Chronic Pain and Bone-Related Pathologies: A Narrative Review

Marie-Eva Pickering,1 Marine Delay,2,3 Véronique Morel2 1Rheumatology Department, CHU Gabriel Montpied, Clermont-Ferrand, 63000, France; 2PIC/CIC Inserm 1405, CHU Gabriel Montpied, Clermont-Ferrand, France; 3Neurodol Inserm 1107, Faculté de Médecine, Université Clermont-Auvergne, Clermont-Ferrand, FranceCorrespondence: Marie-Eva Pickering, Rheumatology Department, CHU Gabriel Montpied, Clermont-Ferrand, 63000, France, Email [email protected]: Pain related to bone may occur as a result of trauma, bone fracture, genetic disease, arthritis, benign or malignant primary bone tumors and bone cancer metastases. We discuss the pathophysiology of chronic bone-related pain, treatment options and therapeutic perspectives.Methods: Using predefined terms, we searched PubMed, MEDLINE, and Google Scholar for meta-analyses, evidence-based reviews, and clinical practice guidelines. This narrative article reviews pathologies linked to chronic bone pain and discusses the preventive and therapeutic strategies for better bone pain management.Results: Pathophysiology of bone-related pain is complex, especially in cancer conditions and missing gaps are underlined. Treatment of pain, after adequate evaluation, includes classical analgesics, adjuvants for neuropathic and refractory pain, specific bone drugs, surgery and non-pharmacological approaches. Prevention of chronic bone pain encompasses prevention of central sensitization and of causal diseases.Conclusion: Translational research, drug repurposing, an interdisciplinary approach and a person-centered assessment to evaluate, beyond pain, physical, social and functional abilities, are proposed future directions to improve chronic bone pain management and optimize independence and quality of life.Summary: Chronic bone-related pain is frequent and is associated with an impairment of quality of life. In this review, we summarize the pathophysiology of chronic bone pain, describe treatment approaches and envisage new avenues for pain alleviation. Our article will help doctors manage chronic bone pain and address unmet needs for future research to alleviate bone-related pain.Keywords: bone, prevention, treatment, pain