What causes multiple myeloma pain?

Myeloma bone disease causes bone to break down faster than it can be repaired. This can lead to painful conditions like:

  • Osteopenia. This means thin bones. This can cause a dull general pain or a more local ache.
  • Lytic lesions. This is the loss of pockets of bone, which can also cause dull overall aches or pain at a specific place.
  • Bone fractures. As bones thin, they break more easily.
  • Spinal compression. if a vertebra in your spine breaks, the damaged bone can press on your spinal cord and cause sharp, shooting pains in your limbs.
  • Malignant spinal compression. A tumor pressing on your spinal cord can also cause back pain that slowly gets worse. It might feel like a tight band around your chest and belly. It can also move down to your legs and bottom.
  • Spinal collapse. More than one broken vertebrae can cause your spinal column to collapse. It could be a dull ache, a sharp pain in your ribs and belly, or a shooting pain that moves up and down your leg.
  • Kyphosis. If your spine collapses, you can get a curve in your back that leads to chronic back pain.
  • Hypercalcemia. As bone is destroyed, your system gets swamped with calcium. It can lead to pain and problems like constipation and vomiting.
  • Peripheral neuropathy. Myeloma or its treatments can damage your nerves and lead to this condition, which causes tingling, numbness, and sometimes a sharp burning or jabbing pain in various body parts.

Where Does It Hurt?

Multiple myeloma can cause pain in any bone, but you’ll most likely feel it in your:

  • Back
  • Hips
  • Pelvis
  • Skull
  • Belly
  • Chest
  • Arms
  • Legs
  • Jaw
  • Teeth

Medicines to Treat Multiple Myeloma Pain

Medications are one way to help you handle pain, and there are many to choose from. Your doctor will talk with you about when and how often to take pain medicine. Always ask your doctor before you take anything, even those you can get from the drugstore.

Drugs that treat multiple myeloma pain include:

  • Over-the-counter pain relievers like acetaminophen, aspirin, ibuprofen, and naproxen. They help with mild to moderate pain.
  • Opioids. These are stronger pain-fighting medicines that you get with a doctor's prescription. Morphine is one of the most common for multiple myeloma pain. Other opioids include codeine, fentanyl, hydrocodone, hydromorphone, methadone, and oxycodone. These come in pills, patches, lozenges, and sprays. If used for a long time, they can lead to dependence, so be sure to follow your doctor's instructions for taking them.
  • Antidepressants. Some of these drugs, such as amitriptyline, duloxetine, and nortriptyline, can help treat nerve pain, called neuropathy, that often comes with multiple myeloma.
  • Anticonvulsants. Medications like gabapentin (Neurontin), pregabalin (Lyrica), and topiramate (Topamax) also treat nerve pain.
  • Corticosteroids. These medicines, like dexamethasone and prednisone, can help fight tumors and control inflammation.
  • Anesthetics. Lidocaine skin patches, ointments, and gels can numb pain in specific areas. Your doctor can also inject anesthetic or anti-inflammatory drugs near a painful spot or nerve center, which is called a nerve block.

Other Treatments

Procedures and devices used to treat multiple myeloma include:

Radiation

External beam radiation, which uses a machine to beam energy at the cancer, can be used to treat:

  • Painful bone lesions that haven’t responded to chemotherapy.
  • Spinal compression due to tumor

Surgery

Surgeons can insert rods and plates to support fragile bones.

There are two treatments for fractured vertebrae that can stabilize the bone and help ease back pain:

  • Percutaneous vertebroplasty: Your doctor injects the broken vertebrae with medical-grade cement.
  • Balloon kyphoplasty: The doctor uses a tool called an inflatable bone tamp to create a space in the vertebra to inject medical-grade cement and shore up the bone.

Intrathecal Pump

Your doctor might talk to you about this device, which is inserted into your body and drips pain medicine into the area around your spinal cord.

TENS

Short for transcutaneous electrical nerve stimulator, this device goes on your skin and releases low-voltage electricity to block nerve pain signals.

Other Pain Relief Options

Along with medication, natural remedies along with alternative and complementary treatments may ease pain, lower stress, and help you feel better. These include:

  • Physical therapy
  • Heat or cold applied to painful areas of the body
  • Exercise
  • Acupuncture
  • Massage
  • Counseling to ease stress
  • Meditation
  • Hypnosis
  • Guided imagery
  • Reiki
  • Therapeutic touch
  • Music therapy

Talk to your doctor before you try any complementary therapy to make sure it's a good choice for you.

A healthy lifestyle also can help you feel better with multiple myeloma and may help you fight pain. Healthy eating and regular exercise can give you energy, keep your muscles and bones strong, and curb your stress. Talk to your doctor or nurse about how much rest you need each day and how often you can be active.

Smoking and drinking too much may make you feel worse. Ask your doctor for help quitting or cutting back.

WebMD Medical Reference

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WebMD Voices

Linda H., 53
Signal Mountain, TN
I work full time, so managing fatigue is something I'm always focused on. Regular exercise is the key for me. I walk at least several days a week, go to a tai chi class twice a week, and do water aerobics on Saturdays with other cancer survivors. It not only helps fight fatigue, but it's also a great de-stresser.
Cindi M., 53
Lincoln, NE
I get monthly massage therapy to keep me feeling good. I've established a great relationship with my massage therapist, who's been with me for 6 years of the journey. She really knows my body and is good at working out the kinks and adjusting when pain has me over-accommodating on one side or another.
Jenny A., 50
Salt Lake City, UT
What I've learned is while you can't control what randomly happens in life, you can control how you respond. After treatment, I got involved in patient advocacy and started a foundation to support myeloma patients and research. The journey to be actively involved in helping others was my emotional therapy.
Dawn T., 58
Boca Raton, FL
I try to eat healthy. I start my day with organic oatmeal topped with walnuts, green tea, and a green smoothie with protein powder. I've learned my body needs a large green salad to counteract the constipation from my trial drugs. I generally stick with seafood, poultry, or beans for protein. I also drink tons of water.
Tom Z., 54
Red Bank, NJ
Get involved with the Multiple Myeloma Research Foundation to be around other active and positive people with MM. Do yoga and meditation. Find something to be passionate about. Explore your creative side. I took up photography. Attitude is everything. Stay positive –– new treatments are being discovered yearly.
Pat C., 70
Fayetteville, GA
Don't feel guilty because you cannot do as much as you used to. Ask for help with things that leave you a bit exhausted. My friends did small things like let me out of the car right in front of the door. Support groups are important. Sharing your experience with others with the same disease is so helpful.
Carol M., 59
Vero Beach, FL
With good nutrition, whatever exercise you can manage, and an active social life, you can still lead a happy, productive life. I'm not saying it's easy because it's not. Quitting sugar, eating green, taking naps, getting massages, trying to lead a stress-free life, and keeping busy is exhausting. But it works.
Jim W., 51
Kansas City, MO
The first thing is to get a second opinion. This is, to me, the most important thing to do. Your doctor may only treat three or four myeloma patients a year. You want to go to a doctor who sees at least 50 myeloma patients a year or is part of a practice that sees 100 myeloma patients a year.
Eric A., 51
Annapolis, MD
To help with fatigue, I've always received my treatments on Friday afternoon. This allows me to go home straight after. I then have the weekend to rest and recuperate. Typically, the second day after treatment has me feeling the worst. I try to make time for extra rest and a nap in the afternoon on Sunday.
Bob T., 61
Forest Hills, NY
One of the most important things that I learned when I was diagnosed with myeloma is not to shut out the world or go quiet. Tell people what happened. It isn't some sort of thing that you should view as a weakness or a mark of shame. You need to get comfort and information. Isolation will only breed fear.
Michelle C., 51
New York, NY
Infection can not only put you in the hospital, but prevent you from continuing treatment. Keeping well while being around children all the time can be tricky. It's important to wear a mask regularly if you must be in a crowd. If you can, enjoy vacations and high-traffic places while your numbers are good!

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