Bone pain is pain or discomfort that starts in one or more of your body’s bones. There are many causes of bone pain, ranging from minor to serious. Identifying the underlying cause of bone pain is essential for effective management and treatment.
Bone pain has many possible causes, ranging from minor injuries to more serious underlying conditions.
1. Osteoporosis
Osteoporosis is when bones become thinner and weaken over time, increasing the risk of fractures (broken bones). Although osteoporosis often causes no pain until a bone breaks, if left untreated, it can lead to chronic (long-term) aching pain, usually affecting the hips, lower back, hands, knees, and neck.
Bones are living tissues packed with nerves that send pain signals to the brain and help regulate how bones grow, break down, and heal. As bones continue to break down and weaken, dysfunction of these nerves can disrupt the normal bone-building cycle, leading to chronic bone pain.
Other osteoporosis symptoms:
- Loss of height
- Stooped or hunched posture
- Bone fractures that occur from minor falls or everyday activities, such as lifting, coughing, or bending
2. Bone Fractures & Bruises
Bone injuries, including fractures and bruises, are a common cause of bone pain.
A bone fracture, or broken bone, occurs when a bone cracks or completely breaks, usually due to falls, sports injuries, or car accidents. A bone fracture typically causes sharp, severe pain at the fracture site.
Other fracture symptoms:
- Swelling
- Bruising
- Tenderness
- Difficulty moving the affected body part
A bone bruise occurs when a bone is struck with enough force to damage the soft tissue around it without breaking the bone itself, causing fluid buildup in the bone marrow.
Other bone bruise symptoms:
- Throbbing bone pain
- Swelling
- Tenderness
3. Osteoarthritis
Osteoarthritis is the leading cause of chronic bone pain. It’s a degenerative joint disease that causes joint tissues to wear down over time, primarily in the neck, lower back, knees, hips, and hands. You may notice the bone pain during or after physical activity. Symptoms tend to develop gradually.
Other osteoarthritis symptoms:
- Achiness that may worsen at night
- Joint stiffness, especially after resting or in the morning
- Limited range of motion in affected joints that improves with movement
- Swelling around the affected joints, especially after periods of physical activity
- Clicking or popping sounds when the affected joint bends
4. Bone Infection
Osteomyelitis is a bone infection that can cause mild to severe bone pain, which may feel like a deep throbbing or aching. It can develop when a bacterial or fungal infection in another body area, such as the skin, spreads through the bloodstream and infects one or more nearby bones. Osteomyelitis can be acute (short-term) or chronic.
Other osteomyelitis symptoms:
- Excessive sweating
- Fever
- Swelling and warmth around the affected area
- Feeling generally unwell
5. Paget’s Disease of Bone
Paget’s disease is a chronic bone disorder that affects the way bone is broken down and rebuilt. Typically, the body removes old pieces of bone and replaces them with new bone. With Paget’s disease, new bone forms more quickly than the body removes old bone. Because new bone forms too quickly, the bones are bigger, weaker, and softer than healthy bone.
Many people with Paget’s disease have no symptoms. When symptoms do develop, pain is one possible symptom.
Other Paget’s disease symptoms:
- Misshapen bones
- Frequent broken bones
- Arthritis in joints close to the affected bones
- Nerve pain, weakness, or numbness when enlarged bones press on nearby nerves
- Hearing loss (when the disease affects bones in the skull)
6. Bone Cancer
Bone cancer develops when abnormal cells multiply and grow uncontrollably, forming a tumor in the bone. Primary bone cancer, cancer that initially develops in bones, is rare. Most forms of bone cancer are metastatic, meaning cancer cells from another body area spread into the bone.
Bone pain is the most common symptom in people with bone cancer. Initially, the pain may come and go or worsen at night or during certain activities. Over time, the pain can worsen and may become constant. Bone cancer symptoms vary, depending on which bone(s) the tumors develop in.
Other bone cancer symptoms:
- A lump or swelling in the affected area
- Fatigue
- Unintended weight loss
- Bone fractures
Less Common Causes
Other less common causes of bone pain include:
- Osteonecrosis: This is a condition that causes bone death from a lack of blood flow to the affected bone. Poor blood flow has many possible causes, including traumatic injuries, excessive alcohol consumption, prolonged steroid use, and blood clotting disorders. Symptoms, including bone pain and limited range of motion, develop gradually and progressively worsen.
- Rickets: This disorder is caused by vitamin D deficiency. It leads to weak, soft bones. Symptoms include bone pain, fractures, muscle weakness, dental problems, and skeletal changes, like bowed legs.
- Multiple myeloma: This type of blood cancer affects plasma cells in the bone marrow, leading to pain and weak bones prone to fractures.
- Hyperparathyroidism: With this condition, parathyroid glands in the neck produce too much parathyroid hormone (PTH). PTH helps regulate vitamin D, calcium, and phosphorus levels in the bones and blood. With too much PTH, blood calcium levels increase, leading to bone pain, fragile bones, fatigue, nausea, and mood changes.
- Fibrous dysplasia: With this rare bone disorder, the body replaces normal bone tissue with fibrous tissue (like collagen), causing bone pain, abnormalities, and fractures.
Bone pain often feels like it comes from deep within the body. It may be constant or come and go, worsening during certain activities or times of the day. People with bone pain may describe it as:
- Dull aching
- Sharp
- Stabbing
- Throbbing
- Tenderness
The type of bone pain you experience can provide important clues about the potential cause. For example, pain that worsens with activity may be a sign of injury, whereas pain that worsens at night is associated with certain types of arthritis. Understanding these signals can help in early diagnosis and effective treatment.
Depending on the underlying cause, bone pain may be localized or widespread. Localized bone pain occurs in one specific area, such as the forearm, rib cage, or shin. Localized pain may worsen with pressure on the affected area or during particular movements. Widespread bone pain may affect a large area, such as the entire back, or multiple body areas, like the back, arms, and legs.
It is essential to see a doctor anytime you have unexplained bone pain. A proper evaluation is necessary to diagnose the cause of bone pain and start appropriate treatment. See a doctor promptly if you have bone pain with any of the following symptoms:
Consider going to a primary care provider, an orthopedic surgeon who specializes in musculoskeletal injuries and diseases, or a rheumatologist who specializes in autoimmune and musculoskeletal conditions.
Your doctor will likely review your medical history and perform a physical examination to reach a diagnosis. They may want to know:
- Where you feel bone pain
- When it first developed
- How severe the pain is
- What activities worsen or improve the pain
Diagnostic tests can help provide an accurate diagnosis. Your doctor may order:
- Blood tests: These tests check for signs of inflammation, infection, or markers of bone diseases such as osteoarthritis.
- Bone density scan: A dual-energy X-ray absorptiometry (DEXA or DXA) scan uses a low-dose X-ray to measure bone minerals, such as calcium. The measurement assesses bone strength and thickness (bone density) to help diagnose osteoporosis.
- Imaging scans: This could include X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans. These imaging scans help provide a better look at the bones to detect fractures, bone deformities, infections, and abnormalities like tumors.
- Bone biopsy: This involves removing a small piece of bone tissue or a bone marrow sample to help diagnose bone infections and cancers.
Treatment for bone pain depends on the cause and severity of pain.
At-Home Treatments
Self-care strategies can help ease bone pain from the comfort of your home. These include:
- Heat and cold therapy: Placing an ice pack or frozen damp cloth over acute injuries can help reduce pain and inflammation. Heat therapy, such as a heating pad over the painful area, can temporarily relieve more chronic causes of bone pain.
- Rest and activity modification: Your healthcare provider may recommend avoiding certain activities briefly to promote healing.
- Over-the-counter pain relievers: Medications such as Advil (ibuprofen) and Tylenol (acetaminophen) can temporarily relieve pain and inflammation.
- Lifestyle modifications: Maintaining your weight, avoiding smoking, and consuming a calcium-rich diet can support overall bone health.
Medical Treatments
Medications and medical interventions can help address the underlying cause of bone pain and provide pain relief. These may include:
- Prescription medications: For moderate to severe pain or chronic conditions, more potent pain relievers (like opioids), nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroids can help reduce bone pain and inflammation. Antibiotics treat bone infections, and bisphosphonates help treat osteoporosis.
- Physical therapy: Working with a physical therapist can help treat osteoarthritis, injuries, and other conditions that cause bone pain and limit range of motion. Physical therapy programs help improve strength, flexibility, balance, and coordination to help maintain mobility and independence. Some physical therapists also help improve body mechanics and posture and teach how to use assistive devices to relieve pain and promote mobility.
- Surgery: Bone fractures, anatomical abnormalities, and tumors may require surgery to repair or remove damaged tissues and bones.
Bone pain has many possible causes, including injuries like fractures and bruises, and chronic conditions like osteoporosis and osteoarthritis. Symptoms can range from sharp to dull, throbbing, or tender. Unexplained bone pain should be evaluated, especially if you have other symptoms like a fever and fatigue.
