What is osteoporosis? It is a systemic bone loss disease with chronic low back pain and even deformity and fracture as the main manifestation. It is a systemic bone disease that predisposes middle-aged and elderly people. Predisposed population: the disease is more common in women than men, and is common in postmenopausal women and the elderly. With the increase of the elderly population in China, the incidence of osteoporosis is on the rise and is a health concern in China and globally. Understanding and awareness of osteoporosis ①Decrease in bone mass: should include a decrease in the proportion of bone minerals and its matrix, etc. ②Bone microstructure degeneration: due to the imbalance of bone tissue resorption and formation, etc., which is manifested by the destruction, thinning and fracture of bone trabecular structures. ③Bone brittleness increases, bone mechanical strength decreases, fracture risk increases, and microfracture or complete fracture easily occurs due to reduced load bearing capacity. Compression fractures of the lumbar spine may occur quietly or fractures of the distal end of the flexor, proximal femur and upper end of the limb bone may occur with little external force. Treating osteoporosis in three parts I. Calcium supplementation Calcium is an important component of bones and is mainly derived from food. If you cannot take in sufficient amount of calcium from food, you can supplement calcium. It is not harmful to consume slightly more calcium than needed. One to two tablets a day can fully replenish the daily calcium requirement, and because it contains vitamin D, it can make calcium absorption more complete. Vitamin D is essential in the prevention and treatment of osteoporosis. Without vitamin D, the body can not absorb and use calcium, ordinary people need about 400 international units of vitamin D per day (equivalent to] 100 ml of milk, – tablets of multivitamin pills or 30-60 minutes of sunbathing per week), excessive vitamin D is harmful to the human body. After entering the liver, vitamin D undergoes a series of hydroxylation enzymatic reactions to produce 1,25(OH2)D and other active metabolites involved in bone metabolism. Roscalciferol, also known as calcitriol, is one of the active metabolites of vitamin D. It not only promotes intestinal calcium ion absorption and increases urinary calcium reabsorption by the distal tubule, but also activates osteoclasts to enable bone resorption and activates osteoblasts to promote bone formation. Estrogen replacement therapy can prevent osteoporosis and reduce the incidence of fractures; reduce menopausal symptoms such as flushing, reduced vaginal secretion, irritability, insomnia and excessive sweating; and reduce blood cholesterol levels, thus reducing the occurrence of heart disease. Estrogen replacement methods can be given orally, by injection or by subcutaneous implantation. Estrogen replacement methods can cause breast tenderness and fluid retention. Some women may menstruate again, but not become pregnant. Some people are concerned about estrogen causing cancer, and the risk of cancer can be reduced if progestins are used in conjunction with treatment. For those who already have typical osteoporosis, the use of calcitonin, diphosphonate and sodium fluoride can rapidly reduce pain and relieve the condition, but they should be used under the guidance of physicians. In patients with existing fractures, surgical treatment is intensified to prevent complications.