What are the signs and symptoms of myeloma?

Common symptoms

The most common symptom of myeloma is back pain caused by damage to the vertebrae of the spine. In serious cases this can cause damage to the spinal cord.  

Tiredness is also very common. This is due a lack of red blood cells, which causes anaemia.

As both back pain and tiredness are common symptoms of other illnesses, myeloma can be difficult to spot. But generally with myeloma, these symptoms are severe and persistent. For example, lying down or taking mild painkillers does not relieve back pain and rest does not improve the feeling of tiredness.

Other symptoms

• Persistent bone pain in other areas of the body
• Bone injury and fractures, caused by thinning of bone
• Frequent, persistent infections, caused by a lack of healthy white blood cells that normally fight infection
• Thrombocytopenia – a lack of platelets, which are needed to clot the blood, causes bruising and bleeding
• Hypercalcaemia – an excess of calcium in the blood, which causes tiredness,  loss of appetite and nausea. Calcium enters the blood because the bone is being worn down.
• Hyperviscosity – too much paraprotein, which thickens the blood and causes bad circulation

Some symptoms may need emergency attention and patients with these should seek medical advice urgently. These are:

• Abnormal weakness particularly in the lower limbs. This is caused by compression of the spinal cord, either by a myeloma tumour or by collapse of one or more of the bones in the spine.
• Loss of bladder control, also caused by compression of the spinal cord
• Sudden onset of mental confusion and depression, dehydration and vomiting, caused by high levels of calcium in the blood

But it is unlikely that patients will show all these symptoms at the same time.

Long term effects of myeloma

Even with the best myeloma treatment myeloma there are some long-term side effects. However, these are generally manageable with medication.

Kidney damage is a common consequence of myeloma. Paraprotein produced by myeloma cells, is deposited in the kidneys as it passes from the blood into the urine. This builds up and causes damage that can be irreversible.

Patients with myeloma need to drink plenty of water to reduce the risk of kidney damage. It is also very important not to use painkillers called non-steroidal anti-inflammatory drugs (NSAIDs), the most well know being Nurofen™ (ibuprofen), as these may worsen the problem.

Most people who have myeloma will suffer bone damage to some extent. Specific drugs are available which target and limit this bone damage.

Another blood condition that develops in some people with myeloma is called amyloidosis. This is caused by paraprotein being deposited in various tissues around the body and has a wide variety of symptoms. Myeloma is not the only cause of amyloidosis.

What causes it?