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#1
Old 01-01-2012, 11:16 AM
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Are there nerves in bones?

Are there nerves in bones? if you break a bone, is the pain from the broken bone itself, or from the effect of the injury on surrounding muscle and tissue? when old bone injuries ache, what causes it?
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Old 01-01-2012, 11:50 AM
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I was just asked this by a nine year old the other day and thought there weren't, but my husband disagrees. I'm curious what the answer is as well.
#3
Old 01-01-2012, 12:09 PM
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Pretty much quote wikipedia

http://en.wikipedia.org/wiki/Bone

Quote:
Other types of tissue found in bones include marrow, endosteum and periosteum, nerves, blood vessels and cartilage.
#4
Old 01-01-2012, 12:10 PM
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Oh yes, there are nerves in bones.
11 years ago I had to have a bone marrow biopsy done under local anaesthesia. The local numbed the pain sensors in the skin and underlying muscle, but couldn't do anything about the pain sensors in the bone.
It hurt like the devil! Fortunately the oncologist worked fast and was done in 3 minutes.
#5
Old 01-01-2012, 12:13 PM
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Indeed there are nerves in bones - a fact well appreciated by those who would break others' on the wheel (<= link not for the squeamish). I can't think of a worse death.

Closer to home, have you ever hit the bone your ankle with anything hard? Ouch!
#6
Old 01-01-2012, 12:19 PM
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Quote:
Originally Posted by The Hairy One View Post
The local numbed the pain sensors in the skin and underlying muscle, but couldn't do anything about the pain sensors in the bone.
The sensitive surface of bones (i.e. periosteum) can be anesthetized by local anesthetics since they are reachable with a needle. However, the interior of the bone, where the marrow is, cannot be reached without first breaking through the surrounding bone - not something that can be done with a needle, and not practical anyway since any injected anesthetic would be quickly diluted by the bone marrow itself which resembles in look and consistency, thickened blood.
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Old 01-01-2012, 12:25 PM
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Quote:
Originally Posted by Northern Piper View Post
Are there nerves in bones? if you break a bone, is the pain from the broken bone itself, or from the effect of the injury on surrounding muscle and tissue?
Yes. Both. There are nerves in bones, but a lot of the acute pain from a broken bone is indeed due to the inflammation causing tissues to press on nerves in the soft tissue around the bone. This is why rest, ice, compression and elevation - which all help reduce inflammation - help to soothe a fresh injury, even though they don't affect the bone directly.

Quote:
when old bone injuries ache, what causes it?
No freakin' clue. I've asked orthopedists, and not gotten a real firm answer. Inflammation around old scar tissue is a frequent guess, though. (But why is there suddenly inflammation there, doc?)
#8
Old 01-01-2012, 01:38 PM
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Quote:
Originally Posted by KarlGauss View Post
The sensitive surface of bones (i.e. periosteum) can be anesthetized by local anesthetics since they are reachable with a needle. However, the interior of the bone, where the marrow is, cannot be reached without first breaking through the surrounding bone - not something that can be done with a needle, and not practical anyway since any injected anesthetic would be quickly diluted by the bone marrow itself which resembles in look and consistency, thickened blood.
Related question I guess. I know that when a dentist wants to numb a lower tooth they go in the back of the jaw because there's a "key hole" where the nerve runs from the tooth to the brain and it's accessible there. For a bone marrow biopsy is there no similar "key hole" to get at those nerves"? (Or is it a deal you could go up the wiring a bit to get at the nerve but there's some reason doing that would be a really bad idea?)
#9
Old 01-01-2012, 02:02 PM
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Originally Posted by notsoheavyd3 View Post
Related question I guess. I know that when a dentist wants to numb a lower tooth they go in the back of the jaw because there's a "key hole" where the nerve runs from the tooth to the brain and it's accessible there. For a bone marrow biopsy is there no similar "key hole" to get at those nerves"? (Or is it a deal you could go up the wiring a bit to get at the nerve but there's some reason doing that would be a really bad idea?)
That's a great point. You are right, it could be done but only if the marrow is in an area served by one or a few identifiable nerves. In that case, one could "block" those nerves just like a dentist does.

The problem is that the marrow is diffuse within bones. Further, marrow is found in bones like the vertebrae, sternum, and pelvis which don't lend themselves to a block like, say, an arm or leg does. So I assume that there are lots of potential nerves involved (or even nerve plexus/plexi). Easier to knock the patient out!

Last edited by KarlGauss; 01-01-2012 at 02:04 PM.
#10
Old 01-01-2012, 02:40 PM
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Based on some personal experience, I'm a little surprised to learn that the answer is yes.

About 15 years ago I found myself in a New Zealand hospital with a broken pelvis (after crashing my paraglider). The treatment included 7 weeks in traction, achieved by means of a stainless steel rod through my right tibia. I had plenty of time to contemplate the quarter-inch diameter metal spike protruding about an inch outside my skin.

When it came time to remove this, I assumed it would be an ordeal, certainly involving at least local anesthesia. Not at all - the doctor showed up with what looked like an ordinary ViseGrip, latched onto the rod, and yanked it out with a couple of sharp twists. It hurt, but not nearly as much as I would have thought. The holes healed rapidly, and I was in good shape to leave the hospital a week later.
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