8 causes of bone pain
Bone pain isn’t as common as joint pain or muscle pain, but it can be a sign of a serious injury or condition. Bone pain can be aching or quite intense, depending on the cause. Many people with acute bone pain, often from a fracture, become nauseated because of the intensity of the pain. But whether you are experiencing bone tenderness or acute pain, see a doctor investigate the underlying cause.
Most common causes of bone pain and when the pain may be an emergency.
Bone fracture or broken bone is the most obvious cause of bone pain. A fracture can be the result of an accident or a fall, or it can be as sudden as a stress fracture. People with osteoporosis are at risk of breaking bones because the bones are more fragile. If you suspect you have a broken bone, go to the emergency department as soon as possible. An untreated fracture can cause serious problems and may not heal properly.
Osteomyelitis (bone infection)
Osteomyelitis is not common, but it affects 2 out of 10,000 people in the United States. It affects adults, who usually develop an infection in the vertebrae or pelvis, and children, who most commonly get the infection at the ends of the bones in the arms or legs. After a bone fracture, it is infected by bacteria in the bloodstream, or by an open wound, and progresses to the bone. Symptoms include bone tenderness or pain, fever, nausea, and swelling or redness around the area.
Sickle cell anaemia
Blood diseases, such as sickle cell anaemia, can block blood flow in the blood vessels. These blockages can cause bone pain. People with sickle cell anaemia may have a few or more episodes. The bone pain is very severe. This is called a crisis. Those who experience a pain crisis often need to be hospitalized to stabilize the pain. Doctors use strong pain relievers such as opioids and other treatments such as blood transfusions. Bone pain lasts only a few hours or takes weeks to resolve.
Researchers estimate that each year, about 3,500 U.S. adults and children are diagnosed with bone cancer. There are several types of bone cancer, including chondrosarcoma, chordoma, osteosarcoma and Ewing sarcoma. Bone cancer symptoms can include bone pain, but it’s not unusual for bone cancer to be detected after someone has broken a bone. Bone cancer weakens your bones and makes them susceptible to fractures. When an X-ray is done for the fracture, the radiologist may detect abnormalities that could be related to bone cancer.
Some types of cancer, such as leukaemia, lymphoma, myelodysplastic syndromes, and myeloma, cause pain in the bones, most often in the arms, legs, and ribs. The pain is caused by the accumulation of cancer cells in the bone marrow. For some, bone pain is the first noticeable symptom of the disease. When you are treated for cancer, your bone pain decreases or goes away completely. Leukaemia can weaken bones and lead to osteoporosis and brittle bones.
Cancer treatments often include strong medications that can have several, sometimes severe, side effects or complications. Bone pain is one such side effect for some people who are treated with chemotherapy, such as nab-paclitaxel, docetaxel, or methotrexate, hormonal therapy like raloxifene and tamoxifen, and targeted therapies, like trastuzumab, and olaparib. Bisphosphonates, given to people with osteoporosis also can cause bone pain. If you are receiving such treatments, tell your healthcare provider about any unusual symptoms you experience.
Chemotherapy for cancer treatment weakens your immune system by depleting your white blood cells. These are the cells that help you fight infection. A weakened immune system can make it easier for you to develop infections and related problems. Oncologists may prescribe filgrastim to patients after treatment to stimulate the growth of white blood cells. The medication is administered by injection or intravenously (IV). One of the side effects of filgrastim, which affects more than 30% of patients, is bone pain, which is very painful due to discomfort.
Tailbone pain, also called coccydynia or coccygodynia, is a common pain with many possible causes, from falling on your backside to sitting too long on a hard seat. Even vaginal childbirth can cause tailbone pain. In most cases, the pain isn’t serious and will go away on its own. If taking over-the-counter pain killers, applying ice to the tailbone area, and sitting on soft cushions doesn’t help, contact your doctor. You may need an X-ray, physical therapy, and stronger pain-relieving options until the area heals.
Diagnosing the cause of bone pain
Your doctor will want to know your complete medical history, previously diagnosed conditions, and details of your bone pain. These may include:
- The location of your pain
- When your pain began
- The level of pain and whether or not it is increasing
- If your pain changes with your activities
- Any other symptoms you may have
Depending on the specifics of your pain, as well as a thorough physical examination, additional testing may include:
- X-rays of the bone that hurts (to identify breaks, fractures, and abnormalities).
- CT scan, MRI, or bone scan of the affected area or your entire body (to identify tumours or other abnormalities).
- Blood studies.
- Urine studies.
- Hormone level studies.
- Pituitary and adrenal gland function studies.
Treatment for bone pain
Your doctor will determine your treatment based on your diagnosis. If you have a bone fracture, they need to be repaired. If you have an underlying condition, such as osteoporosis or cancer, you need a special long-term treatment plan to diagnose it.
Prescription medications can include:
- Drugs to relieve inflammation
- Antibiotics, if you have an infection
- Hormones, if you have a hormone imbalance
- Pain relievers
Some exercises that might help alleviate bone pain from specific causes include:
Low back pain
Stretching, walking, swimming, bicycling, and light strength training can ease lower back pain.
Osteoporosis causes your bones to lose density and become weak and brittle, increasing your chances of bone fractures. Exercising several times a week can help build strength.
Walking, treadmill, climbing stairs, dancing, swimming, and bicycling are recommended. Working with light weights can also help build strength.
If you have arthritis, it may be tempting to avoid exercise. But that is unwise. Exercise helps to keep your joints flexible and can reduce pain in the long run. A balanced exercise regimen of stretching, walking, swimming, and bicycling can help.
Avoid exercises that put stress on your joints, such as running, competitive sports, and aerobics.
When to see a doctor
Serious conditions often cause bone pain. Mild bone pain can also indicate an emergency. If you experience bone pain that does not improve in a few days, see your doctor.
You should also see a doctor if you have bone pain, weight loss, loss of appetite, or general fatigue.
Bone pain caused by injury also requires a visit to the doctor. Direct injury fractures to the bone require medical treatment. Without proper treatment, the bones will heal and prevent movement in the wrong places. Lesions can also infect you.