(1) Pain: The most common symptom of primary osteoporosis is low back pain, which accounts for 70%-80% of the patients with pain. Pain spreads along the spine to both sides, decreases when supine or sitting, increases when posterior extension or prolonged standing or sitting, is light during the day, increases at night and when waking up in the morning, and increases when bending, muscle movement, coughing and stooling. Bone pain generally occurs when 12% or more of bone mass is lost. In old age osteoporosis, the vertebral trabeculae atrophy, the number decreases, the vertebral body compresses and deforms, the spine flexes forward, the lumbar muscles double contraction in order to correct the forward flexion of the spine, muscle fatigue and even spasm, producing pain. A recent compression fracture of the thoracolumbar spine can also produce acute pain, with strong pressure and percussion pain in the spinal spinous process of the corresponding area, which can generally be gradually reduced after 2-3 weeks, and some patients can present with chronic low back pain. If the corresponding spinal nerve is compressed, radiating pain in the extremities, sensory-motor disorders in both lower extremities, intercostal neuralgia, retrosternal pain similar to angina pectoris, or epigastric pain similar to acute abdomen may occur. If compression of the spinal cord, cauda equina also affects the bladder and rectal function. (2) Shortening of body length and hunchback: mostly appear after pain. The front part of the vertebrae of the spine is almost mostly composed of cancellous bones, and this part is the pillar of the body with a large weight, especially the 11th and 12th thoracic vertebrae and the 3rd lumbar vertebrae, which have a greater load and are easily compressed and deformed, causing the spine to tilt forward and the dorsal curvature to increase, resulting in hunchback, and as we grow older, osteoporosis increases and the curvature of the hunchback increases, resulting in significant knee contracture. Each person has 24 vertebrae, the height of each vertebra is about 2cm in normal people. (3) Fracture: This is the most common and serious complication of degenerative osteoporosis, which not only increases the patient’s pain, aggravates the economic responsibility, and seriously limits the patient’s activities, and even shortens the life span. According to our statistics, the incidence of fracture in elderly people is 6.3-24.4%, especially in elderly women (over 80 years old). Fractures caused by osteoporosis are more common in the early stages of old age with distal radius fractures (Colles fractures) and later in old age with fractures of the lumbar spine and upper femur. Fractures generally occur when 20% or more of bone mass is lost, and for every 1.0 DS decrease in BMD, the incidence of vertebral fractures increases 1.5-2 times. About 20%-50% of patients with vertebral compression fractures have no obvious symptoms. (4) Decreased respiratory function: compression fractures of the thoracic and lumbar spine, backward curvature of the spine, and thoracic deformity can significantly reduce lung volume and maximum ventilation, and the incidence of lobar emphysema in the anterior region of the upper lobe of the lung can be as high as 40%. Most elderly people have no degree of emphysema, lung function decreases with age, if coupled with thoracic deformity due to osteoporosis, patients often have chest tightness, shortness of breath, dyspnea and other symptoms.