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Symptoms of myeloma

Myeloma, also called multiple myeloma does not always cause symptoms in its early stages, and might be picked up on a routine blood test. 

The main signs and symptoms of myeloma are:

  • bone pain - often in your back, hips, shoulders or ribs
  • broken bones (fractures)
  • tiredness (fatigue), shortness of breath and weakness which are all symptoms of anaemia
  • lots of infections or infections that don't go away
  • feeling sick (nausea) and loss of appetite
  • spinal cord compression - myeloma can cause fractures of the bones including in the spine this can cause pressure on the spine
  • feeling thirsty, passing urine more frequently, confusion and drowsiness - these are all symptoms of high calcium levels in the blood
Your symptoms are unlikely to be cancer but it is important to get them checked by a doctor.

Bone pain and damage

Up to 70 out of every 100 people (70%) have pain when they are diagnosed with myeloma. People mostly describe the pain as dull or aching, and it is often felt in the lower back or ribs.It might feel like there is pain in your muscles too.

Pain in the bones is caused by a lot of plasma cells collecting there. The large numbers of plasma cells damage the bones. Occasionally, a bone breaks (fractures).

Fatigue due to anaemia

Breathlessness and tiredness can happen because you do not have enough red blood cells (anaemia). This happens because there are abnormal plasma cells in your bone marrow. The abnormal plasma cells damage the bones and crowd out the normal blood cells. 

Infections

You might be more prone to infection, such as chest infections. Once you have an infection, it might take longer to get better. This is because you do not have enough healthy white blood cells to fight the bacteria or viruses.

Too much calcium in your blood

When the bones are damaged, calcium is released into the bloodstream. Too much calcium in the blood is called hypercalcaemia. This makes you feel very thirsty, sick and tired. You might also pass a lot of urine, as your body tries to get rid of the extra calcium. If hypercalcaemia is not treated and gets worse, it can make you drowsy and difficult to wake.

About 30 out of 100 people (30%) with myeloma have symptoms like these when they first go to the doctor.

Spinal cord compression

Spinal cord compression happens when pressure on the spinal cord stops the nerves working normally. The symptoms depend on where the pressure is in the spinal cord.
Pain is often the first symptom and more than 9 out of 10 people (90%) with spinal cord compression have it. The pain could be:

  • anywhere in your back or neck or it may feel like a band around your body
  • worse when you cough, sneeze or go to the toilet
  • getting worse or doesn’t go away
  • stopping you sleep or wakes you up at night

Other symptoms are:

  • changes to sensations in your body, such as pins and needles or numbness
  • weakness in your legs or arms
  • not being able to open your bladder or bowels
  • difficulty controlling your bladder or bowels
  • erection problems
Spinal cord compression is an emergency. Contact your doctor straight away if you have any symptoms of spinal cord compression.

Changes to how your kidneys work

This is a later symptom of myeloma. The large amounts of antibody protein (immunoglobulin) made by the abnormal plasma cells can damage your kidneys as it passes through from the bloodstream to the urine. The antibody protein is called the Bence Jones protein. It is the small part of the antibody (immunoglobulin) called the free light chain.

This leads to a number of different symptoms including:

  • nausea
  • loss of appetite and weight loss
  • dehydration
  • tiredness and lack of energy
  • swollen ankles, feet and hands

Bruising and bleeding

Abnormal bruising and bleeding can happen because the large numbers of plasma cells in your bone marrow have stopped platelets from being made. But this is quite rare in myeloma.

Last reviewed: 
27 Mar 2020
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    R Kyle and others
    Mayo Clinic Proceedings, 2003, Volume 78, Issue 1

  • Cancer and its management (7th edition)
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    Lippincott, Williams and Wilkins, 2011

  • Early detection of multiple myeloma in primary care using blood tests: a case-control study in primary care

    C Koshiaris and others

    The British Journal of General Practice 2018  volume 13. pii: bjgp18X698357

  • Prevalence of symptoms in patients with multiple myeloma: a systematic review and meta-analysis

    C Ramsenthaler and others 

    European Journal of Haematology 2016 Volume 97 number 5 pages 416-429

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