Neuropathy in Multiple Myeloma – Symptoms, Causes, and What to Do

If you live with multiple myeloma, you may notice changes in your nerves. This is called neuropathy. You can feel numbness, tingling, or weakness in your hands and feet. Many people with multiple myeloma experience peripheral neuropathy before or during treatment. Experts report that up to 75% of patients develop symptoms, and about 44% feel pain. You might see problems with daily tasks. Some people face dizziness or muscle loss. Your treatment, such as bortezomib or thalidomide, can raise your risk. Multiple Myeloma and Neuropathy affects you in many ways, so knowing what to expect helps you stay safe and comfortable.

• Nearly half of patients with multiple myeloma report neuropathic pain.

• About 20% notice symptoms at diagnosis.

• Up to 75% develop neuropathy during treatment.

Key Takeaways

• Up to 75% of multiple myeloma patients experience neuropathy during treatment. Recognizing symptoms early can help manage discomfort.

• Common symptoms include numbness, tingling, and weakness in hands and feet. Report any new symptoms to your doctor promptly.

• Bortezomib and thalidomide are treatments that can cause nerve damage. Discuss any side effects with your healthcare team to adjust your treatment plan.

• Lifestyle changes, like regular exercise and a balanced diet, can improve nerve health. Avoid smoking and limit alcohol to protect your nerves.

• Early reporting of symptoms and regular monitoring can help prevent severe neuropathy and improve your quality of life.

Multiple Myeloma and Neuropathy Overview

What Is Myeloma-Related Neuropathy

You may wonder what makes multiple myeloma and neuropathy different from other nerve problems. Myeloma-related neuropathy happens when your multiple myeloma or its treatment damages the nerves outside your brain and spinal cord. These nerves make up your peripheral nervous system. When you have multiple myeloma, you can develop symptoms that affect how you feel, move, or control body functions.

Here is a table showing the types of neuropathy you might experience with multiple myeloma and neuropathy:

You may notice tingling or numbness in your hands and feet. Some people feel burning pain or lose their sense of touch. Muscle weakness or cramps can make walking or holding objects hard. Dizziness or bladder issues can also happen. Multiple myeloma and neuropathy often appear together, especially during treatment.

How Peripheral Nerves Are Affected

Your peripheral nervous system carries signals between your brain, spinal cord, and the rest of your body. In multiple myeloma and neuropathy, abnormal proteins from myeloma cells can damage these nerves. The M protein, made by myeloma, may strip away the protective covering of nerves. This process, called demyelination, leads to nerve problems.

Treatments for multiple myeloma, such as bortezomib and thalidomide, can also harm your peripheral nervous system. Bortezomib and thalidomide are common drugs used in treatment. Bortezomib can cause nerve pain, numbness, or weakness. Thalidomide may lead to similar symptoms. You may need to take bortezomib or thalidomide for a long time, which increases your risk. Doctors often monitor your peripheral nervous system closely during treatment with bortezomib and thalidomide.

You may hear that multiple myeloma and neuropathy are more common than in other blood cancers. Both bortezomib and thalidomide raise the risk of nerve damage. Some people think neuropathy only comes from diabetes, but multiple myeloma and neuropathy can look the same. You should always tell your doctor about new symptoms during treatment.

Tip: Early reporting of tingling, numbness, or weakness helps your care team adjust your treatment plan and protect your peripheral nervous system.

Multiple Myeloma Neuropathy Symptoms

When you have multiple myeloma, you may notice many symptoms that affect your nerves. These symptoms can change how you feel, move, and control your body. Knowing what symptoms of neuropathy look like helps you talk to your doctor and manage your health.

Sensory Symptoms (Numbness, Tingling, Pain)

Sensory symptoms are the most common signs and symptoms of neuropathy in multiple myeloma. You may feel pain or lose sensation in your hands and feet. These symptoms often appear before or during treatment with bortezomib or thalidomide. Here are some sensory symptoms you might notice:

• Numbness in fingers or toes

• Tingling or prickling sensation

• Burning, freezing, jabbing, or throbbing pain

• Sensitivity to touch or temperature

• Feeling like you are wearing gloves or stockings

• Loss of balance, especially when eyes are closed

• Loss of reflexes

• Trouble hearing or ringing in the ears

• Feeling sand or gravel in your shoes

• Loss of proprioception (knowing where your feet are)

Painful neuropathy can make daily tasks harder. You may find it difficult to walk or hold objects. Bortezomib and thalidomide often cause these symptoms during treatment.

Motor Symptoms (Weakness, Cramps, Falls)

Motor symptoms affect how your muscles work. You may notice weakness or cramps. These symptoms of neuropathy can make movement difficult. Bortezomib and thalidomide can cause motor symptoms during treatment. Look for these signs and symptoms:

• Muscle weakness in arms or legs

• Muscle cramping

• Loss of muscle mass

• Decrease in reflexes

• Difficulty writing or holding small objects

• Poor coordination

• Falling more often

Motor symptoms of multiple myeloma neuropathy often start in your hands and feet. They can get worse over time, especially with ongoing treatment.

Autonomic Symptoms (Dizziness, Gut, Bladder Issues)

Autonomic symptoms affect body functions you do not control. These symptoms of neuropathy can change how your body works. Bortezomib and thalidomide may cause these symptoms during treatment. Here is a table showing common autonomic symptoms:

You may feel dizzy or lightheaded. Gut and bladder issues can appear. These nervous system symptoms may affect your daily life. Peripheral neuropathy can cause heat intolerance or sexual problems.

Tip: If you notice any new symptoms, tell your doctor. Early reporting helps prevent painful neuropathy and protects your nervous system.

Causes of Myeloma-Related Neuropathy

Disease-Related Causes

You may wonder what causes nerve damage in multiple myeloma. Disease-related causes come from the myeloma itself. These causes can affect your nerve function and lead to peripheral neuropathy. Here are some common disease-related causes:

• Myeloma proteins can damage nerve cells and strip away their protective covering.

• Amyloidosis, a buildup of light chain deposits, can cause nerve damage.

• High levels of paraprotein may thicken your blood, slowing circulation and harming nerves.

• Bone disease from myeloma, such as fractured vertebrae, can press on nerves and cause problems.

• Autoimmune responses may attack your nerves.

These causes can make you feel numbness, tingling, or weakness. You may notice changes before starting treatment.

Treatment-Related Causes

Treatment-related neuropathy is a common concern for people with multiple myeloma. Some treatments can cause neurotoxicity and lead to nerve damage. Bortezomib and thalidomide are the most frequent causes of neurotoxicity. You may need these drugs for your treatment, but they can affect your nerves. Bortezomib can cause numbness, tingling, and pain. Thalidomide may lead to similar symptoms. Doctors often monitor you for neurotoxicity during treatment. If you develop nerve damage, your doctor may adjust your dose or switch your treatment. Chemotherapy-induced neuropathy can also happen with other drugs, but bortezomib and thalidomide are the main causes in multiple myeloma.

Note: Neurotoxicity from bortezomib and thalidomide can lower your quality of life. Early reporting helps your care team protect your nerves.

Other Risk Factors

Other risk factors can increase your chance of developing neuropathy in multiple myeloma. Diabetes is a major risk factor. If you have diabetes, you may notice more severe nerve damage. Vitamin D deficiency also raises your risk. Studies show that low vitamin D levels make peripheral neuropathy more likely. You should ask your doctor to check your vitamin levels. Lifestyle factors such as smoking and high alcohol use can worsen nerve damage. Some medications may also cause neurotoxicity.

Here is a table showing how diabetes affects neuropathy in multiple myeloma:

You can lower your risk by managing diabetes, checking vitamin levels, and avoiding smoking or excess alcohol.

Complications and Risks in Multiple Myeloma Neuropathy

Common Complications (Shingles, Kidney, Fractures)

You may face several complications when you have multiple myeloma and receive bortezomib or thalidomide treatment. These complications can affect your daily life and increase your need for medical care. The most common problems include nerve damage, infections, and organ issues.

Here is a table showing what complications you might experience:

You may also develop shingles, a painful viral infection. Shingles often appears because your immune system becomes weaker from myeloma and treatment. You can get other infections, such as Haemophilus, more easily. Bone fractures can happen if myeloma weakens your bones. Spinal compression may occur, causing pain and movement problems.

Hospital visits may increase if you have peripheral neuropathy. Studies show that patients with peripheral neuropathy have higher hospitalization rates and medical costs.

Who Is Most at Risk

Certain groups have a higher chance of severe neuropathy and complications during multiple myeloma treatment. You should know what factors put you at risk:

• Smoking can harm your nerves and blood flow.

• Diabetes can damage nerves and make neuropathy worse.

• Alcohol use can cause nutritional problems and nerve damage.

• Infections from bacteria or viruses can lead to peripheral neuropathy.

• Some medications, including bortezomib and thalidomide, can increase your risk.

If you have any of these risk factors, you may notice more severe symptoms during treatment. People with diabetes or those who smoke often have worse nerve problems. Chronic alcohol use can make neuropathy harder to manage. Infections can appear more often if your immune system is weak from myeloma or treatment.

You may need more hospital care if you develop peripheral neuropathy. In a large study, patients with peripheral neuropathy had higher hospitalization rates and medical costs than those without nerve problems. You should watch for new symptoms and talk to your doctor about your risk.

Managing Peripheral Neuropathy in Multiple Myeloma

Peripheral neuropathy can affect your daily life when you receive treatment for multiple myeloma. You may wonder what steps you can take to prevent, manage, and treat peripheral neuropathy. This section explains what strategies help you stay safe, reduce symptoms, and improve your quality of life.

Prevention Strategies

You can lower your risk of developing neuropathy during treatment. Here is what you can do:

• Ask your doctor for a baseline nerve assessment before starting bortezomib or thalidomide.

• Report any new symptoms, such as tingling or numbness, as soon as they appear.

• Request regular monitoring for signs of peripheral neuropathy, especially if you receive bortezomib or thalidomide.

• Learn about the symptoms of neuropathy so you can recognize changes early.

• If you notice mild symptoms, your doctor may not need to adjust your treatment. For moderate symptoms, your doctor may hold treatment until symptoms improve.

• Chemotherapy dose reduction and regimen modification are the only proven strategies to prevent bortezomib-induced neuropathy. No specific therapies exist to prevent this side effect.

• Ask your care team to check for vitamin B deficiencies and other secondary causes of neuropathy.

Tip: Early reporting and regular monitoring help you and your doctor catch problems before they get worse.

Medical Management and Adjustments

You have several treatment options to manage neuropathy symptoms. Your doctor may adjust your medications or recommend therapies to treat peripheral neuropathy. Here is what works best:

• If you develop neuropathy during bortezomib or thalidomide treatment, your doctor may reduce your dose or change your schedule.

• Early dose reduction helps you complete treatment and lowers the risk of severe symptoms.

• Studies show that patients who receive dose modifications for bortezomib experience fewer neuropathy symptoms and finish treatment more often.

• Your doctor may switch you to a lower-risk drug or change the route of administration, such as using subcutaneous bortezomib instead of intravenous.

• Medications like gabapentin, pregabalin, duloxetine, and amitriptyline can help treat peripheral neuropathy pain and improve your quality of life.

• Topical treatments, such as amitriptyline cream, may relieve pain and allow you to continue chemotherapy.

• High-dose intravenous methylcobalamin and glutathione before chemotherapy can lower the risk of neuropathy.

• Dexanabinol, a synthetic cannabinoid, has shown promise in restoring nerve function in animal studies.

Here is a table showing what medical treatments help manage neuropathy in multiple myeloma:

Note: Your doctor will choose the best treatment options based on your symptoms and medical history.

Self-Care and Lifestyle Tips

You can take steps at home to treat peripheral neuropathy and improve your quality of life. Here is what helps:

• Engage in physical activities, such as walking or gentle exercise, to boost your mood and energy.

• Try music therapy to reduce anxiety, fatigue, and pain.

• Seek social support and spend time with friends or family to feel positive.

• Use distraction techniques, like watching TV or doing hobbies, to take your mind off symptoms.

• Complementary therapies, such as massage, aromatherapy, or reflexology, may help you cope with pain.

• Take pain medications as prescribed and care for your hands and feet. Wear protective shoes and check water temperature before bathing.

• Maintain a balanced diet and monitor your vitamin levels with your doctor.

• Stop smoking and limit alcohol use to protect your nerves.

• Reduce your risk of falls by keeping walkways clear, using good lighting, and installing rails if needed.

• Practice good posture and avoid crossing your legs for long periods.

• Use warmth or cold packs safely to relieve discomfort.

• Structured exercise programs improve physical and mental health, restore function, and help you manage treatment-related toxicities.

• Physiotherapy provides education on movement, aerobic and postural exercises, and pain management strategies. Strengthening exercises prevent muscle loss and reduce complications.

Here is a table showing what physical therapy can do for you:

Callout: Patient-reported outcomes give the best measure of how well neuropathy management works. Your feedback helps your care team understand your symptoms and adjust your treatment options.

You can improve your long-term outcomes by following healthy behaviors and working closely with your healthcare team. What you do at home matters as much as what happens in the clinic. Early reporting, dose adjustments, and home safety all play a role in successful management.

You play a key role in managing neuropathy with multiple myeloma. Recognizing symptoms early helps you stay safe and comfortable. Open communication with your healthcare team makes a big difference:

• You may find it hard to tell if symptoms come from treatment or the disease.

• Sharing side effects helps your care team adjust your plan.

• Asking questions encourages your doctor to discuss neuropathy and support you.

Taking action and working with your care team can reduce symptoms and improve your quality of life. Remember, you are not alone—support is always available.

FAQ

What is the most common sign of neuropathy in multiple myeloma?

You often notice numbness or tingling in your hands and feet. This feeling may start slowly and get worse over time. You might also feel burning or sharp pain.

What should you do if you notice new nerve symptoms?

Tell your doctor right away. Early reporting helps your care team adjust your treatment. Quick action can prevent symptoms from getting worse.

What treatments help manage neuropathy symptoms?

Doctors may use medicines like gabapentin, pregabalin, or duloxetine. Physical therapy and gentle exercise can also help. Your care team may adjust your chemotherapy dose.

What can you do at home to protect your nerves?

Wear comfortable shoes, check water temperature, and keep your home well-lit. Eat a balanced diet and avoid smoking or drinking alcohol. Gentle exercise supports nerve health.

What makes neuropathy worse in multiple myeloma?

Diabetes, vitamin deficiencies, smoking, and some medicines can make neuropathy worse. High alcohol use and infections also increase your risk. Managing these factors helps protect your nerves.

See Also

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Essential Insights On LGL Leukemia: Symptoms And Treatments

Recognizing Ewing's Sarcoma: Symptoms And Underlying Causes

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Exploring Head And Neck Cancer: Symptoms And Causes