Diabetic osteoporosis (DOP) is a serious chronic diabetic complication characterized by reduced bone mass, impaired bone microstructure, and increased bone fragility. It significantly elevates fracture risk and compromises bone healing, constituting a major cause of disability and reduced quality of life. DOP-related pain, along with associated psychological issues such as anxiety and depression, tend to forms a vicious cycle of "pain-psychological impairment-worsened bone metabolism," severely affecting physical and mental functions as well as social adaptation. Thus, effective pain relieve and psychosocial support are essential for improving the overall prognosis in DOP patients. This review summarizes epidemiological features, pain mechanisms, and multidimensional interventions for DOP, discusses current clinical challenges, and provides a reference for comprehensive clinical management.