Multiple atraumatic osteoporotic vertebral fractures: Unusual cause of pain in adult

•Multiple atraumatic spinal fractures can occur in patients who are on chronic steroid use.•Painful vertebral fractures pose diagnostic and management challenges in a young patient.•Early diagnosis can only be achieved if there is high index of suspicion by the treating physician.

Secondary osteoporosis may not be detected early, and thus the condition remains clinically silent until the patient presents with multiple atraumatic compression fractures. It is devastating for a young patient to develop multiple vertebral fractures in view of the associated morbidity and mortality. To decrease the risk of additional fractures and preserve the quality of life in these patients, interventions should be initiated early. Hence, it is important to consider multiple osteoporotic vertebral fractures as a complication in any patient on prolonged steroid therapy.