Bone Pain

There are 206 bones in the human body. The biggest being the femur or thigh and the smallest is the stapes in the middle ear. We don’t have much to do with the stapes but we have a lot to do with the others.

Bone pain can often be a worrying sign, particularly without due cause like a whack or an injury such as osteoporosis, a stress fracture or actual break.

However, as most of our tendons attach to the bones via the surface fibrous coat called the periosteum there is scope for other issues as well. Further bone has a tendency to grow in response to stress, sometimes impinging on tendons and other structures.

A comprehensive list of bone pain causes is listed here. Let’s breakdown the common causes of bone pain that we as Physiotherapists treat.

Arthritic Joints

Arthritic change impacts on the bones hugely, especially when the cartilage is worn completely away. Management of the strength and control around the joints plays a huge part in helping these issues alongside injections such as hyaluronic acid (lubricant), but eventually, where possible, joint replacement can be really good.

The Mayo Clinic sets this out well here. In summary, this is,

Keep your joints moving. Daily, gently move your joints through their full range of motion to reduce your pain and stiffness, strengthen your muscles and increase your endurance.
Keep good posture. We can show you how to sit, stand and move correctly.
Work to your limits. Balance activity and rest, and don’t overdo.
Manage weight. Being overweight contributes to arthritis pain.
Stop smoking. Smoking causes stress on connective tissues, which increases arthritis pain.

Stress Fractures

Sportsmen and women can develop issues with the bone called stress fractures where the bony structure reduces in its density in an abnormal response to load. These can be treated well by allowing the bone to heal and identifying the biomechanical reasons behind the bony overload. This is something we have huge experience in, especially in the female runner who is particularly susceptible.

The most common group for this are runners, soldiers and dancers. The most common areas for stress fractures are the shin followed by the 2nd and 3rd metatarsals or toe bones.

Further research on stress fractures can be found here.

Bony growths

Case courtesy of Dr Hani Salam, Radiopaedia.org. From the case rID: 9030

Arthritis change leads to some bone growth around the edge of a joint. However, in the younger person stress from sport and life can cause other areas to grow.

For example, Haglund’s deformity develops in the heel and can impinge into the Achilles Tendon and bursa. Osgood Schlatter’s disease and Sever’s are bone issues common in young sportspeople. Further, around the hip, there are things like CAM deformities of the neck of the femur which pinch the front of the hip joint causing Femoro-Acetabular Impingement.

Age and bone growth information can be found here.

There is a lot we can do with bone issues and they play a huge part in our daily workload. Please let us help you with them!

Further reading can be found here for arthritis.