Question

I have just been reading the new MEA information leaflet on pain management. This covers muscle, joint and nerve (neuropathic) pain ME/CFS. But why isn’t there any mention of bone pain? I have hip pain that was eventually diagnosed as being due to osteomalacia and vitamin D deficiency – which I understand is more common in ME. This is now being treated because my doctors felt I was at increased risk of having a fracture in the hip bone.

Answer

We don’t include bone pain in the ME/CFS pain list because this is not a type of pain that is commonly reported by people with ME/CFS. And there is no evidence to indicate that the underlying disease process in ME/CFS causes bone problems.

Bone pain is often described as a fairly constant dull ache that is deep inside the body, localised and not dependent on movement like joint pain.

Whilst there are obvious causes of acute bone pain – such as trauma and infection – more persistent bone pain must always be taken seriously. This is because bone pain can be caused by the spread of a malignancy to the bones, especially when the pain occurs in the long bones in the arms or legs.

So anyone with ME/CFS who develops bone pain must see their GP who can take a full history, examine the area affected, and arrange some blood tests and possibly an Xray or CT bone scan.

One other important cause of bone pain, especially hip pain, that can be linked to ME/CFS is vitamin D deficiency which can then cause thinning of the bones – a condition called osteomalacia. So it’s also important to check on vitamin D levels and possibly arrange a bone density investigation called a DEXA scan. This is a short painless investigation that is carried out in hospital.

More Information:

• The ME Association produces a range of free literature that may be of interest including:
  
  • Pain Management: We discuss the various types of pain and how each can best be managed. 
  • Vitamin D and Deficiency: We examine vitamin D, consider if deficiency is likely in ME/CFS and how it can be treated.