501:, which can be safely administered in low doses. Radiotherapy utilizes radioactive isotopes and other atomic particles to damage the DNA in cells, thus leading to cell death. By targeting cancer tumors, radiotherapy can lead to decrease in tumor size and even tumor destruction. A form of radiotherapy that is often used in cases of bone cancer is systemic radioisotope therapy, where the radioisotopes target sections of the bone specifically undergoing metastasis.
516:
Treatments focusing on biological components such as cannabinoid receptors are being tested for effectiveness. Through testing in mouse models, it has been shown that activation of the CB-1 receptor helps reduce reactions associated with acute pain, indicating that it alleviates bone pain. Thus, a
445:
Bone tumors are composed of a conglomeration of cell types, including cancer and immune system cells. Often, tumor cells secrete growth factors that activate receptors close to primary afferent neurons. Activation of these neural receptors is a contributing factor to pain sensation. Additionally,
512:
Mouse and other animal models are being heavily used to determine the neuron tissue densities in bone and mechanisms for maintenance of bone pain. This information is pertinent to determining the biological and physiological components of pain in the bone. By creating a detailed map relating the
524:
Modern research and techniques are attempting to provide longer-lasting and more effective methods of treating bone pain by developing and applying new physiological knowledge of nervous tissue within the bone. If thorough understanding of the intra-neuronal mechanisms relating to pain can be
52:, 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
1313:
Furuse, S. Kawamata, T. Yamamoto, J. Niiyama, Y. Omote, K. Watanabe, M. Namiki, A.(2009). Reduction of Bone Cancer Pain by
Activation of Spinal Cannabinoid Receptor 1 and Its Expression in the Superficial Dorsal Horn of the Spinal Cord in a Murine Model of Bone Cancer Pain.
442:. When the cancer cells have metastasized, the mechanical dynamics of the bone matrix become weaker as skeletal strength decreases. This leads to several other complications throughout the body, including pain, thus decreasing the patient's quality of life.
434:
models, it has been determined that bone pain related to cancer occurs as a result of destruction of bone tissue. Chemical changes that occur within the spinal cord as a result of bone destruction give further insight into the mechanism of bone pain.
429:
Pain caused by cancer within bones is one of the most severe forms of pain. Because of its severity and uniqueness with respect to other forms of pain, it is extensively researched. According to studies of bone cancer in mouse
481:
Nociceptors responsible for bone pain can be activated via several mechanisms including deterioration of surrounding tissue, bone destruction, and physical stress which shears the bone, vascular, muscle, and nervous tissue.
810:
Mach, D. Rogers, S. Sabino, M. Luger, N. Schwei, M. Pomonis, J. Keyser, C. Clohisy, D. Adams, D. O'leary, P. Mantyh, P. (2002). Origins of skeletal pain: Sensory and sympathetic innervation of the mouse femur.
63:, 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
478:) sensory neurons. In combination, they can provide an initial burst of pain, initiated by the faster myelinated fibers, followed by a slower and longer-lasting dull pain initiated by unmyelinated fibers.
513:
types of nerves going through the different sections of bone, it is possible to pin-point locations in the bone that are at a higher risk of being susceptible to bone pain.
504:
In the case of bone fractures, surgical treatment is generally the most effective. Analgesics can be used in conjunction with surgery to help ease pain of damaged bone.
1192:
Ajdinovic B, Jaukovic L, Antoniou D (2013). "Five benign myoskeletal diseases in paediatrics and the role of nuclear medicine. Do they differ from those in adults?".
525:
developed, then new and more effective treatment options can be created and tested. Thus, it is critical to fully understand the mechanism which dictates bone pain.
45:, 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.
1549:
824:
Falk S, Uldall M, Heegaard AM. (2012). The role of purinergic receptors in cancer-induced bone pain. J Osteoporos. 2012;2012:758181. doi: 10.1155/2012/758181
1544:
67:(an outer membrane) of bone tissue is highly pain-sensitive and an important source of pain in several disease conditions causing bone pain, like
462:) that innervate bone tissue leads to the sensation of bone pain. Bone pain originates from both the periosteum and the bone marrow which relay
490:
The use of anesthetics within the actual bone has been a common treatment for several years. This method provides a direct approach using
1284:
von Moos, R. Strasser, F. Gillessen, S. Zaugg, K. (2008). Metastatic bone pain: treatment options with an emphasis on bisphosphonates.
758:
Zwas, T. Elkanovitch, R. George, F. (1987). Interpretation and
Classification of Bone Scintigraphic Findings in Stress Fractures.
337:, which is transmitted by ticks and is characterized by debilitating polyarthritis, neurologic symptoms, and erythema migrans
91:, and other bone diseases. Thus, there are several types of bone pain, each with many potential sources or origins of cause.
329:
1539:
1499:
1660:
450:, which are produced at high rates by cancer cells within tumors, activate nociceptors when they bind together.
295:
1346:
1466:
324:
133:
1432:
518:
1729:
745:
Luger, N. Mach, D. Sevcik, M. Mantyh, P. (2005). Bone cancer pain: From mechanism to model to therapy.
319:
242:
137:
20:
300:
1698:
415:
are rare in children, as these diseases are a sequelae of chronic wear and tear for several years.
121:
954:
Aziz I, Hadjivassiliou M, Sanders DS (Sep 2015). "The spectrum of noncoeliac gluten sensitivity".
284:
223:
209:
1744:
1632:
1461:
776:
Mantyh, P. Clohisy, D. Koltzenburg, M. Hunt, S. (2002). Molecular
Mechanism of Cancer Pain.
260:
187:
155:
1655:
227:
8:
379:
167:
151:
107:
1409:
1339:
1118:
1091:
1072:
979:
936:
881:
856:
466:
signals to the brain creating the sensation of pain. Bone tissue is innervated by both
191:
145:
141:
1260:
1734:
1714:
1607:
1242:
1201:
1165:
1123:
1064:
1023:
971:
928:
908:
886:
498:
103:
940:
1572:
1422:
1232:
1113:
1103:
1076:
1054:
983:
963:
920:
876:
868:
666:
609:
555:
373:
163:
125:
1675:
1642:
1627:
412:
205:
80:
1059:
1042:
1770:
1719:
1622:
1489:
716:
710:
653:
647:
596:
590:
408:
267:
255:
238:
129:
115:
72:
1153:
967:
924:
1765:
1759:
1617:
1582:
1534:
1494:
1332:
1237:
1220:
471:
447:
396:
358:
279:
181:
159:
88:
68:
1529:
1514:
1509:
1300:
Mercadante, S. (1997). Malignant bone pain: Pathophysiology and treatment.
1246:
1221:"Clinical presentation and etiology of osteomalacia/rickets in adolescents"
1205:
1169:
1127:
1068:
1027:
1011:
975:
932:
890:
363:
345:
334:
273:
177:
111:
84:
1108:
1739:
1665:
1650:
1612:
1567:
1524:
1519:
1417:
1391:
376:, a severe infection of the joint that can lead to permanent joint damage
59:
For many years, it has been known that bones are innervated with sensory
1688:
1602:
1440:
1376:
463:
459:
424:
400:
353:
219:
201:
64:
1154:"Chronic musculoskeletal pain in children: part I. Initial evaluation"
872:
1724:
1693:
1683:
1577:
1504:
1484:
1476:
1399:
1386:
1012:"Chronic musculoskeletal pain in children: part II. Rheumatic causes"
491:
392:
305:
173:
76:
1381:
439:
340:
314:
213:
195:
99:
A number of diseases can cause bone pain, including the following:
24:
263:, a very dangerous disease that can cause permanent cardiac damage
1453:
475:
388:
368:
349:
1219:
Hazzazi MA, Alzeer I, Tamimi W, Al Atawi M, Al Alwan I (2013).
467:
310:
60:
53:
438:
Metastatic cancer cells often establish themselves within the
431:
384:
290:
1355:
1218:
699:
696:
681:
678:
636:
621:
579:
231:
49:
42:
38:
1005:
1003:
1001:
999:
997:
995:
993:
669:
633:
612:
576:
558:
1191:
1147:
1145:
1143:
1141:
1139:
1137:
1009:
953:
690:
627:
570:
517:
new target for potential treatments is activation of the
245:(also termed osteitis deformans or just Paget's disease).
1550:
congenital insensitivity to pain with partial anhidrosis
792:
McCredie J (2007). Nerves in bone: the silent partners.
458:
Stimulation of specialized pain-sensitive nerve fibers (
407:
Common causes of bone and joint pain in adults, such as
1324:
990:
497:
Another commonly used method for treating bone pain is
136:(both often occur without obvious digestive symptoms),
1134:
83:
nerve supply seems to play an important role, e.g. in
947:
693:
672:
615:
561:
270:, which can present without gastrointestinal symptoms
1225:
Saudi
Journal of Kidney Diseases and Transplantation
687:
675:
630:
618:
573:
564:
909:"Extraintestinal manifestations of coeliac disease"
684:
624:
567:
1040:
906:
902:
900:
752:
1151:
772:
770:
768:
19:"Ostalgia" redirects here. For nostalgia for the
1757:
1545:congenital insensitivity to pain with anhidrosis
1034:
533:Bone pain is also known by the following names:
1187:
1185:
1183:
1181:
1179:
897:
48:Bone pain belongs to the class of deep somatic
765:
1340:
1296:
1294:
850:
1212:
1176:
1089:
848:
846:
844:
842:
840:
838:
836:
834:
832:
830:
1307:
907:Leffler DA, Green PH, Fasano A (Oct 2015).
1347:
1333:
1291:
1083:
788:
786:
1278:
1236:
1117:
1107:
1058:
880:
854:
827:
75:, etc. However, in certain diseases, the
741:
739:
737:
735:
783:
1758:
806:
804:
802:
747:Journal of Pain and Symptom Management
1328:
1096:Pediatric Rheumatology Online Journal
732:
249:
1265:The Lecturio Medical Concept Library
857:"The neurobiology of skeletal pain"
799:
287:can present with knee or ankle pain
13:
1152:Junnila JL, Cartwright VW (2006).
1010:Junnila JL, Cartwright VW (2006).
453:
276:, which affects people of all ages
14:
1782:
1540:Congenital insensitivity to pain
1500:Paroxysmal extreme pain disorder
665:
608:
554:
1253:
16:Feeling that originates in bone
818:
1:
956:Nat Rev Gastroenterol Hepatol
913:Nat Rev Gastroenterol Hepatol
725:
325:Juvenile idiopathic arthritis
134:non-celiac gluten sensitivity
1090:Uziel Y, Hashkes PJ (2007).
494:to relieve pain sensations.
485:
7:
1092:"Growing pains in children"
1060:10.4081/reumatismo.2012.230
1041:Buskila D, Ablin J (2012).
760:Journal of Nuclear Medicine
535:
507:
446:inflammatory lipids called
237:Others, such as fractures,
10:
1787:
422:
330:Legg–Calvé–Perthes disease
320:Inflammatory bowel disease
138:inflammatory bowel disease
34:
21:German Democratic Republic
18:
1707:
1674:
1641:
1595:
1560:
1475:
1431:
1408:
1369:
1362:
1286:Supportive Care in Cancer
968:10.1038/nrgastro.2015.107
925:10.1038/nrgastro.2015.131
418:
301:Fibrous dysplasia of bone
94:
33:(also known medically by
1354:
1238:10.4103/1319-2442.118087
1043:"Pediatric fibromyalgia"
528:
387:diseases, including the
296:Henoch–Schönlein purpura
1661:Posteromarginal nucleus
1596:Measurement and testing
243:Paget's disease of bone
285:Hypermobility syndrome
224:ankylosing spondylitis
210:oncogenic osteomalacia
1745:Drug-seeking behavior
1633:Visual analogue scale
1109:10.1186/1546-0096-5-5
778:Nature Reviews Cancer
380:Spondyloarthropathies
261:Acute rheumatic fever
1656:Anterolateral system
1288:. 16(10): 1105-1115.
474:) and unmyelinated (
228:rheumatoid arthritis
168:sickle cell anaemia
108:hyperparathyroidism
35:several other names
1735:Philosophy of pain
1410:Respiratory system
1261:"Septic Arthritis"
855:Mantyh PW (2014).
794:Skeletal Radiology
250:Causes in children
192:spinal cord injury
156:Cushing's syndrome
146:ulcerative colitis
1753:
1752:
1608:Cold pressor test
1591:
1590:
873:10.1111/ejn.12462
815:. 113(1):155-166.
723:
722:
1778:
1708:Related concepts
1699:Pain eradication
1457:
1444:
1395:
1367:
1366:
1363:By region/system
1349:
1342:
1335:
1326:
1325:
1319:
1311:
1305:
1298:
1289:
1282:
1276:
1275:
1273:
1271:
1257:
1251:
1250:
1240:
1216:
1210:
1209:
1189:
1174:
1173:
1158:Am Fam Physician
1149:
1132:
1131:
1121:
1111:
1087:
1081:
1080:
1062:
1038:
1032:
1031:
1016:Am Fam Physician
1007:
988:
987:
951:
945:
944:
904:
895:
894:
884:
852:
825:
822:
816:
808:
797:
790:
781:
774:
763:
756:
750:
743:
706:
705:
702:
701:
698:
695:
692:
689:
686:
683:
680:
677:
674:
671:
643:
642:
639:
638:
635:
632:
629:
626:
623:
620:
617:
614:
586:
585:
582:
581:
578:
575:
572:
569:
566:
563:
560:
536:
374:Septic arthritis
164:multiple myeloma
122:Gastrointestinal
65:periosteal layer
1786:
1785:
1781:
1780:
1779:
1777:
1776:
1775:
1756:
1755:
1754:
1749:
1703:
1670:
1643:Pathophysiology
1637:
1628:Tail flick test
1587:
1556:
1471:
1455:
1442:
1433:Musculoskeletal
1427:
1404:
1393:
1358:
1353:
1323:
1322:
1312:
1308:
1304:. 69(1-2):1-18.
1299:
1292:
1283:
1279:
1269:
1267:
1259:
1258:
1254:
1217:
1213:
1194:Hell J Nucl Med
1190:
1177:
1150:
1135:
1088:
1084:
1039:
1035:
1008:
991:
952:
948:
905:
898:
853:
828:
823:
819:
809:
800:
791:
784:
775:
766:
757:
753:
749:. 29(5): 32-46.
744:
733:
728:
668:
664:
611:
607:
557:
553:
531:
510:
488:
456:
454:Pathophysiology
427:
421:
413:gouty arthritis
252:
206:bone metastasis
142:Crohn's disease
97:
28:
17:
12:
11:
5:
1784:
1774:
1773:
1768:
1751:
1750:
1748:
1747:
1742:
1737:
1732:
1727:
1722:
1720:Pain tolerance
1717:
1715:Pain threshold
1711:
1709:
1705:
1704:
1702:
1701:
1696:
1691:
1686:
1680:
1678:
1672:
1671:
1669:
1668:
1663:
1658:
1653:
1647:
1645:
1639:
1638:
1636:
1635:
1630:
1625:
1623:Hot plate test
1620:
1615:
1610:
1605:
1599:
1597:
1593:
1592:
1589:
1588:
1586:
1585:
1580:
1575:
1570:
1564:
1562:
1558:
1557:
1555:
1554:
1553:
1552:
1547:
1537:
1532:
1527:
1522:
1517:
1512:
1507:
1502:
1497:
1492:
1490:Pain asymbolia
1487:
1481:
1479:
1473:
1472:
1470:
1469:
1464:
1459:
1451:
1446:
1437:
1435:
1429:
1428:
1426:
1425:
1420:
1414:
1412:
1406:
1405:
1403:
1402:
1397:
1389:
1384:
1379:
1373:
1371:
1364:
1360:
1359:
1352:
1351:
1344:
1337:
1329:
1321:
1320:
1318:. 111: 173–86.
1316:Anesthesiology
1306:
1290:
1277:
1252:
1211:
1175:
1133:
1082:
1033:
1022:(2): 293–300.
989:
946:
919:(10): 561–71.
896:
861:Eur J Neurosci
826:
817:
798:
796:. 36: 473–475.
782:
764:
762:. 28: 452-457.
751:
730:
729:
727:
724:
721:
720:
707:
662:
658:
657:
644:
605:
601:
600:
587:
551:
547:
546:
543:
540:
530:
527:
509:
506:
487:
484:
455:
452:
448:prostaglandins
423:Main article:
420:
417:
409:osteoarthritis
405:
404:
382:
377:
371:
366:
361:
356:
343:
338:
332:
327:
322:
317:
308:
303:
298:
293:
288:
282:
277:
271:
268:celiac disease
264:
258:
256:Acute leukemia
251:
248:
247:
246:
239:osteoarthritis
235:
217:
199:
185:
171:
149:
130:celiac disease
119:
116:kidney failure
96:
93:
73:osteoarthritis
41:coming from a
15:
9:
6:
4:
3:
2:
1783:
1772:
1769:
1767:
1764:
1763:
1761:
1746:
1743:
1741:
1738:
1736:
1733:
1731:
1728:
1726:
1723:
1721:
1718:
1716:
1713:
1712:
1710:
1706:
1700:
1697:
1695:
1692:
1690:
1687:
1685:
1682:
1681:
1679:
1677:
1673:
1667:
1664:
1662:
1659:
1657:
1654:
1652:
1649:
1648:
1646:
1644:
1640:
1634:
1631:
1629:
1626:
1624:
1621:
1619:
1618:Grimace scale
1616:
1614:
1611:
1609:
1606:
1604:
1601:
1600:
1598:
1594:
1584:
1583:Low back pain
1581:
1579:
1576:
1574:
1571:
1569:
1566:
1565:
1563:
1559:
1551:
1548:
1546:
1543:
1542:
1541:
1538:
1536:
1535:Referred pain
1533:
1531:
1528:
1526:
1523:
1521:
1518:
1516:
1513:
1511:
1508:
1506:
1503:
1501:
1498:
1496:
1495:Pain disorder
1493:
1491:
1488:
1486:
1483:
1482:
1480:
1478:
1474:
1468:
1467:Delayed-onset
1465:
1463:
1460:
1458:
1452:
1450:
1447:
1445:
1439:
1438:
1436:
1434:
1430:
1424:
1421:
1419:
1416:
1415:
1413:
1411:
1407:
1401:
1398:
1396:
1390:
1388:
1385:
1383:
1380:
1378:
1375:
1374:
1372:
1370:Head and neck
1368:
1365:
1361:
1357:
1350:
1345:
1343:
1338:
1336:
1331:
1330:
1327:
1317:
1310:
1303:
1297:
1295:
1287:
1281:
1266:
1262:
1256:
1248:
1244:
1239:
1234:
1231:(5): 938–41.
1230:
1226:
1222:
1215:
1207:
1203:
1199:
1195:
1188:
1186:
1184:
1182:
1180:
1171:
1167:
1164:(1): 115–22.
1163:
1159:
1155:
1148:
1146:
1144:
1142:
1140:
1138:
1129:
1125:
1120:
1115:
1110:
1105:
1101:
1097:
1093:
1086:
1078:
1074:
1070:
1066:
1061:
1056:
1052:
1048:
1044:
1037:
1029:
1025:
1021:
1017:
1013:
1006:
1004:
1002:
1000:
998:
996:
994:
985:
981:
977:
973:
969:
965:
962:(9): 516–26.
961:
957:
950:
942:
938:
934:
930:
926:
922:
918:
914:
910:
903:
901:
892:
888:
883:
878:
874:
870:
867:(3): 508–19.
866:
862:
858:
851:
849:
847:
845:
843:
841:
839:
837:
835:
833:
831:
821:
814:
807:
805:
803:
795:
789:
787:
780:. 2: 201-209.
779:
773:
771:
769:
761:
755:
748:
742:
740:
738:
736:
731:
719:
718:
713:
712:
708:
704:
663:
660:
659:
656:
655:
650:
649:
645:
641:
606:
603:
602:
599:
598:
593:
592:
588:
584:
552:
549:
548:
544:
542:Pronunciation
541:
538:
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526:
522:
520:
519:CB-1 receptor
514:
505:
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472:A delta fiber
469:
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451:
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398:
397:mononucleosis
394:
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375:
372:
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365:
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360:
359:Osteopetrosis
357:
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326:
323:
321:
318:
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280:Growing pains
278:
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253:
244:
240:
236:
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198:degeneration.
197:
193:
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186:
183:
182:osteomyelitis
179:
175:
172:
169:
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161:
160:histiocytosis
157:
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139:
135:
131:
127:
123:
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117:
113:
109:
105:
102:
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100:
92:
90:
89:osteonecrosis
86:
82:
78:
74:
70:
66:
62:
57:
55:
51:
46:
44:
40:
36:
32:
26:
22:
1530:Phantom pain
1515:Hyperalgesia
1510:Chronic pain
1448:
1394:(swallowing)
1392:Odynophagia
1315:
1309:
1301:
1285:
1280:
1268:. Retrieved
1264:
1255:
1228:
1224:
1214:
1197:
1193:
1161:
1157:
1099:
1095:
1085:
1053:(4): 230–7.
1050:
1046:
1036:
1019:
1015:
959:
955:
949:
916:
912:
864:
860:
820:
813:Neuroscience
812:
793:
777:
759:
754:
746:
715:
709:
652:
646:
595:
589:
532:
523:
515:
511:
503:
499:radiotherapy
496:
489:
480:
470:(A beta and
457:
444:
437:
428:
406:
403:, and mumps.
364:Osteosarcoma
346:Osteomalacia
335:Lyme disease
274:Fibromyalgia
188:Neurological
178:Lyme disease
112:osteoporosis
98:
85:osteomalacia
58:
47:
30:
29:
1740:Cancer pain
1666:Substance P
1651:Nociception
1613:Dolorimeter
1568:Pelvic pain
1525:Hyperpathia
1520:Hypoalgesia
1441:Arthralgia
1423:Pleurodynia
1418:Sore throat
545:Derivation
464:nociceptive
460:nociceptors
354:adolescents
152:Hematologic
140:(including
1760:Categories
1689:Anesthesia
1676:Management
1603:Pain scale
1573:Proctalgia
1477:Neurologic
1377:Eye strain
1200:(1): 2–8.
1160:(Review).
1049:(Review).
1047:Reumatismo
958:(Review).
915:(Review).
863:(Review).
726:References
661:osteodynia
492:analgesics
468:myelinated
425:Bone tumor
401:chickenpox
313:such as a
266:Untreated
222:, such as
204:, such as
190:, such as
176:, such as
174:Infectious
154:, such as
128:, such as
106:, such as
1725:Suffering
1694:Cordotomy
1684:Analgesia
1505:Allodynia
1485:Neuralgia
1449:Bone pain
1400:Toothache
1270:27 August
604:ostealgia
486:Treatment
393:influenza
306:Infection
220:Rheumatic
202:Oncologic
196:vertebral
104:Endocrine
81:haversian
77:endosteal
69:fractures
31:Bone pain
1730:SOCRATES
1456:(muscle)
1454:Myalgia
1382:Headache
1247:24029258
1206:23529387
1170:16848385
1128:17550631
1069:23024967
1028:16883927
976:26122473
941:15561525
933:26260366
891:24494689
550:ostalgia
508:Research
440:skeleton
341:Lymphoma
315:fracture
214:leukemia
126:systemic
25:Ostalgie
1443:(joint)
1119:1869025
1077:6689576
984:2867448
882:4453827
476:C fiber
389:measles
369:Rickets
350:rickets
61:neurons
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717:-dynia
711:osteo-
654:-algia
597:-algia
419:Cancer
311:Injury
95:Causes
54:cancer
23:, see
1771:Bones
1561:Other
1462:Acute
1102:: 5.
1073:S2CID
980:S2CID
937:S2CID
648:oste-
529:Names
432:femur
385:Viral
291:Lupus
37:) is
1766:Pain
1578:Back
1387:Neck
1356:Pain
1302:Pain
1272:2021
1243:PMID
1202:PMID
1166:PMID
1124:PMID
1065:PMID
1024:PMID
972:PMID
929:PMID
887:PMID
591:ost-
539:Name
411:and
232:gout
212:and
194:and
180:and
166:and
144:and
132:and
79:and
50:pain
43:bone
39:pain
1233:doi
1114:PMC
1104:doi
1055:doi
964:doi
921:doi
877:PMC
869:doi
352:in
124:or
1762::
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