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Multiple Myeloma: Bone Pain and Lesions

Overview

Multiple myeloma is a type of blood cancer. It forms in plasma cells, which are made in the bone marrow. Multiple myeloma causes cancer cells to rapidly multiply in the bone marrow. These cancer cells eventually crowd out and destroy healthy plasma and blood cells in the bone marrow. Plasma cells are responsible for producing antibodies. Myeloma cells can cause the production of abnormal antibodies, which can cause the blood flow to become slow. This condition is also characterized by the existence of multiple tumors. It most often occurs in bone marrow with the most activity, which can include the marrow in bones, such as the:

  • ribs
  • hips
  • shoulders
  • spine
  • pelvic bones

Causes of multiple myeloma bone pain

Causes

Multiple myeloma can cause soft spots in the bone called osteolytic lesions, which appear as holes on an X-ray. These osteolytic lesions are painful and can increase the risk of painful breaks or fractures.

Myeloma can also cause nerve damage or pain when a tumor presses up against a nerve. Tumors can also compress the spinal cord, which can cause back pain and muscle weakness.

According to the Multiple Myeloma Research Foundation, approximately 85 percent of patients diagnosed with multiple myeloma experience bone loss to some degree and the pain associated with it.

Treatments for bone pain and lesions

Treatment

Multiple myeloma can be painful. While treating the myeloma itself will be the first priority, several treatment options are available that focus purely on relieving your pain. Medical and natural treatment options are available to treat bone pain and lesions. Always talk to your doctor before starting a new treatment. Pain treatments may help bone pain but will not stop the myeloma from growing on its own.

Medical treatments

Medical treatment options include the following:

  • Analgesics is an umbrella term for different pain relievers. The most commonly used analgesics to treat bone pain are opioids and narcotics, such as morphine or codeine.
  • Bisphosphonates are prescription medications that can prevent the bone cells from breaking down and damaging the bone. You can take them by mouth or receive them through your vein, or intravenously.
  • Doctors sometimes use anticonvulsants and antidepressants to treat pain that stems from nerve damage. These can sometimes interrupt or slow down the pain signals that are sent to the brain from the nerve cell.
  • Surgery is most often used to treat fractures. Your doctor may recommend surgery to insert rods or plates into the fracture to support fragile and weakened bones.
  • Radiation therapy is often used to attempt to shrink tumors. This can help to relieve pinched nerves or compressed spinal cords.

You should avoid over-the-counter (OTC) medications since they may interact with your other pain medications or cancer treatments. Consult your doctor before taking any OTC medications.

Medical treatments

Natural treatments are most frequently used along with medical interventions, such as medications and surgery. Natural treatments can provide strong pain relief and include:

  • physical therapy, which can include general strength building or can be used to expand the range of motion or strength of an area of the body after bone damage or surgery
  • exercise therapy, which can promote healthy bones and reduce future pain
  • massage therapy, which can relieve muscle, joint, and bone pain
  • acupuncture, which is a safe treatment for promoting nerve health and help with bone pain relief

Natural supplements

For people with multiple myeloma, some natural supplements can help your overall health and become part of your pain regimen. Never take any new supplements without first talking to your doctor. They can interact with other medications you’re already taking.

Natural supplements can include supplements, such as fish oil and magnesium. Fish oil capsules or liquid contains an abundance of omega-3 fatty acids, which may improve peripheral nerve health and may reduce painful nerve damage and inflammation. Magnesium can:

  • improve nerve health
  • strengthen bones
  • prevent future bone pain
  • regulate calcium levels to prevent hypercalcemia

While some people take calcium supplements in an attempt to strengthen bones, this can be dangerous. With calcium from the broken-down bones already flooding the bloodstream, adding calcium supplements could result in hypercalcemia, or having too much calcium in the blood. This isn’t a supplement you should take without your doctor advising you to do so.

Long-term effects of multiple myeloma

Outlook

Multiple myeloma is a serious condition on its own, but both the cancer and the resulting bone damage can lead to several serious long-term effects. The most obvious of these long-term effects is chronic bone weakness and pain. The lesions and soft spots in the bone that occur due to the myeloma are difficult to treat and may cause continued fractures even if the myeloma itself has gone into remission.

If tumors press up against the nerves or cause spinal cord compression, you may experience long-term nervous system damage. Since some myeloma treatments can also cause nerve damage, many people develop tingling or pain in areas of nerve damage. Treatments are available to offer some relief, such as Lyrica or Cymbalta. You can also wear loose socks and padded slippers and walk regularly to help relieve pain.

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Multiple Myeloma: Diagnosis & Next Steps
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