Bone pain

Bone pain is one of the most debilitating side effects of various diseases - from osteoarthritis to cancer, or the result of an injury. Each of these diseases has its own symptoms and causes, and each requires immediate medical attention.

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ]

Causes of Bone Pain

Bone pain may be the result of a bone tumor. The pain occurs when tumor infiltrates skeletal structures. The tumor may compress surrounding blood vessels, nerves, and soft tissue, or may activate nociceptors (pain receptors) located in the area.

Bone pain can also be a result of tissue compression caused by fibrosis (tissue swelling) after the patient has undergone radiation therapy. The main source of bone pain in cancer patients can be a pathological fracture and osteoclasts – tumor cells caused by bone resorption. This condition promotes bone loss and, at the same time, provokes the tumor to increase in size.

[ 7 ], [ 8 ]

What is osteoporosis?

Osteoporosis, which literally means "porous bones," is a progressive bone disease that causes bones to become weak and permeable. Pain can be caused by a sudden fracture after a fall or, in some cases, even by coughing or simply bending a limb. These fractures often affect the hip, wrist, or spine, but they can occur in any bone. Because osteoporosis has no symptoms or pain in its early stages, a fracture can be the first sign that a person is very ill.

Although osteoporosis is often thought of as a disease that primarily affects women, one in four men over 50 also suffers a fracture due to osteoporosis, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Half of all women over 50 break a bone due to the disease. Osteoporosis affects about 8 million women and 2 million men.

Symptoms of osteoporosis:

• Pain throughout the body.
• Pain in the arm.
• One limb is shorter than the other.
• Humped bones.
• Bone pain.

Types of osteoporosis

Osteoporosis is primarily related to age, but in some cases it is caused by other medical conditions, as well as certain medications and lifestyle factors. Types of osteoporosis include:

Primary osteoporosis

Primary osteoporosis is caused by age-related bone loss that outpaces new bone formation or the decline in sex gland function in postmenopausal women and older men. Primary osteoporosis accounts for more than 95 percent of cases in women and about 80 percent in men.

Secondary osteoporosis

Secondary osteoporosis can be caused by a variety of reasons, including medications or chronic diseases and conditions. Common conditions that can contribute to the development of osteoporosis include:

• chronic kidney disease
• celiac disease
• rheumatoid arthritis
• hyperthyroidism
• cystic fibrosis

Medications that may trigger osteoporosis include chronic steroids, anticonvulsant medications, and excessive use of thyroid hormone therapy. Low calcium and vitamin D intake may also contribute to osteoporosis.

Bone tumors

When cells divide abnormally and uncontrollably, they can form an extra mass or piece of tissue. This one-time piece of tissue is called a tumor. Tumors also form in the middle of bones. As the tumor grows, its abnormal tissue can displace healthy tissue.

Some tumors are benign. Benign bone tumors do not spread to other parts of the body and are unlikely to cause death, but they can be dangerous and require treatment. Benign tumors can grow and compress healthy bone tissue.

Other types of tumors may be malignant, meaning cancerous. Malignant bone tumors can cause cancer that spreads throughout the body.

Symptoms:

• The area of the body with the affected bone is hot to the touch
• Fever with high temperature
• Fatigue
• General weakness
• Bone pain

If the tumor turns out to be benign, everything will be fine in the long run with the right treatment. However, a benign bone tumor can also grow or turn malignant, so you need to have regular checkups with your doctor.

Hypercalcemia

Hypercalcemia is a condition in which there is too much calcium in the blood. Calcium has important functions, such as helping to keep bones healthy. However, this condition can cause too many problems. Hypercalcemia in humans is quite rare. It occurs in less than one percent of people, according to the National Institutes of Health (NIH).

Symptoms:

• Spinal deformity.
• Muscle pain.
• Vomit.
• Changes in bowel function.
• Bone pain.

Paget's disease

Paget's disease, also known as osteitis deformans, is a chronic condition that affects the skeleton. Paget's disease typically affects older adults. According to the American Academy of Orthopaedic Surgeons (AAOS), the condition affects three to four percent of those over age 50.

In this disease, abnormal bone formation occurs. The new bone becomes larger in size, weaker and usually deformed.

Paget's disease can affect any part of the skeleton. It may be just one or two parts of the skeleton, or the disease may be widespread. The arms, spine, skull, pelvis, and leg bones are commonly affected by this disease.

Doctors don’t know what causes Paget’s disease. Genetic and viral factors may play a role, but more research is needed. Although there are no known good preventative measures that can be taken, a diet containing enough calcium and vitamin D, as well as regular exercise, may help promote bone health.

When symptoms occur, they may include:

• bone pain;
• joint stiffness;
• bone fractures;
• deformities of the legs or skull;
• hearing loss;
• Nerve compression and sensory problems due to enlarged bones.

Osteosarcoma

Osteosarcoma is a bone cancer that usually develops in the shinbone near the knee, the femur near the knee, or the upper arm bone near the shoulder. It is the most common type of bone cancer in children.

Osteosarcoma tends to develop along with growth spurts in early adolescence. The risk of developing the tumor increases precisely when bones are growing rapidly.

This type of cancer is more common in boys than in girls. It is also more common in tall children and African-Americans (ACS 2012). In children, the average age of onset of osteosarcoma is 15 years. Osteosarcoma also occurs in adults over 60 years of age and in patients who have undergone chemotherapy. People with a family history of cancer and those diagnosed with retinoblastoma, a cancer of the retina of the eye, are at higher risk of developing sarcoma.

Symptoms of Osteosarcoma

These vary depending on the location of the tumor. Common signs of this type of cancer include:

• pain in the bones when moving, at rest, or when lifting objects;
• bone fractures;
• swelling;
• redness;
• lameness;
• limited joint mobility.

Rickets

Rickets is a nutritional disorder that can develop if you don't get enough vitamin D, calcium, or phosphate. Rickets causes the growth plate (the growth edge of the bone) to malfunction, soften and weaken the bones, delayed growth, and, in severe cases, skeletal deformities.

Vitamin D helps your body absorb calcium and phosphate from your intestines. You can get vitamin D from the foods you eat, like milk, eggs, and fish, but your body also makes the vitamin when exposed to sunlight.

Vitamin D deficiency makes it difficult for your body to maintain high enough levels of calcium and phosphate. When this happens, your body produces hormones that cause it to produce calcium and phosphate to release them to support your bones. When your bones don’t have enough of these minerals, they become weak and soft.

Rickets is most common in children between the ages of 6 and 24 months. Children are at the greatest risk of developing rickets because they are constantly growing. Children may not get enough vitamin D if they live in an environment with little sunlight, have dark skin, do not drink dairy products, or follow a vegetarian diet. In some cases, rickets is a hereditary disease.

Symptoms:

• Pain in the arm.
• Weakness and vulnerability in the bone.
• Short stature.
• Spinal deformity.
• Bone pain.
• Osteomyelitis.

A bone infection, also called osteomyelitis, can occur when bacteria or fungi invade the bones.

In children, bone infections most often occur in the long bones of the arms and legs, but in adults they also commonly occur in the hips, spine, and legs.

Bone infections can appear suddenly or develop over a long period of time. If not treated properly, bone infections can damage bones.

Nature of bone pain

Severe bone pain is common in more than 65% of patients with bone metastases. The most common sites of pain for victims are the pelvis, hips, skull, and vertebrae. The patient often describes the pain as aching, but some patients experience short, shooting pains that radiate from the torso to the extremities. Movement usually increases the pain.

Bone pain may signal disease progression, new infections, or complications from treatment. Pain is a reliable indicator of early complications, such as metastases, osteoporosis, hypercalcemia, fractures, and spinal cord compression.

These circumstances not only negatively affect the patient's quality of life, but in some cases can provoke a fatal outcome, which occurs not due to metastases, but solely due to bone and skeletal complications.

Diagnostic methods for bone pain

When a patient complains of bone pain, this requires confirmation of the diagnosis, usually by radiographic methods, namely bone X-rays. Conventional X-ray film can adequately detect typical lesions with metastases, but it is not sensitive enough to detect certain complications.

In these cases, radionuclide scintigraphy and magnetic resonance imaging (MRI) are the preferred diagnostic tools.

Who should you contact if you have bone pain?

As we can see, bone pain can be caused by various diseases. If you feel this pain, you should definitely see a doctor for diagnosis and timely treatment.