When the blood supply to a bone is stopped or partially blocked, the bone tissue dies and this is called avascular necrosis.
The most common part of the body to be affected is the femur or thigh bone, at the head, near the hip joint, and it causes hip pain.
Pain in or around the affected joint may be the first sign you have of the disease although many people have no symptoms at all.
As well as the hip, avascular necrosis can also occur in the wrist, knee, shoulder or foot. It is a progressive condition, meaning it worsens as time goes on, and management usually becomes a life-long process.
Avascular necrosis that is left untreated will allow the bone to continue to deteriorate; it will eventually become so weakened that it collapses, causing disability. Leaving your condition untreated may lead to increased pain and loss of mobility in two years or so.
But what caused the blood supply to be blocked to the bone in the first place? There are several possible causes, the most common being an injury, like a fracture or dislocation.
The injury can damage the blood vessels to the bone, starving it of oxygen and nutrients necessary for the rebuilding of the bone tissue. Bone cells start to die and the bone becomes weakened.
People who have had to take corticosteroids for a long time, for conditions such as lupus and rheumatoid arthritis, have a higher risk of developing avascular necrosis. Exactly how these anti-inflammatory drugs cause the disease is not yet fully understood by scientists.
Heavy drinkers put themselves at risk of developing avascular necrosis. Several drinks a day over a period of time causes fatty deposits in the blood vessels which could restrict blood flow to the bones.
The more alcohol consumed in a day, the higher the risk. There are also some diseases which can cause avascular necrosis, as can chemotherapy treatment [Side-effects Of Chemotherapy]and radiation therapy.
The focus of treatment is to prevent any further loss of bone tissue and improve movement of the affected joint. The type of treatment will depend on the extent of the bone loss you have already suffered. Conservative treatments are usually the first stage and include nonsteriod anti-inflammatory drugs to relieve the pain.
You will be advised to rest, and even use crutches if a leg joint is affected, to reduce the weight and stress on the affected bone health and allow natural healing to take place. It is also a good idea to reduce the amount of physical activity to help slow the progress of the disease.
There are certain types of exercise that can help with avascular necrosis, and it is best to see a physical therapist who is trained in such treatments. The aim of these exercises is increase joint mobility and range of movement, and once you know what exercises to do, you will be able to continue them at home on a daily basis.
In more advanced cases, surgery may be the best option. There are several surgical procedures that can be performed, depending on the bone that is affected and the extent of the deterioration. While you might start with a conservative approach, as your avascular necrosis progresses, surgery may become the only option.
You need to accept that treatment for your avascular necrosis will be an ongoing process, but with the correct treatment, there is no reason that you cannot lead a productive life. Research is continuing into the prevention and treatment of avascular necrosis.