Indian J Palliat Care Close
 

Figure 2: Mechanism of musculoskeletal pain: Neoplastic cells secrete diverse cell factors to promote proliferation and stimulate osteoclastic bone resorption via receptor activator of nuclear factor‑kappa‑B ligand/ receptor activator of nuclear factor‑kappa‑B pathway in osteoblasts and osteoclasts. Osteoclasts create an acidic microenvironment by secreting H+ ions causing dissolution of bone minerals causing structural disintegration which may lead to pathological fracture. The acidic microenvironment excites sensory neurons in the bone by the activation of acid‑sensing nociceptors transient receptor potential vanilloid 1 and acid‑sensing ion channel 3, transducing noxious signals via the dorsal root ganglion (primary afferent neuron) and then the spinal cord (secondary afferent neuron) and causes the sensation of pain

Figure 2: Mechanism of musculoskeletal pain: Neoplastic cells secrete diverse cell factors to promote proliferation and stimulate osteoclastic bone resorption via receptor activator of nuclear factor‑kappa‑B ligand/ receptor activator of nuclear factor‑kappa‑B pathway in osteoblasts and osteoclasts. Osteoclasts create an acidic microenvironment by secreting H+ ions causing dissolution of bone minerals causing structural disintegration which may lead to pathological fracture. The acidic microenvironment excites sensory neurons in the bone by the activation of acid‑sensing nociceptors transient receptor potential vanilloid 1 and acid‑sensing ion channel 3, transducing noxious signals via the dorsal root ganglion (primary afferent neuron) and then the spinal cord (secondary afferent neuron) and causes the sensation of pain