A common disease of the elderly, a multifactorial disease associated with aging. It is a systemic skeletal disease characterized mainly by a decrease in bone mass and destruction of the microstructure of bone, which increases the brittleness of bone and predisposes to fracture. The cause of primary osteoporosis is still unclear, but it is generally believed to be related to endocrine disorders, calcium malabsorption and disuse; it may also be related to genetic factors and immune factors. It is more common in women than in men, and it is common in postmenopausal women and the elderly. Fractures are likely to occur with or without minor trauma, especially in women over 75 years of age, where the incidence of fractures can be as high as 80%. Clinical manifestations: pain – the most important symptom. The cause is the rapid bone transformation, increased bone resorption, the destruction and disappearance of bone trabeculae during resorption, and the destruction of subperiosteal dermis can cause generalized bone pain, of which low back pain is the most common. Another cause of pain is fracture. Patients with uncomplicated osteoporosis may have no symptoms or only weakness. Bone pain, especially in the back and pelvic region, is often persistent and generally related to the degree of osteoporosis. In particular, it is aggravated by exertion, limiting the body’s activities, and can cause different degrees of muscle atrophy in the lower limbs over time. The course of osteoporosis progresses slowly, and patients mostly come to the clinic with low back pain or fracture. (a) Low back pain – the most common symptom. It is particularly pronounced when a compression fracture of the vertebral body occurs, but most patients can also be asymptomatic. The pain is often mild but persistent at the time of presentation, sometimes severe and can last for several weeks. After the acute pain subsides, chronic pain of varying degrees may remain. Low back pain mainly manifests as dull pain in the lower back and lumbosacral region, mostly occurring in a sitting or standing position, while resting in a lying position can reduce or relieve the pain. (ii) Fractures Compression fractures of the spinal vertebrae, hip fractures and distal radius fractures are the three most common fractures in patients with osteoporosis. Compression fractures occurring in the thoracolumbar segment have mild bowel palsy and intercostal neuralgia in the chest in addition to fracture symptoms. The fracture heals as usual and after 4-5 years the condition is stable and no more fractures occur. At this time, the torso is shorter than before the fracture, hunchback may appear, and in severe cases, it may cause thoracic deformity and affect cardiopulmonary function. The rib cartilage is close to the upper edge of the pelvis and is often accompanied by pain on both sides of the waist. Some patients may also show diffuse pain in the spine, mostly seen in postmenopausal osteoporosis, with diffuse pain and pressure pain along the spine, the cause of which is unknown, and the pain may also disappear on its own after a period of time. Medication: 1. Calcium and vitamin D. Give 1-2g of calcium daily and take it at bedtime. 2.Sex hormones. Estrogen is the drug of choice for the prevention of postmenopausal osteoporosis and has a positive effect on reducing the occurrence of fractures. Testosterone propionate can promote the storage of calcium, phosphorus and nitrogen, and is effective for bone composition. 3, calcitonin – inhibit osteoclast activity, slow action can reduce the number of osteoclasts, has the effect of pain relief to increase activity, and has the effect of improving calcium balance. 4, other drugs: parathyroid hormone, diphosphonate, fluoride, isoproterenol, etc. In acute fractures, bed rest, appropriate analgesics, calcitonin injection is very effective, wear a special undershirt brace to limit spinal movement. In vertebral compression fractures with significant lumbar pain, the patient may be placed on bed rest, but braking should not be overemphasized, as it may aggravate the development of fracture laxity.