Bone pain and weakened bones

If your cancer is affecting your bones it can cause pain. For example a nagging ache in your bone. Cancers such as multiple myeloma and osteosarcoma start in the bones. This can damage the bone and cause pain. Or sometimes cancer spreads to the bones. 

Some drug treatments, such as hormone therapy, some targeted therapies and immunotherapies can also cause pains in your joints or bones. This often settles down after a few weeks.

Remember pain in your bones can be caused by other things such as arthritis, simple sprains and everyday aches and pains as you get older. 

The best treatment for your bone pain will depend on how bad the pain is and what’s causing it. 

Painkillers

• Mild pain is often helped with drugs such as paracetamol or anti-inflammatory drugs like ibuprofen. Moderate and severe pain needs stronger painkillers such as codeine or morphine. If your medication does not kill the pain, tell your doctor or nurse.
• Or you might see a specialist who manages pain and other symptoms. They can arrange for you to try out different drugs and types of painkillers to see which one suits you best. Read more about controlling pain.

Bone-strengthening drugs

• Medications known as bisphosphonates and monoclonal antibodies can help to relieve bone pain. They can also strengthen your bones and reduce the risk of fractures. 

Radiotherapy

• Radiotherapy is very good for treating bone pain caused by metastatic cancer. The treatment kills off the cancer cells and can be given as a single dose or divided over a few days. It can take 2‒3 weeks to work. Sometimes it can cause a flare-up of pain for a few days after treatment. 

Metastatic cancer in the bones or cancer that affects your bones, such as multiple myeloma, can make your bones weaker and more likely to break (fracture).

Some treatments can also lead to bone loss conditions osteopenia or osteoporosis. These include:

• Hormone therapies
• Chemotherapy drugs that reduce the production of hormones in the body
• Radiotherapy that affects a woman’s ovaries
• Surgery to remove a woman’s ovaries or a man’s testes
• Steroids

You may have a special scan called a DEXA scan before, during or after your treatment to check for signs of osteopenia and osteoporosis, to see if you’re at risk of breaking a bone. Read more about DEXA scans.

Bone-strengthening drugs

• Medications known as bisphosphonates and monoclonal antibodies can also strengthen your bones and reduce the risk of fractures. We have more information on bone-strengthening drugs.

Surgery

• If a bone is very weak, you may need surgery to strength it. This is done in hospital under a general anaesthetic.
• Your surgeon will put a pin into the centre of the weakened bone and might fix a metal plate to hold the bone firm as well. You will need to stay in hospital for a week or so to recover after this surgery.