Bone & Joint
Bone & Joint
A bone is a rigid organ that constitutes part of the vertebrate skeleton. Bones protect the various organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, and enable mobility.
Bones come in a variety of shapes and sizes and have a complex internal and external structure. They are lightweight yet strong and hard, and serve multiple functions.
Bone tissue (osseous tissue) is a hard tissue, a type of dense connective tissue. It has a honeycomb-like matrix internally, which helps to give the bone rigidity. Bone tissue is made up of different types of bone cells. Osteoblasts and osteocytes are involved in the formation and mineralization of bone; osteoclasts are involved in the resorption of bone tissue. Modified (flattened) osteoblasts become the lining cells that form a protective layer on the bone surface.
The mineralised matrix of bone tissue has an organic component of mainly collagen called ossein and an inorganic component of bone mineral made up of various salts. Bone tissue is a mineralized tissue of two types, cortical bone and cancellous bone. Other types of tissue found in bones include bone marrow, endosteum, periosteum, nerves, blood vessels and cartilage.
In the human body at birth, there are over 270 bones, but many of these fuse together during development, leaving a total of 206 separate bones in the adult, not counting numerous small sesamoid bones. The largest bone in the body is the femur or thigh-bone, and the smallest is the stapes in the middle ear.
A number of diseases can affect bone, including arthritis, fractures, infections, osteoporosis and tumours. Conditions relating to bone can be managed by a variety of doctors, including rheumatologists for joints, and orthopedic surgeons, who may conduct surgery to fix broken bones. Other doctors, such as rehabilitation specialists may be involved in recovery, radiologists in interpreting the findings on imaging, and pathologists in investigating the cause of the disease, and family doctors may play a role in preventing complications of bone disease such as osteoporosis.
When a doctor sees a patient, a history and exam will be taken. Bones are then often imaged, called radiography. This might include ultrasound X-ray, CT scan, MRI scan and other imaging such as a Bone scan, which may be used to investigate cancer. Other tests such as a blood test for autoimmune markers may be taken, or a synovial fluid aspirate may be taken.
A joint or articulation (or articular surface) is the connection made between bones in the body which link the skeletal system into a functional whole. They are constructed to allow for different degrees and types of movement.
Some joints, such as the knee, elbow, and shoulder, are self-lubricating, almost frictionless, and are able to withstand compression and maintain heavy loads while still executing smooth and precise movements.
Other joints such as sutures between the bones of the skull permit very little movement (only during birth) in order to protect the brain and the sense organs.
The connection between a tooth and the jawbone is also called a joint, and is described as a fibrous joint known as a gomphosis. Joints are classified both structurally and functionally.
Damaging the cartilage of joints (articular cartilage) or the bones and muscles that stabilize the joints can lead to joint dislocations and osteoarthritis. Swimming is a great way to exercise the joints with minimal damage.
A joint disorder is termed arthropathy, and when involving inflammation of one or more joints the disorder is called arthritis. Most joint disorders involve arthritis, but joint damage by external physical trauma is typically not termed arthritis.
Arthropathies are called polyarticular (multiarticular) when involving many joints and monoarticular when involving only a single joint.
Arthritis is the leading cause of disability in people over the age of 55. There are many different forms of arthritis, each of which has a different cause. The most common form of arthritis, osteoarthritis (also known as degenerative joint disease), occurs following trauma to the joint, following an infection of the joint or simply as a result of aging and the deterioration of articular cartilage. Furthermore, there is emerging evidence that abnormal anatomy may contribute to early development of osteoarthritis. Other forms of arthritis are rheumatoid arthritis and psoriatic arthritis, which are autoimmune diseases in which the body is attacking itself.
Septic arthritis is caused by joint infection. Gouty arthritis is caused by deposition of uric acid crystals in the joint that results in subsequent inflammation. Additionally, there is a less common form of gout that is caused by the formation of rhomboidal-shaped crystals of calcium pyrophosphate. This form of gout is known as pseudogout.
Temporomandibular joint syndrome (TMJ) involves the jaw joints and can cause facial pain, clicking sounds in the jaw, or limitation of jaw movement, to name a few symptoms. It is caused by psychological tension and misalignment of the jaw (malocclusion)
Pain and aches in your bones and joints can range from mild discomfort that goes away by itself to severe aches that require medication. There are many potential causes of bone pain, ranging from a bone bruise or fracture, to less common (albeit very serious) causes, such as bone cancer or infection. Arthritis can cause bone and joint pain. Cancer spreading (metastasizing) into a bone also causes pain. It occurs as a result of a wide range of diseases and/or physical conditions and may severely impair the quality of life for patients who suffer from it.
Joint pain can be caused by injury or disease of the joint or nearby tissues, including the cartilage that serves as cushioning for the adjacent bones. The evaluation of a patient with joint pain calls for a detailed history and physical exam (often focusing on extra-articular findings) and occasionally the sampling of joint fluid and possibly analyzing radiologic and serologic tests.
From a health-care perspective, it is important to know what malady affects the person so that the appropriate treatment can be administered. Disease within the bone or diseases that affect the mineralization or remodeling of bone, as well as problems inflicted upon the bone (breaks, bruises, or infections), may result in pain. A number of diseases can cause bone pain, including the following:
- Endocrine, such as hyperparathyroidism, osteoporosis, renal 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.
- Others, such as fractures, osteoarthritis, Paget’s disease of bone (also termed osteitis deformans or ambiguously, just Paget’s disease).
- Synovitis. The thin membrane (synovium) lining the joints becomes inflamed, releasing chemicals that irritate nerves and increase fluid in the joint.
- Bone erosions. Damaged, pitted bones in your joints cause pain.
- Swollen joint capsule. Fluid builds in the joint from the inflamed synovium, causing pressure, stiffness and pain.
- Ligament damage. The effects of inflammation can damage these bands of flexible tissue that support the joint.
- Muscle weakness. Reduced muscle strength puts more stress on joints.
- Joint fusion. Especially in ankylosing spondylitis, small bones that form the backbone (vertebrae) may fuse together, making it harder and more painful to move.
- Centralized pain. The chronic (long-lasting) pain of inflammatory arthritis can in some cases cause you to become more sensitive to pain.
Treatment depends on a specific underlying cause. The underlying cause will be treated first and foremost. The treatments may include joint replacement surgery for severely damaged joints, immunosuppressants for immune system dysfunction, antibiotics when an infection is the cause, and discontinuing medication when an allergic reaction is the cause. When treating the primary cause, pain management may still play a role in treatment.
The extent of its role varies depending on the specific cause of the arthralgia. Pain management may include stretching exercises, over the counter pain medications, prescription pain medication, or other treatments deemed appropriate for the symptoms. Capsaicin, a substance found in chili peppers, may relieve joint pain from arthritis and other conditions.
Capsaicin blocks the actions of substance P, which helps transmit pain signals, and capsaicin triggers the release of pain-blocking chemicals in the body known as endorphins. Side effects of capsaicin cream include burning or stinging in the area where it is applied. Another topical option is an arthritis cream containing the ingredient, methyl salicylate.
Get information about the drugs used to treat arthritis and its symptoms, from dosages and precautions to side effects and medication safety.
Different types of joint surgery for arthritis and steps you can take before and after to ensure success.
Different types of treatment approaches for arthritis, including biologics, DMARDs, advanced therapies, other medications, and the benefits and risks of arthritis medications.
Get information about natural treatments that can support your health and help ease your pain and arthritis symptoms.
Ways to Relieve Joint Pain Naturally
- Maintaining A Healthy Weight
- Gentle Movement & Exercise
- Taking a Bath in Epsom Salts
- Eating an Anti-inflammatory Diet
- Essential Fatty Acids
- Vitamin D and Vitamin K2
- Gelatin And Collagen
The magnesium sulfate in Epsom Salt is absorbed through the skin and helps reduce inflammation. Add half a cup of salt to a bowl of warm water and soak your painful joint for at least 15 minutes. If you’re experiencing pain in your back or multiple joints, add two cups of Epsom salt to your bath water and soak in the tub for 15 minutes.
This may seem strange since the last thing you want to do when your bones and joints ache is get up and move around, but it will pay off in the long run. Exercise will strengthen and stretch muscles to reduce inflammation. The added movement will also help increase the effects of synovial fluid, which lubricates joints and reduces pain.
Chia seeds, walnuts and foods rich in omega-3 fatty acids are great for reducing inflammation. Meanwhile, fruits and vegetables contain high amounts of pain-reducing antioxidants. Eating a diet rich in these foods can also help you lose weight, which will also alleviate stress on your joints.
Massage some olive oil into your painful joints twice a day and let is absorb into your skin. If you decide to take olive oil orally, you’ll be glad to know that 1.5 tablespoons of olive oil has the same effect as 200 mg of ibuprofen. Whichever way you use olive oil, be sure to buy cold-pressed oil – the heating process some brands use can destroy healthy nutrients.
There are a number of supplements that are an overall healthy addition to your diet and can also improve bone strength, including:
- Vitamin D
- Before you explore any joint pain remedies, be sure to consult with your physician.
Hot or cold packs, or a combination of the two, can soothe sore areas. Heat can help reduce muscle spasms and cold can help reduce inflammation.
Eat a healthy diet that includes enough calcium and vitamin D to keep your bones as strong as they can be.
Maintain a healthy weight to ease stress and strain on your joints.
Exercise regularly. Exercise keeps your bones strong and helps your joints stay flexible.
The information and advice on this page shouldn’t be used to self-diagnose your condition, but may give you a better idea of what’s causing your pain.