In most cases a fracture can cause significant pain because of the rich innervation and nerve distribution at the periosteum. In the case of a fracture, the fracture break can damage the periosteum and usually a fracture and tear of the periosteum occurs, which can then cause significant pain. If the fracture break is unstable and there is micromovement of the fracture, it can also irritate the periosteum and cause severe pain. Therefore, after a fracture, it is important to perform early manipulation and fixation in a cast, and the pain can be significantly relieved or disappear after the fracture has gained mechanical stability. Of course, in some cases, fractures do not necessarily cause very severe pain, which occurs mainly in the elderly. Due to the duller nociception and higher pain threshold in the elderly, sometimes a fracture can occur after a traumatic injury, but it does not necessarily cause significant pain. Therefore, when falls and traumatic injuries occur in the elderly, it is important to have an early X-ray to avoid missing the diagnosis.