Bone pain (also known medically by several other names) is pain coming from a bone, and is caused by damaging stimuli. It occurs as a result of a wide range of diseases or physical conditions or both, and may severely impair the quality of life.
Bone pain belongs to the class of deep somatic pain, often experienced as a dull pain that cannot be localized accurately by the patient. This is in contrast with the pain which is mediated by superficial receptors in, e.g., the skin. Bone pain can have several possible causes ranging from extensive physical stress to serious diseases such as cancer.
Bones contain nerves. The periosteal layer (an outer membrane) of bone tissue is highly pain-sensitive and an important source of pain in several disease conditions causing bone pain, like fractures, osteoarthritis, etc. However, in certain diseases, the endosteal and haversian nerve supply seems to play an important role, e.g. in osteomalacia, osteonecrosis, and other bone diseases. Thus, there are several types of bone pain, each with many potential sources or origins of cause.
Causes
A number of diseases can cause bone pain, including the following:
- Endocrine, such as hyperparathyroidism, osteoporosis, kidney failure.
- Gastrointestinal or systemic, such as celiac disease and non-celiac gluten sensitivity (both often occur without obvious digestive symptoms), inflammatory bowel disease (including Crohn's disease and ulcerative colitis).
- Hematologic, such as Cushing's syndrome, histiocytosis, multiple myeloma and sickle cell anaemia.
- Acute rheumatic fever, a very dangerous disease that can cause permanent cardiac damage
- Growing pains
- Hypermobility syndrome can present with knee or ankle pain
- Henoch–Schönlein purpura
- Infection
- Osteopetrosis
- Spondyloarthropathies
Bone tumors are a conglomeration of cell types, including cancer and immune system cells. Often, tumor cells secrete growth factors that activate receptors close to primary afferent neurons. Activation of these neural receptors is a contributing factor to pain. Also, inflammatory lipids called prostaglandins, which are produced at high rates by cancer cells within tumors, activate nociceptors when they bind together. A form of radiotherapy often used in bone cancer is systemic radioisotope therapy, where the radioisotopes target sections of the bone specifically undergoing metastasis.
In bone fractures, surgical treatment is generally the most effective. Analgesics can be used with surgery to help ease pain of damaged bone.
Modern research and techniques are attempting to provide longer-lasting and more effective methods of treating bone pain by developing and applying new physiological knowledge of nervous tissue within the bone. If thorough understanding of the intra-neuronal mechanisms relating to pain can be developed, then new and more effective treatment options can be created and tested. Thus, it is critical to fully understand the mechanism which dictates bone pain.
Names
Bone pain is also known by the following names:
{| class="wikitable sortable" border="1"
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! Name !! Pronunciation !! Derivation
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| ostalgia || || ost- + -algia
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| ostealgia || || oste- + -algia
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| osteodynia || || osteo- + -dynia
|-
|}