Overview of Multiple Myeloma
Multiple myeloma is a type of blood cancer that forms in the plasma cells, a type of white blood cells in the body. Plasma cells are manufactured in the bone marrow, and the cancer cells rapidly multiply within the bone marrow itself to spread throughout the body. As they grow, these cancer cells start to crowd out and destroy the healthy plasma and blood cells present in the bone marrow. Plasma cells are responsible for manufacturing antibodies that help the body fight off infection. Myeloma cells can lead to the production of abnormal antibodies, causing the blood flow to slow down. This condition is also marked by the formation of multiple tumors.(1) Multiple myeloma commonly occurs in the bone marrow, and it can affect the marrow present in the bones such as:
- Pelvic bones
Multiple myeloma is typically characterized by the appearance of bone lesions, which cause severe pain.
What are the Causes of Multiple Myeloma Bone Pain?
Multiple myeloma is known to cause soft spots in the affected bone known as osteolytic lesions. These appear as holes on an X-ray and are painful. These osteolytic lesions also significantly increase the risk of having painful fractures or breaks. Myeloma is also known to cause damage to your nerves. It can cause immense pain when a tumor starts compressing or pressing up against a nerve. Tumors are also known to compress the spinal cord, leading to severe back pain along with muscle weakness. According to data from the Multiple Myeloma Research Foundation, nearly 85 percent of all patients who have multiple myeloma end up experiencing some degree of bone loss and the severe pain that is typically associated with it.(2)
Bone Pain and Lesions: Available Treatments
Multiple myeloma is a painful condition. While doctors consider treating the myeloma itself as their first priority, there are also several treatment options available for dealing with the pain. There are natural and medical treatment options available for treating bone pain and bone lesions. However, you should always talk to your doctor before you start a new treatment. Keep in mind that while these pain treatments can help you get relief from the bone pain, they won’t stop the myeloma from spreading and progressing on its own.
Medical Treatment Options for Bone Pain and Lesions
Here are some medical treatment options for dealing with bone pain and lesions in multiple myeloma:(3) Analgesics: Analgesic is a broad term that is used for describing different types of pain relievers. The most common types of analgesics that are used in treating bone pain are narcotics and opioids, such as codeine and morphine.(4) Bisphosphonates: These are prescription medications that your doctor prescribes for preventing the bone marrow cells from breaking down and causing damage to the bone. It is possible to take bisphosphonates orally by mouth or through the vein intravenously. Antidepressants and anticonvulsants: These medications are also sometimes used for treating pain that is associated with nerve damage linked with multiple myeloma. These medications can also work for interrupting or slowing down the pain signals that the nerve cell sends to the brain. Surgery: A surgical option is usually used for treating fractures or breaks. Your doctor recommends a surgical intervention for inserting plates or rods into the fracture for supporting weakened and fragile bones. Radiation Therapy: Radiation therapy is also another medical treatment option that is used in an attempt to shrink tumors. Radiation therapy helps relieve compressed spinal cords or pinched nerves that result from multiple myelomas.(5) It is best to avoid taking any over-the-counter (OTC) medications as they are likely to interact with the other cancer treatments or prescribed pain medications you might be taking. It is always best to consult your doctor before you take any type of OTC medications.
Natural Treatment Options for Bone Pain and Lesions
There are many natural treatments that are used alongside medical procedures such as surgery and medications. Many of these natural treatments are helpful in providing substantial pain relief. Some of these treatments can include: Exercise Therapy: This type of therapy helps in promoting healthy bones and also decrease pain in the future. Physical Therapy: Physical therapy can include to help expand a person’s range of motion, boost the strength of the affected area of the body after surgery or bone damage, and it can also be used for general strength building. Massage Therapy: This type of therapy can be used for alleviating joint, muscle, and bone pain. Acupuncture: Acupuncture is a safe treatment that is considered to be highly beneficial in promoting nerve health and also provides bone pain relief.(6)
Natural Supplements to Treat Bone Pain and Lesions
There are many natural supplements that can help you with your pain management and also with your overall health. However, it is essential to keep in mind that just like OTC medications, these can also interact with the other prescribed medications you are taking. You should never take any new supplements without first discussing with your doctor. Many natural supplements can also include magnesium and fish oil. This is because: Magnesium helps improve nerve health, strengthen your bones, prevent future bone pain, and even regulate calcium levels to prevent hypercalcemia in the future. Fish oil supplements are available in capsule and liquid form, and they are powerhouses of omega-3 fatty acids. Omega-3 fatty acids help in improving peripheral nerve health and also help reduce inflammation and painful nerve damage. While many people opt for taking calcium supplements in hopes of strengthening their bones, this can prove to be dangerous as there is already excess calcium flowing through your bloodstream from the broken-down bones. Adding more calcium supplements, in this case, can easily result in hypercalcemia, which is a condition marked by having too much calcium in the bloodstream. This is why you should never take calcium supplements without the advice of your doctor.
Multiple myeloma is a serious condition by itself, but the resulting bone damage from the cancer can cause many types of serious long-term complications, the most obvious one being chronic bone pain and bone weakness. The soft spots and lesions that occur in the bone due to myeloma are not that easy to treat, and they can continue to cause fractures and breaks even when the myeloma goes into a period of remission. If the tumors are pressing up against your nerves, or they lead to spinal cord compression, then you might experience long-term damage to your nervous system. Since many myeloma treatments also cause nerve damage, many people end up developing pain or tingling in the affected areas of nerve damage. There are some treatments that offer relief, but only to a certain extent. These include pregabalin (brand name Lyrica) or duloxetine (brand name Cymbalta). You can also try to wear padded slippers, loose socks, and also try to walk regularly to help alleviate the pain. References
- Themmrf.org. (2019). [online] Available at: https://www.themmrf.org/wp-content/uploads/MMRF_Disease_Overview.pdf [Accessed 29 Aug. 2019].
- Anon, (2019). [online] Available at: https://www.themmrf.org/multiple-myeloma/symptoms/bone-lesions/ [Accessed 29 Aug. 2019].
- Marras, F. and Leali, P.T., 2016. The role of drugs in bone pain. Clinical Cases in Mineral and Bone Metabolism, 13(2), p.93.
- Lussier, D., Huskey, A.G. and Portenoy, R.K., 2004. Adjuvant analgesics in cancer pain management. The oncologist, 9(5), pp.571-591.
- Cancer.org. (2019). Radiation Therapy for Multiple Myeloma. [online] Available at: https://www.cancer.org/cancer/multiple-myeloma/treating/radiation.html [Accessed 29 Aug. 2019].
- Cure Today. (2019). Acupuncture Reduces Symptom Burden in Patients With Multiple Myeloma. [online] Available at: https://www.curetoday.com/articles/acupuncture-reduces-symptom-burden-in-patients-with-multiple-myeloma [Accessed 29 Aug. 2019].
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- How Painful Is Multiple Myeloma & How To Manage Pain?
- What Happens If Multiple Myeloma Is Left Untreated?
- Can You Exercise With Multiple Myeloma & What Exercises Are Better?
- Does Multiple Myeloma Go Into Remission?