The clinical manifestations of primary osteoporosis are not obvious. 70% of vertebral compression fractures in elderly patients are painless, and the only manifestations may be reduced height, shortened stature, and hunchback. This is because the front part of the vertebrae of the spine is almost composed of cancellous bone, 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 back to bend. With age, osteoporosis increases and the curvature of the hunchback increases. Pain is the most common symptom in patients with primary osteoporosis and can occur as circumferential bone pain, with low back pain being the most common, accounting for 70%-80% of patients with pain. Pain spreads along the spine to both sides, decreases when supine or sitting, increases when posteriorly extended when upright or when standing or sitting for a long time, is light during the day, increases at night and when waking up in the early morning, and increases when bending, muscle movement, coughing, and bowel straining. Recent compression fractures of the thoracolumbar spine can also produce acute pain, and there can be strong pressure pain 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. Fractures are the most common and serious complication of osteoporosis, often occurring with minor violence and in the course of daily life. Some patients develop rib fractures simply by doing chest expansion exercises during morning exercises or vertebral fractures with a cough. Another characteristic of these fractures is that they are recurrent, with one fracture easily followed by another. Fractures due to osteoporosis are more common in the early old age with distal radius fractures (Colles fractures) and later in old age with fractures of the lumbar spine and upper femur, which not only increase the patient’s pain and financial responsibility, but also severely limit the patient’s activities and even shorten life expectancy.