If a person has osteoporosis, should I avoid clearing the neurolymphatic reflex points along the spine?
You may continue to massage these places, but just be a bit more gentle as you do so, and listen for any feedback that the person might give you. As you probably know, these points are tender in most people because they become clogged with toxins and stagnant energy. Massaging them helps clear the toxins and gets the energy flowing more freely, which will always benefit the person’s health.
The two cautions here are 1) that the physical pressure you use does not exacerbate any previous injuries or vulnerabilities, and 2) that the person’s energy system is not so weak or disorganized that stirring up toxins overwhelms the system’s ability to eliminate those toxins.
Simply having the person you are working with let you know how much pressure you can apply generally addresses the first caution. For the second, a general balancing such as the "Daily Energy Routine" (Chapter 3 of Energy Medicine) before you do the full spinal flush is usually sufficient.
If the neurolymphatic reflex points are still too painful for any real massage, place one finger on a back neurolymphatic point and the finger of your other hand on the corresponding point in front. Use a back and forth see-saw motion, pressing in on one point as you release on the other. This is much easier for even a highly sensitive individual to tolerate