Multiple myeloma

The most common symptoms of bone disease are: 

Bone pain 

Multiple myeloma cells can often destroy bone tissue. Soft spots’ or ‘holes’ may develop where the bone has been damaged. They can cause bone pain and swelling, particularly in your middle or lower back, ribcage and your hips. Often the pain is dull and aching but persistent. Sometimes moving can make it feel worse.

Bone fractures and reduced bone density 

Thinning of the bone and fractures (breaks) can happen in any bone where damage occurs due to multiple myeloma. These are caused by the disease rather than through an injury.

Numbness, pins and needles or weakness in your feet or legs

This may be a sign of spinal cord compression, where a multiple myeloma tumour presses on your spinal cord. 

Spinal cord compression is a medical emergency, so get medical help immmediately if you have myeloma and develop this symptom or if you lose control of your bladder or bowels.

The growing number of myeloma cells can affect production of blood cells in your bone marrow, as there may be little space for normal blood cells to develop. Lack of blood cells can cause symptoms. 

Fewer red blood cells

Fatigue and anaemia (low haemoglobin). You may also look pale and have shortness of breath and weakness, because less oxygen is carried in your blood. 

Fewer white blood cells

Risk of infection. This includes repeated coughs, colds and flus, and other infections, especially chest infections. It also may take longer to recover from any type of infection. 

Fewer platelets

Unexplained bruising or bleeding, such as nosebleeds or bleeding gums.

The most common kidney problems include reduced kidney function and high blood calcium (hypercalcaemia).

Reduced kidney function 

• Less urine (pee) when you go to the toilet. This doesn’t always happen 
• Swelling in your legs, ankles or feet, caused by fluid retention 
• Shortness of breath 
• Fatigue (feeling very tired)

Kidney damage or sometimes kidney failure can be caused by abnormal proteins called 'light chains' produced by the myeloma cells. The light chains can block the tubes in the kidneys and stop them filtering waste products from your blood properly. 

Hypercalcaemia is when there is too much calcium in your blood. 

It can cause:

• Loss of appetite 
• Nausea (feeling sick) and vomiting
• Constipation and abdominal (tummy) pain
• The need to drink more fluids and urinate (pee) more 
• Tiredness, weakness or muscle pain 
• Confusion, disorientation and difficulty thinking
• Headaches 
• Depression

When bone tissue is destroyed, it causes the level of calcium to rise in your bloodstream. This is called hypercalcaemia. Your kidneys can get overworked by trying to get rid of this excess calcium.