Multiple myeloma is cancer that has an effect at various places in the body. The condition affects the active bone marrow sites such as bones of pelvis, hips, ribs, and spine. The myeloma cells alter the process of bone formation and lead to the development of porous bones. The condition is also characterized by the presence of paraproteins in the body. Paraproteins are the antibodies secreted by malignant cells in large quantity. Multiple myelomas lead to various bone disorders.
What Kind Of Pain Is Associated With Multiple Myeloma?
Multiple myeloma is a type of blood cancer that largely affects the bone marrow. As during the process of progression, the condition causes the weakening of the bone, the patient suffering from multiple myeloma experiences pain in the bones. More than 70% of the people having this condition have bone pain. The best part of all the distress is that the pain can be managed by effectively utilizing the available strategies. Apart from the pain directly related to the weakening of the bone, the pain may also due to the excess pressure on the nerve by the tumor cells. (1)
The bone is continuously in the remodeling process i.e. the bone gets formed and broken simultaneously and there is a balance in this process in a healthy person. The rate of bone formation is equal to the rate of bone resorption. When multiple myeloma reaches the bone, some chemical substances are secreted that increases the rate of bone resorption, leading to weak bones. Further, as in the case of other types of cancer, the cancerous cells rapidly divide and thus leaves a very little growth area for the new healthy bone cells leading to the porosity of the bones.
The above processes give rise to the following conditions that may lead to pain in multiple myeloma:
Hypercalcemia. Increase the resorption of calcium from the bones into the blood leads to multiple organ complications. As the body’s natural chemical balance gets disrupted, the physiological function of various organs takes a toll. For example, increased risk of stones may cause severe pain in kidneys, twitching in the muscles and gastrointestinal problems such as constipation. Higher calcium may also impact mental as well as physical growth.
Bone Fractures. As the increased bone resorption and increased density of cancerous cells, the bone mineral density reduces leading to bone porosity. The porous bone may lead to bone fractures and also causes pain in the bones.
Bone Lesions. Lesions in the bone leads to the development of soft spots and increases the damage to the bones. These are generally found in the weight-bearing joints such as pelvis and spine that helps in movement. Thus, the patient may feel pain during movement and at night.
Nerve Compression. As the physiological and anatomical characteristics of the bones at changed due to multiple myeloma, it may sometimes lead to the collapse of the vertebral column. This is known as a compression fracture. The collapsed bone leaves its position and starts pushing against the nerve going through the vertebral column. This leads to neuropathic pain and numbness.
It is also to be noted that apart from the physical distress, emotional disruption increases the severity of the pain. Further, the concept of pain is subjective in a way that the level of pain sensed by one person may be tolerable in another person. The pain experienced by the patient may be acute, chronic and breakthrough.
Bone disorders are one of the primary symptoms of multiple myeloma. As the condition is related to the abnormal plasma cell growth, it affects the bone marrow present in various bones. This led to the pain of various etiologies. The bone becomes porous and increases the chances of fracture. The pain is also caused due to hairline fractures, bone lesions, and neuropathic pain. Further, hypercalcemia due to increased bone resorption also adds up to the complications.
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