Symptoms of myeloma

Myeloma does not always cause symptoms in its early stages. It 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 - these are symptoms of low red blood cells (anaemia)

• pain, changes in sensation or weakness - these are symptoms of spinal cord compression

• lots of infections or infections that don't go away

• feeling thirsty, passing urine more frequently, confusion and drowsiness - these are all symptoms of high calcium levels in the blood

Symptoms and problems caused by myeloma

Most of the symptoms and problems of myeloma are caused by abnormal plasma cells building up in the bone marrow. These cells make abnormal types of antibodies called paraproteins, which also causes problems.

Bone pain and damage

It is common to have pain when you are diagnosed. People mostly describe the pain as dull or aching. 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).

Feeling tired 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, they release calcium 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.

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

Damage to your kidneys

Abnormal plasma cells make a large amount of antibody protein (immunoglobulin). This can damage your kidneys as it passes through from the bloodstream to the urine. 

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.