Disclosures: Maryam Hosseini, MD: Nothing to disclose

Case Description: This case is a 66-year-old male former body builder living a healthy life style. At 44 he was diagnosed with Stage IV prostate cancer requiring bilateral orchiectomy. The cancer resolved without recurrence. By 48 he developed osteoporosis from hormonal imbalance. Fosamax was given without significant improvement in bone density after 6 years. Due to concerns about worsening osteoporosis and fracture risk, physicians advised him to terminate weight bearing exercises at 54. He discontinued bisphosphonate therapy, changed physicians and began a yoga program including backbends, standing poses and twists without any forward bending.

Setting: Outpatient

Patient: 66-year-old male with PMH of osteoporosis, unresponsive to medical management whose BMD improved after selective yoga poses.

Assessment/Results: Following consistent yoga practice for 12 years without bisphosphonate or other treatment, there was trabecular enhancement at the femoral head and neck. The BMD progressively increased from a T-score of -2.8 for the L1-L4 spine and -2.7 for the left femur to -0.9 and -0.8, respectively.

Discussion: Yoga poses were selected that produce proximal femur and vertebrae torque and compression of the pelvis. This was guided by common sites of osteoporotic fractures and areas measured by DEXA scan. Such yoga poses were previously studied on 241 subjects, average age 68.3, with bone loss from other causes over an 8-year period. 83% showed significant improvement in lumbar and femur BMD without fractures or other serious injury during 100,000 hours of practice. Medication therapy side effects include gastric upset, atrial fibrillation, spontaneous fracture, delayed healing and osteonecrosis. In contrast, yoga side effects include improvements in balance, posture, range of motion, strength, coordination and anxiety. These effects may also reduce the risk of fracture.

Conclusion: This case suggests that yoga can safely reverse bone loss regardless of cause. Yoga can be practiced at home, reducing costs of care and yielding multiple beneficial side effects.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/selective-yoga-therapy-for-osteoporosis-a-case-report/