explain
pain
section
3
page
58
Bone and joint contributions to pain
B
ones and joints are often blamed for deep, movement-
related pain. Thismaymake people fearful of movement
because they are afraid it will injure their joints. We
have all grown upwith the concept of pain ‘deep in the
joint’ and ‘in the bones’. Many a patient has said ‘I need
to get a bit of oil intomy joints’.
There are 206 bones in the body andmanymore joints.
Bones are not normally brittle. They absorb pressures
well andwill adapt and change their shape in response
to the bodies needs. Bones are living, healing structures.
They are full of danger sensors and so are joints. Bones
are covered in a supersensitive layer (the ‘periosteum’),
which acts as an extra protection system. Try tapping
your shinwith your knuckles – it’s the periosteum that
makes it so sensitive.
Joints come in different shapes and sizes. Some are
fibrous with interlocking bones, for example the joints in
your skull. Most are synovial joints (eg. hip, elbow,
finger joints), whichmeans that the joint cavity is
enclosed and contains a slippery lubricating fluid. The
linings inside these joints are particularly full of danger
sensors – especially the synovium, which is the layer of
tissue that makes the lubricating fluid. These danger
sensors can go berzerkwith injury or inflammatory
diseases such as rheumatoid arthritis, which frequently
result in very painful joints. But remember, inflamed
joints are not necessarily painful.
It’s really deep
in here doctor!
‘
’
