Aches and pains in bones; Pain - bones

Bone pain is seen less commonly than joint pain and muscle pain . The source of bone pain may be obvious, as in a fracture following an accident. Or it may be more subtle, such as cancer that spreads (metastasizes ) to the bone.

Whatever the source, bone pain should always be taken seriously. Seek medical attention any time you have bone pain.

Bone pain can occur with many injuries or conditions:

• Cancer in the bones (primary malignancy)
• Cancer that has spread to the bones (metastatic malignancy)
• Disruption of blood supply (as in sickle cell anemia )
• Infected bone (osteomyelitis )
• Infection
• Injury (trauma)
• Leukemia
• Loss of mineralization (osteoporosis )
• Overuse
• Toddler fracture (a type of stress fracture that occurs in toddlers)

For unexplained bone pain, see your health care provider.

Take any bone pain or tenderness very seriously. Contact your health care provider if you have any unexplained bone pain.

Your health care provider will ask you about your medical history and perform a physical exam.

Medical history questions may include:

• Location of the pain
  • Is the pain in the forearms, hands, lower legs, or feet (distal extremities)?
  • Is the pain in the main part of the arm or leg?
  • Is the pain in the heels (calcaneal pain)?
• Time and pattern of the pain
  • When did you first notice the pain (at what age did the pain begin)?
  • How long have you had the pain?
  • Is it getting worse?
• What other symptoms do you have?

Diagnostic tests that may be performed include:

• Blood studies (such as CBC , blood differential )
• Bone x-rays , including a bone scan
• CT or MRI scan
• Hormone level studies
• Pituitary and adrenal gland function studies
• Urine studies

Depending on the cause of the pain, your doctor may prescribe:

• Antibiotics
• Anti-inflammatory medicines
• Hormones
• Laxatives (if you develop constipation during prolonged bed rest)
• Pain relievers

For osteoporosis treatment, see the article on osteoporosis .

Tamisiea DF. Radiologic aspects of orthopedic diseases. In: Mercier LR, ed. Practical Orthopedics. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 16.

Coleman RE, Holen I. Bone metastases. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 57.