Why do my bones hurt and should I worry?

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group
Published: July 9, 2025Updated: July 9, 2025

Summary

Bone pain usually stems from overuse injuries, vitamin D or calcium deficiency, or joint arthritis, but it can also point to fractures, infection, or cancers such as myeloma. Location, timing, and associated symptoms matter. Any deep, unexplained, or night-time bone pain that lasts more than a week deserves medical evaluation and, in people over 50, plain X-ray at minimum.

What happens inside your body when a bone hurts?

Bone pain arises when the thick outer cortex or the inner marrow is irritated by swelling, micro-fractures, reduced blood flow, or tumor growth. "Bone is a living tissue packed with nerves and blood vessels, so even small changes in pressure are painful," explains Sina Hartung, MMSC-BMI.

  • Overuse inflames the periosteumHigh-impact sports can cause shin splints, a periosteal inflammation responsible for up to 10 % of sports-clinic visits.
  • Low mineral density weakens structureOsteoporosis affects one in two women over 50, making micro-fractures a common source of chronic ache.
  • Marrow crowding triggers deep acheConditions like sickle-cell crisis or leukemia fill the marrow cavity, raising pressure and causing throbbing pain.
  • Blood supply mattersAn undiagnosed stress fracture in the femoral neck can cut off blood flow and collapse the hip within months.
  • Inflammatory molecules sensitize periosteal nociceptorsPro-inflammatory cytokines and growth factors released after bone injury reduce the activation threshold of A-delta and C-fibers in the periosteum, turning even light pressure into sharp pain. (NIH)
  • Bone tumors drive pathologic nerve sproutingMetastatic lesions secrete neurotrophic factors that induce new sensory nerve growth into the cortical bone, a mechanism identified as a key contributor to the severe aching of cancer-related bone pain. (Elsevier)

References

Which warning signs suggest a serious cause of bone pain?

Bone discomfort is occasionally a symptom of infection or cancer and should never be ignored when accompanied by constitutional symptoms. "Night pain that wakes you, weight loss, or swelling over the bone are classic red flags," notes the team at Eureka Health.

  • Night-time waking painPersistent pain that is worse at night raises suspicion for malignancy or infection.
  • Unexplained weight loss over 5 % in 6 monthsSuch weight loss accompanies up to 30 % of bone sarcoma cases.
  • Local warmth, redness, or fever above 100.4 °FThese signs suggest osteomyelitis, which needs IV antibiotics within 48 hours to prevent bone destruction.
  • Pain after minimal traumaA fracture from standing height in adults under 50 signals possible metabolic bone disease.
  • Palpable lump or swelling near the painful siteA noticeable mass or swelling over the bone—sometimes warm or tender—is a common presenting feature of primary bone tumours and should prompt urgent imaging. (Macmillan)
  • Increasing difficulty moving the affected limb or jointBone malignancies can limit range of motion or cause a new limp; the NHS notes that trouble using a joint or limb alongside persistent pain warrants specialist referral. (NHS)

References

What are the most common causes of bone pain by age and risk factor?

Age, hormones, and lifestyle direct the differential diagnosis. Sina Hartung, MMSC-BMI, emphasizes, "Matching the pain pattern with patient profile speeds up diagnosis and avoids unnecessary scans."

  • Children: Rapid growth and infectionsGrowing pains peak between ages 8-12, while osteomyelitis is more likely in toddlers after skin infections.
  • Young adults: Stress fractures and vitamin D deficiencyUp to 40 % of military recruits develop tibial stress reactions during basic training.
  • Middle age: Inflammatory arthritisPsoriatic arthritis causes entheseal pain in 0.3-1 % of the general population, often misread as tendonitis.
  • Post-menopause: Osteoporosis and compression fracturesVertebral compression fractures are silent in two-thirds of cases but cause height loss and back pain.
  • Cancer survivors: Bone metastasesBreast and prostate cancers account for 70 % of metastatic bone disease.
  • Sickle cell disease triggers painful bone crises across all agesWebMD notes that the inherited blood disorder sickle cell disease can block blood flow to bone tissue, producing severe, recurrent bone pain episodes irrespective of age or activity level. (WebMD)

References

How can you safely ease bone pain at home?

Mild bone pain that follows a clear strain often improves with supportive measures within two weeks. "Track pain on a 0-10 scale daily; a drop by half within a week signals good progress," advises the team at Eureka Health.

  • Relative rest, not total immobilizationLimit high-impact activity for 48-72 hours but maintain gentle range-of-motion exercises to reduce stiffness.
  • Targeted cold–heat cycleApply ice for 15 minutes to blunt inflammation, then switch to warmth after day three to boost blood flow.
  • Optimize calcium (1,200 mg) and vitamin D (800 IU) intakeA 2023 meta-analysis shows a 15 % reduction in stress-fracture risk when daily requirements are met.
  • Monitor with a pain diaryRecording triggers and relief helps clinicians decide whether imaging is necessary.
  • Light daily movement prevents stiffnessOsteoporosis Canada notes that short walks, gentle stretching, and other low-impact activity help ease discomfort and keep joints flexible when bone pain is mild. (OC)
  • Use OTC pain relievers judiciouslySaint Luke’s Health System advises acetaminophen or NSAIDs for temporary bone pain relief, but only after confirming they are safe with your healthcare provider, especially if you have kidney, stomach, or bleeding risks. (SLHS)
  • Seek medical review if pain worsens or fever appearsMyHealth.Alberta warns to contact a doctor right away when bone pain suddenly intensifies or is accompanied by fever, rash, or chills, as these may signal complications. (MHA)

References

Which tests and treatments might your clinician order for persistent bone pain?

Persistent or unexplained pain warrants structured evaluation. "Plain X-ray is still first-line, but MRI detects stress fractures up to two weeks earlier," says Sina Hartung, MMSC-BMI.

  • Basic labs: CBC, ESR, CRP, calcium, vitamin DElevated ESR (>40 mm/h) plus bone pain has a 75 % sensitivity for infection or malignancy.
  • Imaging ladder: X-ray, then MRI or CTMRI has 92 % sensitivity for occult fractures compared with 65 % for X-ray.
  • Bone density scan for women over 50 or men over 70DEXA T-score below –2.5 confirms osteoporosis and guides anti-resorptive therapy.
  • Medication classes: analgesics, bisphosphonates, antibiotics, or chemotherapyChoice depends on cause; your doctor balances benefit with side-effects like jaw necrosis from long-term bisphosphonates.
  • Radionuclide bone scan flags metabolically active lesions across the skeletonJohns Hopkins lists radionuclide bone scans among core tests for bone disorders; the injected tracer lights up areas of high bone turnover, allowing clinicians to detect metastatic deposits or hidden stress injuries that may be invisible on standard X-rays. (JHM)
  • PET imaging or biopsy clarifies uncertain MRI findingsMayo Clinic notes that PET scans and needle biopsies are often ordered when imaging is inconclusive, helping distinguish infection, fracture, or tumor and ensuring the right treatment—whether radiation, chemotherapy, or surgery. (Mayo)

References

How does Eureka’s AI doctor identify worrying bone pain patterns?

Eureka’s symptom checker asks about pain timing, trauma, fever, and cancer history, then ranks possible causes using evidence-based algorithms. "Our model flags high-risk features like night pain and weight loss and recommends imaging or urgent care in under two minutes," reports the team at Eureka Health.

  • Structured triage questionsUsers answer 12 focused queries that achieve 90 % concordance with orthopedic triage nurses in pilot testing.
  • Integrated lab and imaging suggestionWhen red flags appear, the AI prompts for ESR, CRP, and radiographs, which a licensed physician reviews before ordering.
  • Personalized education sheetsAfter the session, the app sends plain-language guidance tailored to the suspected diagnosis and user age.

Getting ongoing bone-health support through Eureka’s AI doctor

Beyond triage, Eureka tracks recovery and medication adherence. Sina Hartung, MMSC-BMI, notes, "Users with stress fractures who logged pain daily recovered a week faster on average."

  • Symptom and activity tracking dashboardGraphs show pain scores alongside step count, highlighting over-activity spikes.
  • Automated reminders for supplements92 % of users who set vitamin D reminders maintained levels above 30 ng/mL at 6 months.
  • Secure, clinician-reviewed prescriptionsIf bisphosphonate therapy is appropriate, a board-certified doctor reviews the request within 24 hours.
  • High user satisfactionWomen using Eureka for osteoporosis monitoring rate the app 4.8 out of 5 stars.

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Frequently Asked Questions

How can I tell if bone pain is coming from muscle or from the bone itself?

Bone pain is typically deeper, constant, and worsens at night, whereas muscle pain feels more superficial and improves with gentle stretching.

Does vitamin D deficiency really cause bone pain?

Yes, low vitamin D leads to poor calcium absorption, resulting in osteomalacia, a softening of bone that produces diffuse aches, especially in the hips and ribs.

Should I keep walking on a suspected stress fracture?

No. Continued impact can turn a hairline crack into a full fracture. Switch to low-impact activities like swimming until imaging rules out a break.

What infections cause bone pain?

Blood-borne bacteria such as Staphylococcus aureus can seed bone, leading to osteomyelitis, particularly after skin wounds or intravenous drug use.

Can arthritis medications mask signs of a serious bone problem?

Long-term corticosteroids reduce inflammation but also thin bone, so they may hide discomfort while increasing fracture risk.

Is bone pain normal after chemotherapy?

Yes, growth-factor injections and some chemotherapies accelerate marrow turnover, causing temporary bone ache, but persistent or focal pain still requires imaging.

How quickly should a child with limb pain see a doctor?

If pain lasts more than three days, causes limping, or is paired with fever, see a pediatrician promptly to rule out infection or leukemia.

Does weather affect bone pain?

Rapid drops in barometric pressure may slightly increase joint-related pain, but true bone pain from fractures or tumors is unaffected by weather.

This content is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for diagnosis, treatment, and personalized medical recommendations.

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