Does osteopenia cause pain?

No: increases risk: Osteopenia means your bones have lost some of their mineral content, but probably not enough to greatly increase fracture risk. Osteoporosis is more severe mineral loss that does increase the likelihood of fractures. Neither causes pain unless you actually break a bone. (if you have either, be sure your vitamin d level is high enough. Your doctor can do a blood test. But don't overdo vitamin d.).