Bone pain can have many causes and affect daily life. This page gives general information on how bone-related pain typically presents, common causes, possible investigations, which specialists may be consulted, and warning signs that require urgent assessment. Individual diagnosis and care require a clinical consultation.
Bone pain is often described as deep, aching or throbbing and may be felt directly over a bone or deep within a limb. It can worsen with pressure or at night and may be distinguishable from more surface-level muscle pain or joint discomfort. A clinical exam and imaging are usually needed to clarify the source.
Causes range from acute trauma and fractures to stress fractures, bone infections (osteomyelitis), metabolic bone disorders (for example osteomalacia), decreased bone density, and benign or malignant bone lesions. Systemic diseases and immune-mediated conditions can also produce bone pain. More than one factor can contribute at the same time.
Assessment commonly begins with a targeted physical exam. Plain X-rays are often the first imaging step; MRI, CT or bone scan may be used if the diagnosis remains unclear. Blood tests (complete blood count, inflammatory markers such as CRP/ESR, calcium, phosphate, alkaline phosphatase) help guide the assessment. In selected cases a biopsy may be required to obtain tissue for diagnosis.
Start with primary care (family medicine) or internal medicine; based on findings you may be referred to Orthopaedics and Traumatology, Infectious Diseases and Clinical Microbiology, Endocrinology, Oncology, or Physical Medicine and Rehabilitation. Children with bone pain should also be assessed by paediatrics or paediatric orthopaedics.
Seek urgent medical attention if bone pain follows a significant trauma with deformity or inability to use the limb, if pain is severe and uncontrolled, if there is high fever with bone pain, rapidly increasing swelling or redness, an open wound over a bone, or new neurological weakness or numbness. In such situations go to an emergency department or contact emergency services.
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