Multiple Myeloma Back Pain: Causes and Relief

Medically reviewed by Alfredo Chua, M.D.

Written by Anastasia Climan, RDN, CDN and Alicia Adams

Updated on October 14, 2026

Feel better informed on myeloma and get real support from your community.

Join

Key Takeaways

Back pain is one of the most common and challenging symptoms for people living with multiple myeloma, affecting thousands of people and showing up in many different ways, from dull aches to sudden sharp pain.
Multiple myeloma can weaken bones and increase the risk of fractures in the spine, which can lead to ongoing or sudden pain. In some cases, tumors or bone damage can press on nerves or the spinal cord, which is a medical emergency that requires immediate care if symptoms like weakness, numbness, or trouble walking appear.
Keeping track of where your pain is, how it feels, and how it affects your sleep and daily activities can help your healthcare team find the best path forward, so be sure to share any new or worsening pain with them right away.

View all takeaways

Multiple myeloma back pain can come from bone damage in the back or spine, tumors pressing on nerves, treatment side effects, or related conditions.

Back pain is also a common and challenging symptom of multiple myeloma, reported by about 2,600 members of MyMyelomaTeam.

Here’s what myeloma back pain can feel like and which strategies may help.

🗳️ What does your back pain usually feel like?

Dull or aching

Sharp or sudden

Burning or shooting

It changes or feels like more than one of these.

What Does Multiple Myeloma Back Pain Feel Like?

Back pain can feel different from person to person, and members of MyMyelomaTeam describe everything from soreness and ongoing aches to sudden or shooting pain:

“My dad is at home — lot of pain in back and sides; I read yoga and acupuncture can work. Does anyone have experience with this?”
“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.”

These experiences show that back pain with multiple myeloma doesn’t always feel the same. Myeloma can weaken bones and increase the risk of fractures, including compression fractures in the spine.

A fracture may cause sudden, severe pain, while other pain can feel dull, persistent, burning, or shooting.

Let your healthcare provider know where the pain is, what it feels like, how long it lasts, and what makes it better or worse. These details can help them determine the cause and whether testing or treatment is needed.

How Does Back Pain Affect MyMyelomaTeam Members?

Ongoing back pain can affect quality of life, making it harder to stay active, enjoy hobbies, and get through everyday tasks. One MyMyelomaTeam member shared, “With my current condition, I’m unable to play my musical instruments.” Another simply said, “I’m not as active as I once was.”

Pain can also interfere with sleep. One member described having “moderate to severe lower back pain and burning down both legs,” adding that it was difficult to get comfortable enough to rest. Poor sleep can, in turn, make fatigue and coping with pain more difficult.

Don’t assume persistent or worsening back pain is something you simply have to live with. Keep track of where the pain occurs, how severe it is, how long it lasts, and whether it affects movement or sleep, and share these details with your healthcare team.

What Causes Back Pain in Myeloma?

Back pain in multiple myeloma can have several causes. It may come from bone damage caused by myeloma, pressure on nerves in the spine, or sometimes treatment. Where the pain occurs and how it feels can offer clues, but your healthcare team may need imaging or other tests to find the cause.

Back Pain From Myeloma

Multiple myeloma affects plasma cells, a type of white blood cell found in bone marrow. As myeloma cells build up in the bone marrow, they can interfere with the normal process of breaking down and rebuilding bone.

Damaged areas of bone are called bone lesions, or osteolytic lesions. They can develop in the spine, ribs, hips, and other bones.

When a vertebra — one of the bones in the spine — becomes weak, it may crack or collapse. This is called a vertebral compression fracture and can cause sudden or ongoing back pain.

If several vertebrae collapse, the spine may begin to curve forward, which can cause ongoing pain and changes in posture or movement. For some painful compression fractures, doctors may consider kyphoplasty or vertebroplasty.

These procedures use bone cement to help stabilize the damaged vertebra. They are used for certain fractures, not as a general treatment for a curved spine.

Spinal Cord and Nerve Compression

Myeloma-related bone damage or a tumor in or near the spine can press on the spinal cord or nearby nerves. This can cause severe back pain, shooting pain down an arm or leg, numbness, tingling, weakness, or trouble walking.

Pressure on the spinal cord is a medical emergency because it can cause lasting nerve damage. Prompt treatment can help prevent permanent damage. Seek medical care immediately for any of these symptoms, whether or not you also have new or worsening back pain:

Weakness or numbness in the arms or legs
Trouble walking
Problems controlling your bladder or bowels
Trouble passing urine
Pain that shoots down an arm or leg

Peripheral neuropathy (damage to nerves outside the brain and spinal cord) is different from spinal cord compression. Multiple myeloma and some of its treatments can affect nerves, often causing burning, tingling, numbness, or pins-and-needles feelings in the hands or feet.

Back Pain From Myeloma Treatments

Back pain or nerve symptoms may also occur during some myeloma treatments.

Ixazomib (Ninlaro) is a proteasome inhibitor, a drug that blocks protein breakdown inside cells. It’s used with other medicines to treat some people with multiple myeloma. Its prescribing information lists back pain and peripheral neuropathy among possible side effects.

Peripheral neuropathy may cause tingling, numbness, burning, pain, or weakness, usually in the hands or feet.

Daratumumab (Darzalex) is a monoclonal antibody, a lab-made immune protein that targets myeloma cells. It’s used in several multiple myeloma treatment combinations. Back pain has been reported in people receiving some daratumumab-containing treatment regimens.

Don’t assume that new or worsening back pain is simply a treatment side effect. Tell your healthcare team about changes in your pain, especially if it is severe, starts suddenly, or comes with weakness, numbness, or trouble walking.

Multiple Myeloma Bone Pain at Night

For some people with multiple myeloma, bone pain may be more noticeable at night, including when turning or shifting in bed. When pain disrupts sleep, it can also leave you feeling less rested the next day.

If back pain regularly wakes you up or is getting worse, tell your oncology team. They can review your pain treatment and check whether myeloma-related bone damage or another problem needs attention.

What Are Multiple Myeloma Back Pain Treatment Options?

Treatment depends on what is causing the pain and how severe it is. The goals are to control the myeloma, protect weakened bones, and help you stay as comfortable and active as possible.

Medical Management

Treating the myeloma itself may help control the disease that is causing bone damage and pain.

Your doctor may also recommend bone-strengthening medicines. Bisphosphonates, such as zoledronic acid, and denosumab (Xgeva) can help reduce bone complications related to multiple myeloma. The best choice depends on factors such as your kidney health and other treatments.

Radiation therapy may be used for certain painful bone lesions or tumors. Procedures or surgery may also be needed when a damaged bone or unstable area of the spine needs extra support.

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 support weakened bones and reduce pain in specific situations.

Pain Relievers

Your healthcare team may recommend pain medicines based on how severe your pain is. For moderate to severe cancer pain, doctors may prescribe opioids. These medicines can be effective but may cause side effects such as constipation, nausea, and sleepiness.

Check with your oncology team before taking over-the-counter pain medicines. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, can increase the risk of bleeding and kidney problems and may not be safe with some cancer treatments or other medicines.

Physical Therapy and Other Approaches

Physical therapy and supervised exercise may help improve movement, strength, and daily function. One MyMyelomaTeam member shared, “I cannot say enough good about PT. It gave me what I needed to walk again.”

Other approaches, such as heat or cold, massage, yoga, or acupuncture, may help some people manage pain. However, talk with your oncology team before trying them. Some activities or treatments may not be safe if myeloma has weakened your bones or spine.

Complementary approaches can be part of a pain-management plan, but they should be used along with — not instead of — treatment for multiple myeloma.

References

Read full article

Comments
Questions

View all 99 comments

I hear you I have the same problem. I can’t stand or walk for more then 5 minutes with out feeling like I am going to collapse. I have took alive and ibuprofen 800 and it does the same just takes off… read more