Bone problems and myeloma

Bone pain is the most common symptom of myeloma. Pain from bone damage may continue even if the myeloma is in remission. This is because bone damage can continue to cause symptoms even though the myeloma is no longer there. There are ways to treat bone pain.

Always tell your doctor or nurse about any bone pain, including any new pain. There are doctors and nurses who specialise in controlling pain called palliative care specialists. They are based in hospitals, hospices, palliative care units and pain clinics. They work with your myeloma team and your GP to make sure your pain is well controlled.

Treatments for bone pain may include:

• painkillers
• bisphosphonates
• radiotherapy
• surgery, including vertebroplasty or kyphoplasty.

The healthcare team may also talk to you about other ways of managing pain, such as:

• physiotherapy
• nerve blocks
• TENS machines
• relaxation techniques.

Different painkillers are used to treat different types and levels of pain. You can usually take them by mouth. You can also have them as skin patches or sometimes as an injection under the skin, or into a vein.

Your doctor or nurse will assess the pain by asking you questions about it. Give them as much information as you can. It can help to keep a record of when you have the pain and what makes it better or worse in a pain diary. This information can help them to plan the best pain control for you.

Download our pain diary [PDF]

Anti-inflammatory drugs such as ibuprofen can cause kidney damage in people with myeloma. You should check with your doctor or nurse before taking these. We have more information about ways to manage pain.

Radiotherapy uses high-energy rays to destroy the myeloma cells. You may have it to reduce pain in bones and allow the bones to repair themselves.

Radiotherapy can also be used when myeloma in the spine is causing pressure on the spinal cord. This is called spinal cord compression.

In advanced myeloma, radiotherapy can be given to reduce symptoms and control the myeloma for some time.

Myeloma can develop in the bones of the spine. Sometimes this can weaken the bone and put pressure on the spinal cord. This is called spinal cord compression. It can damage the nerves in the back. This causes:

• back or neck pain that is new or suddenly gets worse
• numbness or pins and needles in your toes, fingers or buttocks that is new or suddenly gets worse
• a feeling of unsteadiness on your feet
• weakness in your legs
• problems passing urine (peeing) or problems with bowel control.

If you have any of these symptoms, it is very important to tell your doctor or specialist nurse straight away.

Spinal cord compression should be treated as soon as possible to prevent permanent damage. It is usually treated with steroids and radiotherapy. Sometimes chemotherapy is used, or surgery may be needed.

Doctors will help manage any pain and bisphosphonates may be used to help to strengthen your bones.

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