Back pain is a common and challenging symptom of multiple myeloma, reported by about 2,600 members of MyMyelomaTeam. However, back pain with myeloma can have various causes and feel different to each person.

Keep reading to learn more about what myeloma back pain feels like and how it affects people, plus steps you can take to start feeling better.

How Does Back Pain From Myeloma Feel?

Members of MyMyelomaTeam have offered these descriptions of their back pain:

• “After stifling a sneeze, I felt something painful give in my back.”
• “I had four months of back pain.”
• “I thought I pulled something in my back.”
• “The pain in my back starts from the waist down, which also affects my legs, sometimes causing sciatica.”
• “I had been having pain in my spine, especially the lower lumbar region.”
• “I cough, and the back pain is like a hard hit to the back.”
• “Lower back pain on and off — just started experiencing soreness and pain in my shoulders and arms.”

Myeloma commonly causes vertebral compression fractures (broken bones in the spine) that can cause sudden, sharp pain. Other types of back pain may feel different. Describing your back pain accurately gives your health care provider valuable information to understand what’s causing it.

How Does Back Pain Affect MyMyelomaTeam Members?

Ongoing back pain can significantly affect quality of life. Members of MyMyelomaTeam have said back pain disrupts their daily lives by limiting what they can do. “With my current condition, I‘m unable to play my musical instruments,” one member shared.

Back pain can interfere with exercise. “I move slower now,” wrote one member with back pain. Another said, “I’m not as active as I once was.”

It can also be hard to sleep well when you have back pain. “I have insomnia and don’t get the proper rejuvenation each night that my body craves,” a MyMyelomaTeam member wrote.

Others say pain keeps them up at night: “I’m having moderate to severe lower back pain and burning down both legs. It’s difficult to get comfortable enough to rest.”

It’s important to pay attention to when your back pain occurs, how long it lasts, and what seems to make it better or worse.

What Causes Back Pain in Myeloma?

Myeloma itself, some myeloma treatments, and related conditions can all contribute to back pain. Various causes can lead to back pain that feels a certain way.

Back Pain From Myeloma

Myeloma affects white blood cells called plasma cells, which are part of the immune system and are found in bone marrow. Myeloma causes the excessive production of abnormal plasma cells, known as myeloma cells. These cells overcrowd the bone marrow and produce proteins that disrupt the normal balance between bone formation and bone breakdown.

Myeloma cells can move into bones, destroying bone faster than it can be rebuilt. These areas of destruction are called bone lesions or osteolytic lesions, and they can cause fractures or pain. Lesions that form in the spine can lead to painful vertebral fractures. Multiple vertebral fractures may result in spinal collapse or spinal cord compression, which can, in turn, cause severe nerve pain, peripheral neuropathy (nerve damage that can lead to symptoms like pain, tingling, or weakness), and other serious complications.

If the spine can no longer remain straight due to fractures, it may become abnormally curved, a condition known as kyphosis. This posture can contribute to chronic back pain. Kyphosis may be treated with injections into the collapsed vertebrae. Additionally, myeloma cells can form tumors on bones, placing pressure on spinal nerves and causing both nerve and bone pain.

Back Pain From Myeloma Treatments

Doctors treat myeloma with a variety of medications, and certain drugs may intensify back pain.

Ixazomib (Ninlaro) is a protease inhibitor used to treat myeloma. Protease inhibitors block certain enzymes that help cells grow and divide, targeting tumor cells in the bone marrow. Unfortunately, back pain is a potential side effect.

Daratumumab (Darzalex) is a monoclonal antibody drug — a human-made protein that can be directed to attack specific cells, such as myeloma cells. Another form of this drug combines daratumumab and hyaluronidase-fihj (Darzalex Faspro). Both versions can cause pain in your kidneys and your back.

How To Manage Back Pain To Feel Better

Your doctor will recommend a treatment based on the cause, location, and severity of your back pain. Prescribed medication, surgery, over-the-counter (OTC) drugs, and complementary therapies may provide pain relief.

Medical Management

Addressing back pain starts with managing myeloma. The earlier myeloma is diagnosed and treated, the better the chance of keeping ahead of symptoms such as back pain. Beyond that, doctors can offer various options to help control back pain.

Hematologists-oncologists, or blood cancer specialists, will narrow down the cause of the pain. If they confirm that your back pain stems from myeloma, they’ll set up a treatment plan based on the specific cause. They’ll also consider your type of myeloma, its stage, and your body’s response to your treatment plan. Some doctors may even start people with myeloma on bone-building medications like bisphosphonates or denosumab at diagnosis to help prevent bone problems that lead to pain and fractures.

Vertebral fractures may be treated with surgical techniques such as kyphoplasty. During this minimally invasive procedure, a balloon is used to restore height to the collapsed vertebra, and then the fractured bone is reinforced with special bone cement.

If a tumor is causing back pain, radiation therapy or surgery may bring relief by shrinking or eliminating the tumor. Radiation therapy can also treat osteolytic lesions and may strengthen bones. One MyMyelomaTeam member shared they developed lesions pressing on a nerve in their lower back. “This caused horrible sciatica pain. My doctor ordered 10 treatments of radiation, and it worked!” they wrote.

A back brace may also help stabilize the spine and reduce pressure in specific spots.

Pain Relievers

Pain medications may also be an option. Analgesics (pain relievers) for pain management are an important part of palliative care at any stage of myeloma.

Depending on the level and frequency of pain, doctors may consider prescribing opioids or narcotics. Although these medications can provide potent pain relief, they can also have significant side effects such as constipation and the risk of dependence.

Don’t take OTC pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen, without first talking to your oncology team. These medications may interfere with cancer treatments or other medications and may be harmful without medical supervision.

Other Therapies

Other therapies may help manage back pain, such as physical therapy (PT). “I cannot say enough good about PT. It gave me what I needed to walk again,” reported one MyMyelomaTeam member. Heating pads or ice packs may offer temporary pain relief as well.

Another member found that shifting their bed helped: “Back pain and neck pain have eased up. I adjusted the head of my bed, and that seemed to solve the issue.”

Ask your doctor whether complementary therapies might help manage your back pain when used alongside your myeloma treatment plan. This may include:

• Acupuncture or acupressure
• Yoga
• Meditation
• Exercise
• Diet
• Nutritional supplements
• Medical massage

Talk With Others Who Understand

MyMyelomaTeam is the social network for people with myeloma. On MyMyelomaTeam, more than 26,000 members come together to ask questions, give advice, and share their stories with others who understand life with myeloma.

Do bone fractures, kidney problems, or the side effects of multiple myeloma treatment leave you with severe back pain? If so, what seems to help? Share your experience in the comments below, or start a conversation by posting on your Activities page.