Osteoporosis is frequently referred to as a 'silent disease' because it often progresses without noticeable symptoms in its initial stages. However, when bone loss is substantial, microscopic fractures can develop, even in the absence of a visible major fracture, and these can be a source of pain. The primary cause of back pain experienced by individuals with osteoporosis is typically vertebral (spinal) compression fractures and the associated postural changes or deformities.