Table of ContentsView AllTable of ContentsOsteoporosisBone BruiseFractureInfectionOsteonecrosisOsteomalaciaPaget’s DiseaseVaso-Occlusive CrisisPrimary Bone CancerMetastatic Bone CancerMultiple MyelomaLeukemiaWhen to Call a Healthcare Provider
Table of ContentsView All
View All
Table of Contents
Osteoporosis
Bone Bruise
Fracture
Infection
Osteonecrosis
Osteomalacia
Paget’s Disease
Vaso-Occlusive Crisis
Primary Bone Cancer
Metastatic Bone Cancer
Multiple Myeloma
Leukemia
When to Call a Healthcare Provider
Bonepain in the legs can have several causes, includinginfection, a bone bruise or fracture, or evenbone cancer. The diagnosis will depend on your symptoms and the type of pain (sharp, stabbing, or dull). Imaging and blood tests can help a healthcare provider to determine a diagnosis.
Treatment for bone pain will depend on the cause. It may be as simple as rest and over-the-counter pain medication for a minor injury to cancer care after abone marrow biopsy. Some people may need immediate intervention, for example, to deal with complications ofsickle cell disease.
This article discusses the causes of bone pain and how you can know if the pain is a sign of a serious health concern. It explains how various conditions that cause bone pain are treated.
Verywell / Alexandra Gordon
Osteoporosisis a disease in which your bones become thinner and weaken, typically with age, although it can affect young people. About 54 million people, both male and female, live with osteoporosis in the United States.Risk factors include:
Osteoporosis is a common cause of bone pain.Bone density scansare used to evaluate a diagnosis, withX-raysoften used to confirm a fracture. Treatment will depend on the problem, but prevention is key with the disease. It includes:
A bonebruisemost commonly occurs when a bone hits a hard surface, as in a fall from a great height. It is often associated with another injury, like an anterior cruciate ligament (ACL) tear.
A bruise causes:
The diagnosis of bone pain usually involves visual confirmation of the injury during a physical exam, along with a detailed medical history and an X-ray or other imaging tests. Treatment includes:
To ease your bone pain, your healthcare provider may recommend Tylenol (acetaminophen) or anon-steroidal anti-inflammatory drug (NSAID)like Advil (ibuprofen).
Preventing a Bone BruiseTo prevent bone bruises, wear protective gear during contact sports, like shin guards and knee or elbow pads. Always wear a bicycle helmet when riding, and use seatbelts while riding in a vehicle.
Preventing a Bone Bruise
To prevent bone bruises, wear protective gear during contact sports, like shin guards and knee or elbow pads. Always wear a bicycle helmet when riding, and use seatbelts while riding in a vehicle.
Understanding Bone Bruises
A fracture refers to a broken bone, which may occur as a result of trauma, bone weakening from osteoporosis, orrepetitive stresseson the bone.
Besides a sharp, stabbing pain that worsens with movement or when pressure is applied, swelling and bruising around the fracture may occur. In some cases, the area involving the fracture will appear deformed.
Diagnosis is typically straightforward. The fracture may be visible, or the injury is identified with imaging. Treatment will depend on the location and severity of the fracture. A finger may require basic splinting for a few weeks, while a severe femur (leg) fracture needs immediatesurgery.
Pain management andphysical therapyalso may be part of your fracture treatment plan, in order to strengthen and improve the flexibility and mobility of surrounding muscles.Physical therapy is also useful for improving bone strength and health in people who have osteoporosis or osteomalacia.
Vertebral compression fractures—also called spinal fractures—cause back pain and are most common in individuals with osteoporosis.These fractures may result from simple tasks like performing a household chore, sneezing, or coughing.
Features of Bone Fracture
An infection of the bone—calledosteomyelitis—causes dull bone pain, along with swelling, warmth, redness, and tenderness around the affected area. Afevermay also be present.
Osteomyelitis may occur as a result of bacteria within the bloodstream seeding the boneorfrom an infection that spreads to the bone from an adjacent soft tissue or joint. Antibiotics are used to treat many types of bone infections after a diagnosis that relies on blood tests and imaging.
Antibiotics, given through the vein (intravenous), are necessary to treat a bone infection. In some cases, surgical techniques are used to remove dead bone and tissue.
An Overview of Osteoporosis
Osteonecrosisoccurs when a bone’s blood supply is compromised, resulting in death of bone and bone marrow cells and subsequent bone collapse. In addition to pain, limited use of the affected area is common. For instance, with osteonecrosis of the hip, a person may limp and require the use of a cane or walker.
Besides serious injury or trauma, the most common risk factors for developing osteonecrosis include:
Treatment may vary depending on the location and severity of the osteonecrosis. It can include anti-inflammatory medication and surgical options.
Groin Pain: Causes and How to Get Rid of It
Osteomalaciarefers to decreased bone mineralization and subsequent bone softening. This bone condition most commonly occurs as a result ofvitamin D deficiency. While not always present, the dull, aching bone pain of osteomalacia tends to be worse with activity and bearing weight.
In addition to generalized bone pain and tenderness, a person with osteomalacia may experience:
Treatment depends on the underlying cause but may requirevitamin D supplementssince vitamin D deficiency is the most common cause. Improvement in bone pain can be significant, occurring within weeks.
Why You Need Vitamin D
Paget’s diseaseis a chronic bone condition that affects older adults. In this disease, the bone remodeling process (in which old bone is removed and new bone is formed) goes awry. This leads to the formation of excess bone that is brittle or abnormally shaped.
Paget’s Disease vs. Osteoarthritis
Vaso-Occlusive Crisis From Sickle Cell Anemia
Unfortunately, these sticky, stiff cells get stuck to the walls of small blood vessels, eventually blocking blood flow and oxygen delivery—a phenomenon called a vaso-occlusive crisis (VOC).
Bone pain from a VOC can be intense and felt in the legs, arms, and back.
Triggers are variable and often unknown, but may include:
Sickle cell anemia requires life-long treatment. In addition to pain medications, patients often take antibiotics to prevent and treat infections and Hydrea (hydroxyurea) to help reduce the number of vaso-occlusive crises.
Because sickle cell anemia is a genetic disease, vaso-occlusive crises may begin in babies as young as 6 months old and last throughout life.
Bone pain is the most common symptom of bone cancer. The pain usually comes and goes at first and then becomes constant. Besides a deep or dull aching pain that is worse at night and during activity, swelling around the bone, weight loss, and fatigue may occur with bone cancer 410.
Primary bone cancers, ranging from most to least common, include:
Both osteosarcoma andEwing’s sarcomaare more common in children and adolescents. Chondrosarcoma is most common in adults older than 40 years.
Metastatic bone cancer refers to cancer that begins in another organ (most commonly, the breast, lung, thyroid, kidney, and prostate) and spreads (metastasizes) to the bone. Cancer that spreads to the bone weakens it, causing pain and making the bone more prone to breaking.
An oncologist will order blood tests, especially if the cancer is metastatic and the primary cancer site is unknown. While certainly not an exhaustive list, some of these blood tests that may be ordered include:
An Overview of Bone Cancer
Multiplemyelomais a cancer of plasma cells, a type of immune system cell that normally produces antibodies. These cells grow abnormally and uncontrollably within the bone marrow and eventually cause a multitude of symptoms including:
Your healthcare provider also will order imaging and evaluate a bone marrow aspiration andbiopsy. Treatment may include chemotherapy, steroid medications, and/or stem cell transplants.
What Is Multiple Myeloma?
Withleukemia, abnormal blood cells grow uncontrollably within a person’s bone marrow. This excess growth of cancer cells leads to overcrowding within the bone marrow, which causes bone and joint pain.
The aching bone pain is usually felt in the long bones of the arms and legs as well as the ribs. It is most common inacute lymphoblastic leukemia, but may also occur inacute myeloid leukemiaor myelodysplastic syndrome.
Bone Pain and Cancer TreatmentsOnce cancer has been diagnosed, treatment will depend on the type of cancer, its location, and how advanced its growth and spread have become. It also will depend on if the cancer is a primary bone cancer or not.Radiationis a key therapy for treating primary and metastatic bone cancer. Othercancer treatmentsinclude:ChemotherapySurgeryTargeted therapyImmunotherapy drugsOpioids and otherpain medication
Bone Pain and Cancer Treatments
Once cancer has been diagnosed, treatment will depend on the type of cancer, its location, and how advanced its growth and spread have become. It also will depend on if the cancer is a primary bone cancer or not.Radiationis a key therapy for treating primary and metastatic bone cancer. Othercancer treatmentsinclude:ChemotherapySurgeryTargeted therapyImmunotherapy drugsOpioids and otherpain medication
Once cancer has been diagnosed, treatment will depend on the type of cancer, its location, and how advanced its growth and spread have become. It also will depend on if the cancer is a primary bone cancer or not.Radiationis a key therapy for treating primary and metastatic bone cancer. Othercancer treatmentsinclude:
Types of Cancer and How They Differ
It’s important to seek medical attention for any type of bone pain, especially (and more urgently) if your pain is severe, persistent, worsening over time, or associated with:
Your healthcare provider will evaluate the pain, your mobility, and related factors. They will likely order imaging tests to diagnose your bone pain, and rule out other causes ofjoint painormuscle pain. Beyond X-rays and bone scans, these tests may include:
Questions From a Healthcare ProviderExpect to answer these questions about your bone pain:Where is your pain located?When did your bone pain first become noticeable?Have you experienced any recent trauma or injury?Is your pain constant or does it come and go?Does anything make your pain worse or better?Does your pain wake you up at night?Are you experiencing other symptoms (e.g., fever, weight loss, or muscle weakness)?
Questions From a Healthcare Provider
Expect to answer these questions about your bone pain:Where is your pain located?When did your bone pain first become noticeable?Have you experienced any recent trauma or injury?Is your pain constant or does it come and go?Does anything make your pain worse or better?Does your pain wake you up at night?Are you experiencing other symptoms (e.g., fever, weight loss, or muscle weakness)?
Expect to answer these questions about your bone pain:
Summary
Bone pain in your legs can have many causes. They may be obvious, as is the case when you injure yourself and know the cause of a bone bruise or fracture. The cause also may become clear during routine tests, like a bone density scan that reveals osteoporosis or an X-ray that shows Paget’s disease even where no pain occurred.
In other cases, though, the bone pain in your legs may be more difficult to diagnose. It also may involve a serious illness such as cancer or complications of sickle cell disease.
Contact your healthcare provider for diagnosis and treatment of your bone pain. And seek immediate care for a sudden injury or if symptoms are severe.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Osteoporosis Foundation.What is osteoporosis and what causes it?Heuchemer L, Emmert D, Bender T, Rasche T, Marinova M, Kasapovic A,et al.Schmerztherapie bei Osteoporose [Pain management in osteoporosis].Orthopade. 2020 Apr;49(4):363-376. German. doi:10.1007/s00132-020-03898-5.Office of the Surgeon General (US).Lifestyle approaches to promote bone health.Ward P, Chang P, Radtke L, Brophy RH.Clinical Implications of Bone Bruise Patterns Accompanying Anterior Cruciate Ligament Tears.Sports Health. 2022 Jul-Aug;14(4):585-591. doi:10.1177/19417381211029583.Kim YJ.Red flag rules for knee and lower leg differential diagnosis.Ann Transl Med. 2019 Oct;7(Suppl 7):S250. doi: 10.21037/atm.2019.07.62.Kutsal FY, Ergin Ergani GO.Vertebral compression fractures: Still an unpredictable aspect of osteoporosis.Turk J Med Sci. 2021 Apr 30;51(2):393-399. doi:10.3906/sag-2005-315.Zhao DY, McCann L, Hahn G, Hedrich CM.Chronic nonbacterial osteomyelitis (CNO) and chronic recurrent multifocal osteomyelitis (CRMO).J Transl Autoimmun. 2021 Mar 20;4:100095. doi:10.1016/j.jtauto.2021.100095.American College of Rheumatology.Osteonecrosis.Cohen A, Drake MT.Clinical manifestations, diagnosis, and treatment of osteomalacia.American Academy of Orthopedic Surgeons.Paget’s disease.Ralston SH, Corral-Gudino L, Cooper C, Francis RM, Fraser WD, Gennari L,et al.Diagnosis and Management of Paget’s Disease of Bone in Adults: A Clinical Guideline.J Bone Miner Res. 2019 Apr;34(4):579-604. doi:10.1002/jbmr.3657.Li X, Dao M, Lykotrafitis G, Karniadakis GE.Biomechanics and biorheology of red blood cells in sickle cell anemia.J Biomech. 2017;50:34–41. doi:10.1016/j.jbiomech.2016.11.022Ferguson JL, Turner SP.Bone cancer: Diagnosis and treatment principles.Am Fam Physician.2018 Aug 15;98(4):205-13.American Academy of Orthopedic Surgeons.Metastatic bone disease.National Organization for Rare Disorders.Multiple Myeloma.Leukemia & Lymphoma Society.Signs and Symptoms.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Osteoporosis Foundation.What is osteoporosis and what causes it?Heuchemer L, Emmert D, Bender T, Rasche T, Marinova M, Kasapovic A,et al.Schmerztherapie bei Osteoporose [Pain management in osteoporosis].Orthopade. 2020 Apr;49(4):363-376. German. doi:10.1007/s00132-020-03898-5.Office of the Surgeon General (US).Lifestyle approaches to promote bone health.Ward P, Chang P, Radtke L, Brophy RH.Clinical Implications of Bone Bruise Patterns Accompanying Anterior Cruciate Ligament Tears.Sports Health. 2022 Jul-Aug;14(4):585-591. doi:10.1177/19417381211029583.Kim YJ.Red flag rules for knee and lower leg differential diagnosis.Ann Transl Med. 2019 Oct;7(Suppl 7):S250. doi: 10.21037/atm.2019.07.62.Kutsal FY, Ergin Ergani GO.Vertebral compression fractures: Still an unpredictable aspect of osteoporosis.Turk J Med Sci. 2021 Apr 30;51(2):393-399. doi:10.3906/sag-2005-315.Zhao DY, McCann L, Hahn G, Hedrich CM.Chronic nonbacterial osteomyelitis (CNO) and chronic recurrent multifocal osteomyelitis (CRMO).J Transl Autoimmun. 2021 Mar 20;4:100095. doi:10.1016/j.jtauto.2021.100095.American College of Rheumatology.Osteonecrosis.Cohen A, Drake MT.Clinical manifestations, diagnosis, and treatment of osteomalacia.American Academy of Orthopedic Surgeons.Paget’s disease.Ralston SH, Corral-Gudino L, Cooper C, Francis RM, Fraser WD, Gennari L,et al.Diagnosis and Management of Paget’s Disease of Bone in Adults: A Clinical Guideline.J Bone Miner Res. 2019 Apr;34(4):579-604. doi:10.1002/jbmr.3657.Li X, Dao M, Lykotrafitis G, Karniadakis GE.Biomechanics and biorheology of red blood cells in sickle cell anemia.J Biomech. 2017;50:34–41. doi:10.1016/j.jbiomech.2016.11.022Ferguson JL, Turner SP.Bone cancer: Diagnosis and treatment principles.Am Fam Physician.2018 Aug 15;98(4):205-13.American Academy of Orthopedic Surgeons.Metastatic bone disease.National Organization for Rare Disorders.Multiple Myeloma.Leukemia & Lymphoma Society.Signs and Symptoms.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Osteoporosis Foundation.What is osteoporosis and what causes it?Heuchemer L, Emmert D, Bender T, Rasche T, Marinova M, Kasapovic A,et al.Schmerztherapie bei Osteoporose [Pain management in osteoporosis].Orthopade. 2020 Apr;49(4):363-376. German. doi:10.1007/s00132-020-03898-5.Office of the Surgeon General (US).Lifestyle approaches to promote bone health.Ward P, Chang P, Radtke L, Brophy RH.Clinical Implications of Bone Bruise Patterns Accompanying Anterior Cruciate Ligament Tears.Sports Health. 2022 Jul-Aug;14(4):585-591. doi:10.1177/19417381211029583.Kim YJ.Red flag rules for knee and lower leg differential diagnosis.Ann Transl Med. 2019 Oct;7(Suppl 7):S250. doi: 10.21037/atm.2019.07.62.Kutsal FY, Ergin Ergani GO.Vertebral compression fractures: Still an unpredictable aspect of osteoporosis.Turk J Med Sci. 2021 Apr 30;51(2):393-399. doi:10.3906/sag-2005-315.Zhao DY, McCann L, Hahn G, Hedrich CM.Chronic nonbacterial osteomyelitis (CNO) and chronic recurrent multifocal osteomyelitis (CRMO).J Transl Autoimmun. 2021 Mar 20;4:100095. doi:10.1016/j.jtauto.2021.100095.American College of Rheumatology.Osteonecrosis.Cohen A, Drake MT.Clinical manifestations, diagnosis, and treatment of osteomalacia.American Academy of Orthopedic Surgeons.Paget’s disease.Ralston SH, Corral-Gudino L, Cooper C, Francis RM, Fraser WD, Gennari L,et al.Diagnosis and Management of Paget’s Disease of Bone in Adults: A Clinical Guideline.J Bone Miner Res. 2019 Apr;34(4):579-604. doi:10.1002/jbmr.3657.Li X, Dao M, Lykotrafitis G, Karniadakis GE.Biomechanics and biorheology of red blood cells in sickle cell anemia.J Biomech. 2017;50:34–41. doi:10.1016/j.jbiomech.2016.11.022Ferguson JL, Turner SP.Bone cancer: Diagnosis and treatment principles.Am Fam Physician.2018 Aug 15;98(4):205-13.American Academy of Orthopedic Surgeons.Metastatic bone disease.National Organization for Rare Disorders.Multiple Myeloma.Leukemia & Lymphoma Society.Signs and Symptoms.
National Osteoporosis Foundation.What is osteoporosis and what causes it?
Heuchemer L, Emmert D, Bender T, Rasche T, Marinova M, Kasapovic A,et al.Schmerztherapie bei Osteoporose [Pain management in osteoporosis].Orthopade. 2020 Apr;49(4):363-376. German. doi:10.1007/s00132-020-03898-5.
Office of the Surgeon General (US).Lifestyle approaches to promote bone health.
Ward P, Chang P, Radtke L, Brophy RH.Clinical Implications of Bone Bruise Patterns Accompanying Anterior Cruciate Ligament Tears.Sports Health. 2022 Jul-Aug;14(4):585-591. doi:10.1177/19417381211029583.
Kim YJ.Red flag rules for knee and lower leg differential diagnosis.Ann Transl Med. 2019 Oct;7(Suppl 7):S250. doi: 10.21037/atm.2019.07.62.
Kutsal FY, Ergin Ergani GO.Vertebral compression fractures: Still an unpredictable aspect of osteoporosis.Turk J Med Sci. 2021 Apr 30;51(2):393-399. doi:10.3906/sag-2005-315.
Zhao DY, McCann L, Hahn G, Hedrich CM.Chronic nonbacterial osteomyelitis (CNO) and chronic recurrent multifocal osteomyelitis (CRMO).J Transl Autoimmun. 2021 Mar 20;4:100095. doi:10.1016/j.jtauto.2021.100095.
American College of Rheumatology.Osteonecrosis.
Cohen A, Drake MT.Clinical manifestations, diagnosis, and treatment of osteomalacia.
American Academy of Orthopedic Surgeons.Paget’s disease.
Ralston SH, Corral-Gudino L, Cooper C, Francis RM, Fraser WD, Gennari L,et al.Diagnosis and Management of Paget’s Disease of Bone in Adults: A Clinical Guideline.J Bone Miner Res. 2019 Apr;34(4):579-604. doi:10.1002/jbmr.3657.
Li X, Dao M, Lykotrafitis G, Karniadakis GE.Biomechanics and biorheology of red blood cells in sickle cell anemia.J Biomech. 2017;50:34–41. doi:10.1016/j.jbiomech.2016.11.022
Ferguson JL, Turner SP.Bone cancer: Diagnosis and treatment principles.Am Fam Physician.2018 Aug 15;98(4):205-13.
American Academy of Orthopedic Surgeons.Metastatic bone disease.
National Organization for Rare Disorders.Multiple Myeloma.
Leukemia & Lymphoma Society.Signs and Symptoms.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
