All content on this site is intended for healthcare professionals only. By acknowledging this message and accessing the information on this website you are confirming that you are a Healthcare Professional. If you are a patient or carer, please visit the International Myeloma Foundation or HealthTree for Multiple Myeloma.

The Multiple Myeloma Hub uses cookies on this website. They help us give you the best online experience. By continuing to use our website without changing your cookie settings, you agree to our use of cookies in accordance with our updated Cookie Policy


Now you can personalise
your Multiple Myeloma Hub experience!

Bookmark content to read later

Select your specific areas of interest

View content recommended for you

Find out more

The Multiple Myeloma Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the Multiple Myeloma Hub cannot guarantee the accuracy of translated content. The Multiple Myeloma Hub and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.

Steering CommitteeAbout UsNewsletterContact
You're logged in! Click here any time to manage your account or log out.
You're logged in! Click here any time to manage your account or log out.

Understanding pain in early multiple myeloma

Dec 7, 2022
Learning objective: After watching this presentation, learners will be able to cite developments in the management of pain in patients with multiple myeloma.

Bookmark this article

On November 10, 2022, the Multiple Myeloma Hub held a virtual symposium on the topic of holistic pain management in multiple myeloma, with three established leaders in the field talking on different elements of pain management.

Here, we share the first presentation by Professor Heinz Ludwig, Wilhelminen Cancer Research Institute, Vienna, AT, on the management of pain in early multiple myeloma.

The Multiple Myeloma Hub has previously covered the need for the management of pain in patients with MM.

In this presentation, Professor Ludwig discusses the symptoms of pain at presentation and early in the course of MM (Figure 1), as well as the common sites of bone lesions (Figure 2).

Figure 1. Symptoms in patients with early multiple myeloma* 

*Data from Cleveland Clinic.1


Figure 2. Common sites of bone lesions in multiple myeloma*

*Adapted from Coluzzi, et al.2 Created with

Watch or download the presentation to learn more about understanding pain in early multiple myeloma, including:

  • The symptoms of pain at presentation early in the disease course (01:47; slide 11)
  • The common causes of pain (03:08; slides 1213)
  • Measuring pain and its impact on quality of life using patient-reported outcomes (08:07; slides 16–25)
  • Managing myeloma pain (17:22; slides 2629)

Key points

  • Pain is the most frequent symptom of myeloma at diagnosis and even more so at relapse.​
  • Bone lesions are the major cause of pain in patients with multiple myeloma.
  • Other frequent causes are pain polyneuropathy and reactivation of herpes, as well as pain resulting from adverse events of therapy.​
  • Pain is associated with decreased health-related quality of life; therefore, pain therapy is a priority of supportive care.
  • Pain should be assessed by patients using established instruments, as caregivers tend to underestimate the severity of pain.​
  • Patient-reported outcome measures help improve symptom assessment, patient–caregiver interaction, and patient quality of life.​
  • Pain treatment depends on the cause of pain and includes a broad spectrum of interventions, such as local therapy, pain medication, and adjuvants for pain therapy.

Symposium slides

To download the slides presented, click here.

Download here

This independent educational activity was supported by Mundipharma. All content was developed independently by the faculty. The funder was allowed no influence on the content of this activity.

Disclaimer: All content produced by the Multiple Myeloma Hub is intended to adhere to the Centers for Disease Control and Prevention (CDC) Clinical Practice Guideline for Prescribing Opioids for Pain, issued in November 2022. Opioids are a class of highly addictive prescription painkillers; therefore, all information regarding their use must accurately describe the benefits and serious risks of misuse and abuse. The CDC recommendations do not apply to pain management related to sickle cell disease, cancer-related pain treatment, palliative care, or end-of-life care. Key principles to be taken into consideration include: i) nonopioid therapies are at least as effective as opioids for many common types of acute pain and are preferred for subacute and chronic pain; ii) before starting opioid therapy, clinicians should discuss with patients the realistic benefits and known risks; iii) when opioids are used, clinicians should prescribe immediate-release opioids at the lowest possible effective dosage; and iv) clinicians should regularly reevaluate with patients the benefits and risks of continued opioid therapy and when changing the dosage.

  1. Cleveland Clinic. Multiple myeloma. Accessed Oct 31, 2022.​
  2. Coluzzi F, Rolke R, Mercadante S. Pain management in patients with multiple myeloma: An update. Cancers (Basel) 2019;11(12):2037. DOI: 10.3390/cancers11122037

Your opinion matters

As a result of this content, I commit to reviewing the CARTITUDE clinical program to guide my understanding of cilta-cel in clinical practice.
16 votes - 16 days left ...


Subscribe to get the best content related to multiple myeloma delivered to your inbox