Multiple myeloma refers to the cancer of plasma cells. In normal cases, plasma cells remain present in one’s bone marrow and they constitute significant parts of the human immune system. However, when the plasma cells grow out of control and become cancerous, they cause multiple myeloma. In this situation, plasma cells create an abnormal protein called antibody, known by different names, such as monoclonal protein, M-spike, monoclonal immunoglobulin and so on.

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How Painful Is Multiple Myeloma?

Bone pain is a common symptom in almost every patient suffering from multiple myeloma cancer. This is because; the type of cancer causes pain by making your bone structure weak. In other words, we should say that pain is one of the prominent features related to MM and it takes place due to many underlying causes as well mechanisms. (1)

Along with pain due to complications related to your cancer, it takes place because of several other unrelated medical/health conditions, along with iatrogenic reasons. Irrespective of the reason behind your pain, it devastates a patient largely and affects his/her quality of life as well as the functional status. (2)

Reason Behind The Pain In Multiple Myeloma Cancer

If we talk about any healthy individual, cells refer to osteoclasts work to worn-out or break down old bones. Simultaneously, osteoblasts cells work to create new replaced bone. Together, the mentioned cells consistently rebuild the bones to retain their strength in a remodeling process.

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On the other side, when an individual suffers from multiple myeloma, myeloma cells release relatively higher amount of substances responsible to trigger osteoclasts, because of which more numbers of bones break down than in the normal condition. Furthermore, myeloma cells multiply as well as crowd out osteoblasts cells to prevent the formation of new bones. The complete process leads to bone damages, which cause pain in various ways. These include-

  • Bone Lesions, which are soft spots developing in almost every location, where your bone suffers damage. These lesions take place often on the ribs, pelvis and spine and are common causes of pain in multiple myeloma patients. Pain due to bone lesions becomes worse with body movement.
  • Bone lesions may result in bone fractures, which take place whenever any weak bone cracks. Pain due to broken bone in case of multiple myeloma is a severe one. (3)
  • Multiple myeloma sometimes results in collapse of the bones responsible for the formation of spinal column i.e. compression fracture.
  • Pain in case of multiple myeloma takes place because of hypercalcemia, where excessive amount of calcium broken down releases into the blood, which results in pain due to weak bones.

Pain Management In Case Of Multiple Myeloma Cancer

3-Step Analgesic Ladder

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For most of the patients suffering from pain related to Multiple Myeloma Cancer, doctors recommend for WHO recommended three-step of analgesic ladder to provide fast and enough amount of relief via oral medications.

Multidisciplinary Approach

Even though analgesics succeed to give relieve to patients to some extent, they fail to deal with high prevalence and difficult to treat pains. These include pain caused from skeletal mechanical instability or the one sustained due to neuropathic mechanisms. In this case, pain management demands for a multidisciplinary approach, which involves the integration of analgesic medicines with casual interventions.

Radiation Therapy

Doctors recommend for radiation therapy to shrink tumors, which press on nerves to cause pain. In this way, you patients move freely and bear less pain.

Surgery to Relieve Pain

Doctors recommend for surgery for stabilizing bones. Accordingly, they suggest inserting rods or plates to give support to fragile bones.

References:

  1. https://www.ncbi.nlm.nih.gov/pubmed/20214522
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086027/
  3. https://www.ncbi.nlm.nih.gov/pubmed/18069264

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Sheetal DeCaria MD

Written, Edited or Reviewed By:

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Last Modified On: April 23, 2019

This article does not provide medical advice. See disclaimer

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