<%-- Page Title--%> Health <%-- End Page Title--%>

<%-- Volume Number --%> Vol 1 Num 158 <%-- End Volume Number --%>

June 11, 2004

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What To Do If You Have Bone Pain

Bone pain or tenderness can be a symptom of several conditions including hidden fractures, bone infections, arthritis, leukaemia, bone cancer, or bone metastases (cancer from other tissues that have spread to bone). If the pain in a bone cannot be explained, or does not go away, it warrants immediate attention and a visit to your health care provider.

An Accurate Diagnosis
An accurate diagnosis will not only define the source of the bone pain, but it will also help in discovering the best possible treatment to alleviate the pain and to cure or manage the condition.

An accurate diagnosis and early treatment can help to:
* Avoid infection in a hidden fracture
* Resolve an infection before it causes debilitating damage to bone
* Decrease the risk of arthritic disability
* Prolong life for cancer patients
* Reduce bone pain and complications for cancer patients
* Slow or stop the thinning of bone due to osteoporosis
* Reduce or alleviate pain for all these conditions

Describing Bone Pain
A clear indication of the location, intensity, and duration of your pain can help your doctor make an accurate diagnosis. However, finding the right words to describe pain can be a very difficult task, particularly if the pain is not present at the precise moment you need to tell your doctor about it. One way to help yourself and your doctor is to write down the details of your pain either when it occurs or shortly afterwards. Make note of its severity and frequency. You may also want to include the nature of the pain. For instance, is it a sharp pain or a dull ache?

Achieving a Diagnosis
Your doctor will obtain a medical history of your bone pain, perform a physical examination, and possibly order some diagnostic tests.

Medical History
The questions that may be asked for the medical history commonly include the following:

Is the pain in an arm or leg (upper or lower extremities)?
If so, is it in the main area of the arms and legs or in the forearms, hands, lower legs, or feet (the distal extremities)?
Is the pain in the heels (calcaneal pain)?
Is the pain in the hips, lower back, spine, or neck?
If the pain is in the spine, is it in the middle of the spine or in the lower back or neck?

Time Pattern:
How long ago or at what age did you first notice the pain?
How long have you had the pain?
Is the pain constant or intermittent?
Is the pain getting worse? Is it more intense or more frequent?

Nature of the Pain:
Is the pain, sharp or dull?
Is the pain getting worse? Is it more intense or more frequent?
Do certain positions, motions, or activities affect the pain?

Other Symptoms:
Is the bone swelling?
Do you have a fever?
What other symptoms are you aware of?

Physical Examination
While the focus is on the affected bone, a full physical examination will be performed to rule out various conditions and to support the overall diagnosis. For instance, a physical examination may confirm swollen lymph glands and the possible presence of a bone infection.

Diagnostic Tests
If the cause of the bone pain remains unclear or needs confirmation, the doctor may order diagnostic tests. Some of the tests that may be required include:
* Blood tests
* Bone scan
* CT scan
* Biopsy
* Hormone level studies
* Pituitary and adrenal gland function studies
* Urine studies
* Bone x-rays



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