What Your Spine May Be Telling Us About Bone Health — and Brain Health
Recently, one of my patients brought me an interesting article by Lizette Borreli titled “Lower Spinal Bone Density Linked to Faster Cognitive Decline.” I’m always glad when patients bring articles into the office. It gives us an opportunity to talk about new research and, just as importantly, what that research actually means for everyday health.
The study behind the article caught my attention because it looked at something we normally associate with fracture risk—bone mineral density—and found a possible connection with how our brains age.
What did researchers find?
Researchers looked at bone density in the thoracic spine—the middle portion of the back—and followed participants’ brain imaging and cognitive function over time.
People with lower vertebral bone mineral density tended to experience a faster decline in overall cognitive performance. Researchers also observed changes in portions of the brain’s white matter involved in functions such as attention, working memory, and executive function.
That sounds significant, and it is certainly interesting. But there is an important distinction:
The study does not show that low bone density causes dementia or cognitive decline.
Instead, researchers believe bone and brain health may share some of the same influences as we age. Metabolic health, hormonal changes, physical activity, nutrition, cardiovascular health, diabetes, and other factors may affect both.
In other words, our bones probably shouldn’t be thought of as an isolated part of the body.
Why bone density matters
Most people hear “osteoporosis” and immediately think about broken hips. That is understandable, but bone health involves much more than that.
Low bone density can occur gradually and without obvious symptoms. Osteopenia refers to bone density that is below normal, while osteoporosis represents more significant loss of bone strength and a greater risk of fracture.
If you have been diagnosed with osteopenia or osteoporosis—or have been told that your bone density is declining—it is something every healthcare provider treating your spine should know about.
And that includes your chiropractor.
“Is chiropractic care safe if I have low bone density?”
This is a question I would much rather have a patient ask than quietly worry about.
The answer is that chiropractic care is not one-size-fits-all.
Someone with strong, healthy bones may be treated differently from someone with osteopenia, osteoporosis, a previous compression fracture, or other conditions affecting bone strength. When bone density is significantly reduced, certain higher-force spinal manipulation techniques may not be appropriate because weakened bone is more susceptible to fracture.
That doesn't mean we simply ignore the aches, stiffness, loss of mobility, or muscular tightness that can accompany aging.
It means we adjust our approach.
Gentle care is still care
At Aden Chiropractic, I frequently work with patients who have reduced bone density. My approach with these patients tends to be conservative and comfortable.
Depending on the individual, I may use IASTM (instrument-assisted soft tissue mobilization) to work with tight muscles and connective tissues. I may use lower-force instruments such as the ArthroStim or ProAdjuster when appropriate rather than relying on a traditional manual adjustment.
We also have a Precor stretching machine, which many of my patients enjoy because it allows us to work on flexibility and mobility in a controlled manner.
For selected patients, decompression may also be considered when there is an appropriate musculoskeletal indication and no contraindication.
Sometimes the best treatment decision is also deciding not to perform a particular technique.
That is part of good chiropractic care.
What about the possibility of being injured?
No healthcare treatment is completely without risk, and I don't think patients should be told otherwise.
With osteoporosis in particular, weakened bones can be more susceptible to fracture. That is why knowing your medical history, previous fractures, medications, imaging findings, bone-density results, and current symptoms matters before deciding how—or whether—to treat an area.
If something doesn't look appropriate for chiropractic treatment, or I believe additional evaluation is needed first, I would rather have that conversation and coordinate with your medical provider than take an unnecessary risk.
Our goal is not to see how much force we can use.
Our goal is to determine how little force is necessary to provide comfortable, appropriate care.
The bigger message from this research
I don't think this new research means everyone needs to start worrying about dementia because they have osteopenia.
I think it gives us another reason to pay attention to bone health as part of healthy aging.
Know your bone density when screening is appropriate. Stay physically active. Work on strength, balance, and mobility in ways appropriate for your individual fracture risk. Talk with your medical provider about nutrition, medications, hormonal factors, and osteoporosis treatment when indicated.
And don't be afraid to tell your chiropractor that you have osteopenia or osteoporosis.
If you haven't been to a chiropractor because you're worried that treatment will be too forceful, that is a reasonable concern to bring up. Ask questions. Tell us what you're comfortable with. Bring your bone-density report if you have one.
At Aden Chiropractic, we see people of many different ages, abilities, and health backgrounds. Care for a 25-year-old athlete shouldn't necessarily look the same as care for a 75-year-old with osteoporosis—and that's okay.
Sometimes good care is an adjustment. Sometimes it's gentle instrument work, soft-tissue therapy, stretching, or simply helping someone understand what movements are comfortable and appropriate.
Most importantly, it should start by listening to the person in front of us.
Have questions about chiropractic care and low bone density?
You're always welcome to ask. Even if you're simply wondering whether chiropractic care is appropriate for you, we're happy to have that conversation. To book an appointment online click the link below.
Book Online | Aden Chiropractic
This article is for general educational purposes and is not intended to diagnose or treat osteoporosis, dementia, or cognitive impairment. Chiropractic care does not replace appropriate medical evaluation or treatment for osteoporosis or cognitive changes.
1.Low Bone Density and Cognitive Decline | RSNARSNA·Sep 21, 2026
2.Lower Bone Density Linked to Cognitive Decline | RSNARSNA·Sep 21, 2026
3.Best Practices for Chiropractic Management of Adult Patients With Mechanical Low Back Pain: A Clinical Practice Guideline for Chiropractors in the United StatesChiro·Jun 20, 2023
