Bone Marrow Edema: What You Should Know About It

Bone marrow edema is an inflammatory process in the bones. It often causes pain during exercise, especially when the exercise is prolonged. Want to know more about this topic? Keep reading.
Bone marrow edema: what you should know about it

Bone marrow edema usually refers to  the inflammatory process in the trabecular bone. Inflammation thus occurs in the soft ingredient inside the bones. Its causes range from trauma to degenerative diseases. It also sometimes occurs in people who start engaging in heavy physical activity after a passive lifestyle.

An article published in the scientific journal Dolor, Investigacíon, Clínica y Terapéutica  states that it is a common disease at a rheumatism clinic. Magnetic resonance imaging is increasingly being used to aid in diagnosis. Therefore, it has become easier to identify such a problem.

So what are the characteristics of bone marrow edema?

What is bone marrow edema?

Bones are made up of two tissues that are easy to separate. One of them is cortical bone, which is made of hard and compact material. It surrounds the outer shell of the skeleton. The other is trabecular bone, a softer tissue made up of skeletal lining.

Trabecular bone has a large number of blood vessels, as the bones must also receive nourishment. FASTA University of Argentina   an article published in the Journal of the accumulated fluids inside the trabecular bone causing bone inflammation. This is often because the blood vessels break and bleed inside the bone. It may also be due to the accumulation of inflammatory fluid in the bone after injury. Bone marrow edema is thus a kind of bruising inside the bone. 

It is important to understand that this disease can also develop in the cortical bone, although it is not very common. It is also important to know that its characteristics may vary depending on the reversibility of the disease.

Experts have classified bone marrow edema into two groups:

  1. Transient bone marrow edema:  this is a reversible inflammatory process that decreases with treatment and over time.
  2. Osteonecrosis:  this causes the death of bone-forming cells (osteocytes). For this reason, experts consider it an irreversible disease.
Bone marrow edema occurs within the bone.
Bone marrow edema is an inflammatory process characterized by the accumulation of fluid inside the bone.

What causes bone marrow edema?

Bone marrow edema is caused by injury, falls, strenuous physical exertion, or sports injury. However, the article Rheumatología del Hospital General de Elche warns that the cause of bone marrow edema is not completely clear in many cases.

Although its main trigger is usually a serious injury, small injuries that recur over time can also contribute to the development of bone marrow edema. For example, during a 10-kilometer run, a person hits the ground about 8,000 times. This affects not only the internal skeletal structure but also the muscles and ligaments.

However, exercise is not the only trigger for bone marrow edema. Arthritis, avascular necrosis (lack of blood flow), osteoporosis, or multiple local pain syndrome also contribute to this inflammation. In short, any factor that weakens a bone exposes it to injury.

Symptoms of bone marrow edema

The clinical symptoms of  bone marrow edema may vary depending on the severity of the disease. According to information published in the journal Clinical Rheumatology  , the most significant symptoms of bone marrow edema are:

  • Local pain in damaged skeletal structure.
  • Uncomfortable feeling when the damaged bone is active. The pain increases when you exercise.
  • When the lesion is not treated immediately, pain is felt even when the patient is at rest.
  • In the most severe cases, the  patient may experience an uncomfortable feeling while doing daily activities, such as walking.

Due to the nature of bone marrow edema, it is easy to guess that it usually occurs in the knees, plantar bones, or heel. However, symptoms may vary depending on the skeletal structure involved.


Such damage is not visible on a standard X-ray, so  magnetic resonance imaging is necessary. Studies also show that new techniques such as DET tomography, which reconstructs images of decomposed materials, can be useful tools in detecting bone marrow edema.

Treatment of bone marrow edema

According to experts, the treatment of bone marrow edema involves several steps:

  • Rest is a determining factor for optimal recovery It is important to use crutches to relieve acute symptoms. It is also important to reduce stress and the burden on the bone for at least four weeks.
  • Several medications can be useful, such as painkillers,  bisphosphonates, vitamins, and other bone density enhancers, or iloprost, which dilates blood vessels.
  • After the first phase of medication, it is recommended to continue recovery with physiotherapy. This may include magnetic therapy, heat therapy, muscle relaxation, water exercise, and other therapies.

In more severe cases, it may be necessary to resort to surgery. It is possible to perform a spinal cord dissection procedure by making several holes in the bone to drain the fluid.

The treatment of bone marrow edema consists of several different stages. First, it is important to rest. After that, however, experts recommend physiotherapy.

Preventive methods

Contraception is always the best medicine. It is not recommended to give the body a greater burden to carry than is necessary. It is also important to follow the professional’s instructions when performing extreme physical activity.

If you experience discomfort while walking, running, or engaging in any other activity, see your doctor. Whether it is bone marrow edema, fracture, or sprain, it is  important to make an early diagnosis so that it can be addressed in a timely manner and major complications avoided.

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