After a diagnosis of multiple myeloma, the first thing many people feel in their body is bone pain. Quite a few describe a heavy ache in the lower back, a sharp stabbing on one side of the ribs, or a back that will not straighten after sleeping. In this disease, abnormal plasma cells multiply inside the marrow and keep sending signals that dissolve bone. As that goes on, holes form in the bone, and a vertebra that looked perfectly fine may one day collapse downward. If your back suddenly hurt as if it were buckling even though you lifted nothing heavy, it is worth suspecting a compression fracture at least once.
Honestly, the people I worry about most are the ones who simply endure the pain. There are cases where someone shrugs it off thinking "backs just hurt as you get older" while a fracture progresses. Bone pain in multiple myeloma, unlike a simple muscle ache, does not ease much even with rest, often worsens at night, or hurts in one pinpointed spot. At times like this, rather than raising your painkiller dose on your own, it helps far more to tell your doctor exactly where and in what way it hurts. That is because, beyond adjusting medication, treatment often also includes bone-protecting injections such as bisphosphonates or denosumab.
So how should you spare your spine and joints in daily life? The key is to reduce motions that "twist, bend, and lift suddenly." When picking up something dropped on the floor, do not bend at the waist—squat by bending your knees and stand back up; rather than hanging a heavy shopping bag entirely on one arm, split the load between both hands or use a cart. When getting up from bed, do not twist your body and spring up; instead, roll onto your side, then push your upper body up with your arm while lowering your legs—move like a rolling log. It feels cumbersome at first, but once you get used to it, this protects your spine.
Some people are so afraid that they avoid exercise altogether, but not moving actually weakens the bones and muscles further. Instead of vigorous exercise, a slow walk on level ground, water walking where you move in the water, or light stretching carry less burden. However, motions that bend the back deeply like sit-ups, exercises that twist the trunk hard like golf swings or tennis, and exercises with a lot of jumping carry a fracture risk and are safer to avoid. How much of what exercise you may do depends on your bone condition, so consulting your medical team once before starting will put your mind at ease.
The home environment matters more than you might think. In multiple myeloma, a single small fall can lead to a major fracture, so put a non-slip mat and grab bars in the slippery bathroom and tidy up cords or carpet edges that lie around on the floor. Keeping a small light on for trips to the bathroom on a dark night so you do not trip is another good measure. Take calcium and vitamin D, but the amount may need adjusting depending on your kidney condition, so it is safer to have supplements checked rather than taking them freely on your own.
Above all, if sudden unbearable pain comes on, your legs feel weak or numb, or your control of urination or bowel movements is not as usual, do not put it off—call the hospital right away. It may be an emergency in which the spinal cord is being compressed. What is written here is just a discussion of general lifestyle care; the answer that fits your own condition is ultimately known best by the doctor who examines you directly. Do not be too frightened—jot down your questions and ask them one by one at your visit.
This article is intended to convey general medical information in an accessible way and does not replace individual diagnosis or treatment. Please be sure to consult your own physician about any specific decisions.