Résumé
Bone pain (also known medically by several other names) is pain coming from a bone, and is caused by damaging stimuli. It occurs as a result of a wide range of diseases or physical conditions or both, and may severely impair the quality of life. Bone pain belongs to the class of deep somatic pain, often experienced as a dull pain that cannot be localized accurately by the patient. This is in contrast with the pain which is mediated by superficial receptors in, e.g., the skin. Bone pain can have several possible causes ranging from extensive physical stress to serious diseases such as cancer. For many years, it has been known that bones are innervated with sensory neurons, yet their exact anatomy remained obscure due to the contrasting physical properties of bone and neural tissue. More recently, it is becoming clear what types of nerves innervated which sections of bone. The periosteal layer of bone tissue is highly pain-sensitive and an important cause of pain in several disease conditions causing bone pain, like fractures, osteoarthritis, etc. However, in certain diseases, the endosteal and haversian nerve supply seems to play an important role, e.g. in osteomalacia, osteonecrosis, and other bone diseases. Thus, there are several types of bone pain, each with many potential sources or origins of cause. A number of diseases can cause bone pain, including the following: Endocrine, such as hyperparathyroidism, osteoporosis, kidney failure. Gastrointestinal or systemic, such as celiac disease and non-celiac gluten sensitivity (both often occur without obvious digestive symptoms), inflammatory bowel disease (including Crohn's disease and ulcerative colitis). Hematologic, such as Cushing's syndrome, histiocytosis, multiple myeloma and sickle cell anaemia. Infectious, such as Lyme disease and osteomyelitis. Neurological, such as spinal cord injury and vertebral degeneration. Oncologic, such as bone metastasis and leukemia. Rheumatic, such as ankylosing spondylitis, rheumatoid arthritis, gout.
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