Multiple myeloma is a type of cancer in which abnormal cells reproduce in your bone marrow. It may cause pain in different parts of your body, such as your back, legs, hips, and ribs.

Bone marrow is the spongy tissue in the middle of bones where new blood cells are made. As multiple myeloma grows, it damages bones and leaves behind soft spots called lesions.

Up to 90% of people with multiple myeloma will have bone damage or loss, which can be painful. Approximately 40% of people will also develop bone fractures due to weakening bones. Pain from a broken bone can be severe.

Keep reading to learn more about how multiple myeloma pain affects different parts of your body.

The vertebrae in your spine can collapse if they become weak enough. This is a vertebral compression fracture.

The fractured bones can put pressure on nerves in your spine, causing numbness, weakness, and an uncomfortable pins-and-needles sensation.

Compression fractures can be treated in multiple ways. Sometimes, they require spinal surgery to repair or stabilize. You may get a minimally invasive procedure, including:

  • Kyphoplasty: The surgeon places a thin tube with a balloon at one end into the collapsed vertebrae. The balloon is then inflated to restore the bone to its original position. Cement secures the bone into place.
  • Vertebroplasty: The surgeon injects cement directly into the collapsed vertebrae.

A doctor might recommend that you wear a back or neck brace to hold your spine in place. You can also take pain relievers to manage your discomfort, including:

  • over-the-counter (OTC) pain relievers, such as ibuprofen or naproxen
  • prescription pain relievers, including opioids for severe pain
  • topical ointments, creams, or patches to relieve pain in the areas where it hurts

Speak with a doctor about your options before using them. Some medications can further damage your kidneys if they’ve been affected by multiple myeloma.

When to see a doctor

A vertebral compression fracture from multiple myeloma may cause spinal cord compression.

Get immediate medical attention if you experience sudden back pain with the following symptoms:

  • numbness
  • weakness
  • an uncomfortable pins and needles sensation
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Pain caused by nerve compression in your spine may radiate (spread) into your legs and arms. However, shooting pain, numbness, or weakness can signal a nerve problem in your back and require immediate medical attention.

Multiple myeloma and its treatments can also directly damage nerve cells.

The following treatments may help with nerve irritation, called peripheral neuropathy:

  • antidepressants, such as amitriptyline, gabapentin, and duloxetine
  • immunosuppressants
  • corticosteroids
  • immunoglobulin injections
  • capsaicin cream
  • opioid pain relievers for severe pain

While these treatments may help with peripheral neuropathy, they may not be effective.

Speak with a healthcare professional if you develop peripheral neuropathy during your treatment for multiple myeloma. They could adjust your treatment regimen.

Multiple myeloma can weaken the bones in your hips and ribs. This may cause a persistent, dull ache.

Chemotherapy may help with bone pain by killing myeloma cancer cells in your body.

Similarly, radiation therapy uses powerful X-rays to shrink tumors in bones. After chemo- or radiation therapy destroys cancer cells, new bone begins to regenerate. Bones become stronger and less likely to break.

Some treatments for back pain may also help relieve hip or rib pain, including:

  • OTC and prescription pain relievers
  • bisphosphonates
  • calcium and vitamin D supplements
  • surgical hip repair

As bones break down, they release calcium into the blood. Excess calcium, called hypercalcemia, can lead to several symptoms, such as:

Treatments like chemotherapy may also cause stomach pain by slowing the movement of digested food through your intestines. This may lead to a buildup of stool in your intestine, which could cause bloating and constipation.

To treat constipation, the National Cancer Institute (NCI) recommends the following tips:

  • Eat foods high in fiber.
  • Drink at least 8 cups of water per day.
  • Try to exercise every day.

If these tips don’t help relieve your constipation, speak with a healthcare professional about other options. These may include laxatives or fiber supplements.

Some medications may help reduce pain.

Bisphosphonates like pamidronate and zoledronic acid can be injected into a vein to help strengthen your bones and prevent fracturing. To start, a doctor might give you a bisphosphonate once a month. As your bones strengthen, you may be able to taper down and get these shots less often.

Denosumab is not a bisphosphonate, but it’s a similar drug also used to help treat bone loss from cancer.

Other treatment options may include:

  • auto stem cell transplant
  • medications to kill cancer cells, including lenalidomide, daratumumab, bortezomib, and corticosteroids to increase the efficacy of chemotherapy
  • calcium and vitamin D supplements to help keep your bones strong
  • non-drug interventions to help relieve pain, including massage, acupuncture, acupressure, physical therapy, and exercise

What does multiple myeloma leg pain feel like?

Multiple myeloma may cause pain in your legs. You may experience swelling, weakness, numbness, and tingling.

What are the symptoms of worsening myeloma?

You may develop pain in new parts of your body if multiple myeloma progresses. You may also experience other symptoms, such as:

  • anemia
  • kidney failure
  • increased risk of infection
  • serious bleeding
  • severe pain, weakness, or numbness

What is the most prominent symptom of multiple myeloma?

Fatigue and bone pain that typically affects your ribs, hips, and back are amongst the most common symptoms of multiple myeloma.

Do you get muscle pain with myeloma?

Muscle weakness is a symptom of myeloma, especially muscle pain and weakness in the legs.

Multiple myeloma can be painful, but there are many ways to manage the pain before it interferes with your life. It’s important to follow the treatment plan a doctor recommends to control the cancer.

If your pain isn’t being well-managed, talk with your doctor. There may be other techniques or treatments you haven’t tried yet.