confidence

Osteoporosis does not have to mean giving up the activities you enjoy. Many people with osteoporosis continue to live fully active, independent lives. Some adjustments may be needed — especially if you have had a fracture — but the goal is always to find ways to do as much as possible safely.

• Work with your physiotherapist and GP to identify activities that are safe for you
• Make home adaptations early, before a crisis — proactive safety measures can prevent falls that would otherwise limit independence
• Use assistive devices (walking sticks, grab rails) as tools that extend your independence, not signs of weakness
• Stay socially connected — social engagement is associated with better mental and physical health outcomes

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