Learn about chronic bone pain

 

About 80 to 90 percent of patients visiting orthopedic clinics have various kinds of pain, including neck and shoulder pain, thoracic back pain, pain in the waist and lower extremities, or in hip and knee joints. These types of pain are caused by pathological changes in muscles, anadesma, ligaments, intervertebral disks, cartilage and bones. Pain simply caused by various lesions of bone tissue is called ostealgia or bone pain. 

 

Fracture caused by trauma is the most severe bone pain. Besides its ferocity, pain caused by fracture can also severely affect functions of limbs. 

 

Osteomyelitis caused by bacterial infection can also lead to severe pain, often accompanied by fever. 

 

More attention should be paid to pain caused by tumors. In outpatient cases, some patients with bone pain usually ask doctors for further checkup to eliminate the possibility of cancer in bones. In general, early-phase bone tumors are small and hidden deeply in muscles, and are therefore hard to detect. Pain is its earliest clinical manifestation. The pain caused by bone tumors is more obvious when patients sleep at night, contrary to bone pain caused by injury. 

 

Degeneration is the natural aging of human tissues and organs. Just like the boiling frog story, bone pain caused by degeneration is the pain with the highest incidence but the least attention in the early stage. As time goes on and in the later stage, it will be hard to ease the pain. Bone pain caused by degeneration will be explained in detail below.

 

 

Pain caused by degeneration, especially knee pain, is the most commonly seen bone pain in outpatient clinics. The formal medical name for joint degeneration is osteoarthritis. Generally speaking, cartilage on the surface of a joint will become thinner and fragmented due to long-term wear and weight-bearing. As a result, the subchondral cortical bone is exposed and the friction between cortical bones causes pain. 

 

In the early stage, osteoarthritis of the knees causes pain when patients walk up and down stairs, especially when walking down stairs. In later stages, the pain also occurs when walking on flat ground. 

 

Obesity and overuse of joints or staying in a cold and humid environment for a long time can make the joints age faster. Patients are advised to control weight, reduce walking up and down stairs as well as squat exercises, and keep joints warm by not setting the air-conditioning temperature too low in summer and wearing thermal underwear in winter. These measures can prevent the aging and degeneration of knee joints. 

 

If you already have symptoms of joint pain, you can take non-steroidal anti-inflammatory analgesic medication and joint nutrition, or lubrication medicaments such as glucosamine. Eventually, if your joints are severely worn and you cannot walk, you can undergo joint replacement surgery. 

 

Osteoporosis can cause pain in the whole body or in the chest, waist, and back. Different from the sharp pain caused by trauma, the pain caused by osteoporosis is usually blunt. Patients can only roughly indicate the area of the pain, but can’t identify the specific spot. Patients with osteoporosis can have obvious pain when they become more active after a quiet period. Prolonged sitting, standing, or walking will aggravate the pain, which will be relieved after bed rest.  

 

Pain caused by osteoporosis is usually induced by rapid bone turnover and increased bone resorption. Bone pain normally occurs when more than 12 percent of bone mass is lost. 

 

Since pain intensity varies from person to person, it is hard to determine the severity of osteoporosis only by the degree of pain. Patients should preferably go to hospital for a bone densitometry scan. 

 

The prevention of osteoporosis should start in the teenage years. When the elderly are suspected of having osteoporosis, they should be tested for bone mineral density and markers of bone metabolism. Patients diagnosed with osteoporosis should be actively treated with medications, including calcium tablets, activated vitamin D and various medications that inhibit osteoclasts or promote osteoblasts.