If a patient has osteoporosis and meets all the signs for manipulation, what should you do?

• A. Proceed with manipulation
• B. Consult for further imaging
• C. Do not perform manipulation
• D. Refer to a surgeon

Answer: (C)

In patients with osteoporosis, the integrity of the bone is compromised, which significantly increases the risk of fractures, even with minimal force. Manipulation techniques often involve applying forces that can lead to stress fractures or even complete fractures in osteoporotic bones. This heightened vulnerability means that the potential risks associated with manipulation might outweigh the benefits.

Thus, opting not to perform manipulation in a patient with osteoporosis is crucial due to the concern for exacerbating their condition through further injury. Alternative treatment methods that are safer and more appropriate for managing musculoskeletal issues in patients with osteoporosis—such as physical therapy focused on strengthening, balance training, and pain management—should instead be considered to promote patient safety while effectively addressing their symptoms.