Osteoporosis is the most common metabolic bone disease in the United States and it is characterized by both diminished bone mineral density (BMD) and deterioration of the microarchitecture of remaining bone. Because bone strength is proportional to its density, the consequences of these changes are bone fragility and an increased rate of fractures. Osteoporosis is a silent disease, usually asymptomatic until a fracture occurs. There are no early warning symptoms; when fractures occur, bone density has already been lost. Osteoporosis is often preventable through a lifelong commitment to proper nutrition, adequate and appropriate exercise, and early intervention for those at risk. The most common osteoporotic fracture is the vertebral crush fracture, mostly affecting women older than 55 years. They are major predictors of future fracture risk and are associated with increased morbidity and mortality. Complications include back pain, height loss, kyphosis, and balance difficulties.