Persistent bone pain in the back or ribs: When to ask about myeloma
Fact-checked by Bone pain, especially in the back and ribs, is a common symptom of the blood cancer myeloma.
There are many possible causes of back and rib pain, so it’s often dismissed as age- or injury-related. However, when pain is unexplained, persistent, or getting worse, it should be medically evaluated to help avoid delayed diagnoses and treatment if it is a symptom of myeloma.
Why bone pain is common in myeloma
In healthy bones, bone maintenance and repair involve a tight balance between the cells that break down old or damaged bone and those that help form new bone.
In myeloma, cancerous cells grow out of control in the bone marrow — the spongy center of bones — and disrupt this balance. Bones become weak and damaged, leading to lytic lesions, or holes in the bone. This causes significant pain and makes bones more prone to fractures.
Pain, especially unexplained back pain, may be among the earliest noticeable symptoms of myeloma.
When back or rib pain may be myeloma
Pain can be caused by many things, so it can be difficult to recognize myeloma as the underlying cause. However, some characteristics of myeloma bone pain can help identify it. Particularly, this type of pain often:
- occurs in the back, ribs, and sometimes the hips
- gets worse with movement and at night
- is unrelated to a recent injury
- persists or gets worse for weeks or months
Multiple myeloma back pain or rib pain may feel like a deep ache or a sharp, stabbing sensation. In some cases, myeloma spine pain can occur when the vertebrae collapse. This pain is severe and comes on suddenly. It is a medical emergency and warrants urgent care.
Myeloma is very rare in children and younger adults, so back and rib pain in younger people likely has a different cause. Blood cancer is more likely to be a cause of bone pain in the elderly.
Other symptoms that may occur
Bone damage in myeloma can also cause other problems that occur alongside pain. These include:
- frequent fractures or breaks
- high blood calcium levels, with symptoms such as confusion, nausea or vomiting, and excessive thirst or urination
- spinal cord compression, leading to numbness, muscle weakness, or loss of bladder control
Doctors might also look for other typical myeloma symptoms, such as:
- excessive fatigue, weakness, or shortness of breath
- frequent infections
- easy bruising or bleeding
If these are occurring alongside back pain or rib pain, individuals should undergo further diagnostic testing to rule out myeloma.
Evaluating persistent pain
Individuals should seek medical care if they experience unexplained and persistent bone pain. Doctors will collect a medical history and then run more tests to diagnose myeloma bone disease or rule it out, such as:
- Imaging tests: X-rays, MRI scans, and CT scans may be used to visualize bones and detect lesions or fractures. MRI scans can also show the infiltration of myeloma cells into the bone marrow before more obvious bone destruction occurs.
- Blood tests: These evaluations can be used to measure calcium levels and look for other myeloma-related abnormalities, such as abnormal blood cell counts or signs of kidney damage.
A specialized type of X-ray called a DEXA scan may be used to measure bone mineral density, although this test alone can’t identify myeloma as an underlying cause.
Questions to ask if pain keeps getting worse
If a person has bone pain that won’t go away or keeps getting worse, it’s important to talk with a healthcare provider about next steps, and to develop a plan to manage it. A few things to ask a doctor include:
- What are the possible causes of this type of pain? Could this be myeloma or another type of blood cancer?
- What additional imaging, blood, or other tests do I need to diagnose the problem?
- What pain relief options, including lifestyle changes and medications, are safe for me while testing is ongoing?
- What red flag symptoms should I watch for?
- How long should I wait before re-evaluating if my pain persists? When should I seek emergency care?
Rare Cancer News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
