Cancer-induced bone pain is an important form of chronic cancer pain. The authors are from multiple institutions in the United States and England participating in the ACTTION-American Pain Society Pain Taxonomy (AAPT) initiative.
Criteria for cancer-induced bone pain:
(1) The patient has a primary or metastatic cancer involving bone (as determined by physical exam, imaging studies, etc).
(2) The patient experiences background pain in 1 or more locations with known bone lesions.
(3) The patient experiences acute pain in 1 or more locations with known bone lesions. The pain may occur spontaneously or may be evoked by weight-bearing or movement.
(4) The clinical exam over a site of pain may show:
(4a) hyperalgesia to blunt, non-noxious stimuli or to pin prick.
(4b) hypoesthesia (reduced sensation) to non-noxious thermal stimuli or to light touch.
Background pain may be described as dull, aching, gnawing, annoying or nagging.
Acute pain may be described as electric or shock-like.
The distribution of pain may be radicular, localized or both.
A site of bone pain may be complicated by pathologic fracture. A vertebral site may be complicated by spinal cord compression.
Implications of cancer-induced bone pain:
(1) decreased quality of life
(2) disability with reduced ability to perform activities of daily living (ADL)
(3) reduced mobility, especially if motion evokes pain
(4) anxiety and depression
