Around 1910, residents living in the Jinzu River basin in Toyama Prefecture, Japan, began experiencing severe pain in their lower backs and joints. The longer a person had lived in the area, the more pronounced the symptoms became, with frequent fractures of the arms, ribs, pelvis, and femur. The bones became so fragile that even coughing could cause fractures, and bone atrophy led to a reduction in height, with severe cases losing more than 20 centimeters. The disease came to be known as “Itai-itai,” meaning “it hurts, it hurts” in Japanese, because those afflicted suffered from intense pain.