General Health

All About Bone Health and Chronic Bone Pain in Women

The skeletal system, composed of bones and muscles, forms the framework of the human body and enables mobility and stability. Bones help support the body, store minerals like calcium and phosphorus and maintain internal balance to prevent falls. Bone health is crucial in women, particularly in older women as menopause can affect bone density. 

MedPiper Technologies and JournoMed in association with Indian Women Network had conducted a Women’s Day Special Webinar on 11th March, 2022 where the speakers explored various issues faced by women and how addressing them can transform women’s healthcare. One of the speakers, Dr. Sheerin Sarah Lysander, discussed the importance of bone health and how to tackle chronic bone pain in women. Dr. Lysander is the Consultant Pain and Spine Physician at the Lysander Pain Care and Orthopaedic Centre, Chennai. The event was moderated by Ms. Hema Mani, Chairwoman of Indian Women Network.

Basics of Bone Health

Dr. Lysander explored some of the basic factors involved in overall bone health which include:

  1. Diet: Due to the fast pace of life and easy availability of resources, people often consume foods lacking in calcium and vitamin D. This lifestyle has contributed to the increased number of osteoporosis cases in India, especially in women. Following a balanced healthy diet rich in minerals, especially calcium and vitamin D can help to improve and sustain proper bone health.
  2. Exercise: Regular physical activity helps the muscles and bones to become and stay strong. A sedentary lifestyle causes muscle mass and bone density reduction which further contributes to the high osteoporotic case load. Women tend to place exercise at the end of their priority list as they have a lot on their plate, hence they suffer from chronic pain at an earlier age than men. 
  3. Body weight: High body weight increases pressure on the bones and causes bone pain. 
  4. Supplements: The COVID-19 pandemic has driven the sales of supplements enabling people to over consume them without any medical supervision. While a daily intake of 1000mg of calcium is needed, increased intake of calcium supplements gives rise to kidney stones. Hence, one should take calcium supplements under medical supervision. 

The melanin composition in the Indian population does not allow for easy absorption of Vitamin D from natural sources. Hence a large majority of the Indian population has Vitamin D deficiency and suffer from chronic fatigue. Many doctors prescribe Vitamin D supplements to tackle this deficiency. 

Chronic Bone Pain in Women

Chronic bone pain occurs in the long bones whereas chronic arthritic pain is seen in the smaller bones and joint regions. The causes of bone pain in women include fractures, osteoporosis, osteomyelitis, osteomalacia, multiple myeloma, hyperparathyroidism, Paget’s disease, osteogenesis imperfecta, and cancer. 


While fractures normally occur due to falls and trauma, there are also osteoportic and stress fractures. With trauma fractures, the patients experience sharp, shooting pain, restricted mobility, swelling and disability and they immediately visit a doctor. Stress fractures, on the other hand, are often neglected since it presents as a dull, aching and nagging pain which is mistaken for a sprain. Osteoporotic fractures occur due to low bone density and are commonly seen in patients aged 45 and above. 


In this condition, bone density decreases as a person ages. Osteoporosis is more common in women than in men due to menopause and associated hormonal changes. The patients suffer from continuous aches and pains as there is an overall gradual loss of bone mass. In an X-ray scan, osteoporotic bones appear to be porous with lots of space in the bone cortex as compared to a normal bone. 

Osteoporosis can be either primary or secondary in nature. Primary osteoporosis is seen in older age and occurs due to an oestrogen or a testosterone deficiency. Family history/genetics also play a part in the aetiology of primary osteoporosis. It can also occur due to low calcium/vitamin D intake and less physical activity. 

Secondary osteoporosis takes place due to another underlying condition. These include: 

  • GI tract issues like malabsorption syndrome or carcinoma
  • Endocrine problems like hyperparathyroidism, diabetes mellitus, Cushing’s syndrome, adrenal insufficiency and hyperthyroidism
  • Hypogonadal states like Turner’s syndrome or Klinefelter’s syndrome
  • Haematological problems like multiple myeloma
  • Prolonged use of drugs like glucocorticoids, cytotoxic drugs or antiepileptic drugs. 

The main treatment strategy is to slow down and delay the process of osteoporosis as it cannot be completely treated. Some of the common treatment measures are: 

  • Nutrition: having a diet rich in calcium and Vitamin D 
  • Lifestyle modifications such as including more physical activity
  • Reducing alcohol and caffeine intake as excess amount of both can reduce bone density
  • Multicomponent exercise with strength and balance training
  • Preventing falls and wearing hip protectors especially for those who are susceptible to it. 
  • Calcium and vitamin D supplements and bisphosphonates prevent bone resorption. 
  • Calcitonin and parathormone therapy help to balance out the bone resorption and absorption cycle


In this condition, bone demineralisation occurs making the bone spongy. Osteomalacia is also known as rickets in children. In an X-ray scan, the cortex of the bone is translucent. This condition presents with a dull aching pain and the patient also has symptoms of hypocalcemia. 

Multiple Myeloma: 

Multiple Myeloma is a cancer of the plasma cells of the bone marrow and presents with a sharp pain in the legs, thighs, knees and sometimes shoulder. One of the distinguishing features of multiple myeloma is the prominent muscle cramping and pain. 


Primary bone cancer or bone metastasis due to another cancer can cause long bone pain. There is tenderness along with swelling and redness in the region of the bone affected by the cancer. Spinal cord stimulators or sympathetic blockades are the common course of treatment for treating such kinds of pain. 

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