Patients' Guide to Spinal Cancer

Symptoms of Multiple Myeloma in the Spine

Bone damage caused by this blood cancer can cause neck/back pain, fractures, spinal cord compression, and osteoporosis

Multiple myeloma is a complex disease with no known cause. This blood cancer affects each person differently—some people have a variety of symptoms, while others experience none. Though multiple myeloma can cause problems throughout the body, this article will focus on how one of its most common symptoms—bone damage—that can impact your spine.

Bone loss is common with multiple myeloma; in fact, 85 percent of multiple myeloma patients have some degree of bone loss, according to the Multiple Myeloma Research Foundation. Bone damage associated with this cancer primarily affects the spine, pelvis, and rib cage, and can cause pain and structural problems.

A Closer Look at Multiple Myeloma Bone Damage
To understand how multiple myeloma may damage the bones in your spine, you must first understand how healthy bones are maintained.

Two main types of cells work together to keep your bones healthy: osteoclasts and osteoblasts. Healthy bones continually undergo a process called remodeling, which means that old bone is dissolved and new bone takes its place. Osteoclasts are responsible for removing the old bone, and osteoblasts build new bone.
Chart rendering of the bone remodeling process Under normal circumstances, osteoclasts and osteoblasts work in a balanced fashion—once osteoclasts rid the body of old bone, osteoblasts replace it with new bone. But with multiple myeloma, the cancerous myeloma cells produce proteins that speed up the work of the osteoclasts while slowing down the work of the osteoblasts. This results in soft spots in the bone known as osteolytic lesions.

These osteolytic lesions make your bones susceptible to injury. As it relates to the spine, these lesions can cause neck and/or back pain and increase the risk of certain spinal problems, including fractures, osteoporosis, and spinal cord compression.

Multiple Myeloma Symptoms Impacting the Spine

Neck and/or Back Pain
Bone pain is a hallmark symptom of multiple myeloma, and it’s common to feel it in the spine. As your spinal bones are weakened by the disease, they may lose the structural strength necessary to support your neck and/or back as well as they did before. You may experience neck/back pain locally at the plasmacytoma site (if the tumor is in your back), or you may experience it throughout your back. A plasmacytoma is a malignant (cancerous) solitary plasma cell tumor.

Spinal Fractures
Multiple myeloma weakens your bones, which means it increases your risk of breaking a bone. This cancer can cause the bones of the spine (eg, vertebrae) to collapse, which is known as a compression fracture. A vertebral compression fracture is very painful. If more than one vertebral compression fracture occurs, either at the same time or over a period of time, a spinal deformity, such as kyphosis (humpback appearance) may develop.
Spine cancer: plasmacytoma cord compression Osteoporosis
The bone damage and bone thinning so frequently associated with multiple myeloma can cause osteoporosis. Osteoporosis means “porous bone,” and a porous bone is more likely to break than a strong, solid bone.
illustration of osteoporotic bone

Spinal Cord Compression
Myelopathy is the term used by spine professionals when the spinal cord is compressed. Spinal cord compression may occur when a weakened vertebra or part of the vertebral body breaks or collapses and pushes against the spinal cord. In like manner, a spinal nerve root may be compressed too. Symptoms of myelopathy are termed neurologic, and include weakness, numbness, tingling, or difficulty walking.

Hypercalcemia
Hypercalcemia occurs when too much calcium is in your blood. It’s caused by the increased activity of the osteoclasts that break down bone, which releases excess calcium into the blood. High calcium levels detected in a blood test may be used to indicate multiple myeloma.

You may not know you have hypercalcemia, especially if the condition is mild. Common symptoms of hypercalcemia include excessive thirst, frequent urination and/or pain in your abdominal area. However, these symptoms are similar to those of other medical conditions. Therefore, it is important to obtain an accurate diagnosis from a physician.  

What You Should Do
While neck or back pain is common, pain that suddenly develops, pain that is acute or progressively worsens warrants investigation, a diagnosis. According to the American Cancer Society (ACA), multiple myeloma is uncommon occurring in about 1 out of every 143 people in the United States. The ACA projects there will be about 30,330 new cases of multiple myeloma diagnosed during 2016.

Updated on: 02/23/17
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How Multiple Myeloma of the Spine Is Diagnosed
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How Multiple Myeloma of the Spine Is Diagnosed

Multiple myeloma is a blood cancer that can weaken and damage the bones of your spine. Learn more about the multi-faceted steps leading to diagnosis.
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