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. Osteopenia in itself does not cause pain. Osteopenia increases the risk of bone fractures (broken bones) that can be painful.
- 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 cord 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 cord 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 shoots 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:
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.
Procedures and devices used to treat multiple myeloma include:
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 cord compression due to tumor
Surgeons can insert rods, nails, 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.
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.
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
- Counseling to ease stress
- Guided imagery
- 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.