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Help! Leg Pain after Bone Marrow Biopsy

by elizabeth104 on Thu Aug 30, 2012 5:50 pm

I was diagnosed with MGUS 3 years ago when I was 25 years old. I had my first bone marrow biopsy on July 3, 2012 (POSTERIOR LEFT ILIAC). The bone marrow procedure was very painful... I had a lot of cramping in my legs.

Since the biopsy I have been experiencing left leg pain - sometimes cramping and sometimes numbness/tingling. I noticed it about a week or so after the biopsy. It started in my upper left leg (from my butt down through my thigh) and it mainly bothered me while I was sitting for a long period of time or when I bent over. It felt sort of like a cramping down my leg.

Now, I have started experiencing some numbness and tingling in my left leg and a little bit in my right leg since Sunday (about 5 days now). I am also still having the upper leg pain/cramping in my left leg, but I have been taking advil which helps a little bit. I am not sure if these symptoms are due to the biopsy or not. At one point about a year ago I had pins and needles in my hands and feet... my doctor said that it could be due to the MGUS. It lasted for about a month (maybe a little less) and I haven't had tingling since (well, since right now of course).

Another thing to note is that my mspike has always been very low.... ranging from about .16 to .36 over the last three years. The reason I got the biopsy is because my husband and I want to have children. My hem/onc said that I should have to biopsy to be "super careful" before starting a family. The bone marrow biopsy showed 10-15% plasma cells within the biopsy (6-8% over all). So... basically my doctor said I am now borderline MGUS/Smoldering myeloma... I need to have a repeat biopsy in about 6 months.

So, my question: is this leg pain/cramping due to the biopsy? Is the numbness/tingling due to the biopsy? Could the numbness/tingling be due to the MGUS/SMM? What should I do for the leg pain? What can I do for the tingling (my doctor suggested cocoa butter cream a year ago)? Are these normal complications after a biopsy? If this is all related to the biopsy when will I get better? When I have another biopsy, how can I prevent this from happening?

elizabeth104
Name: Elizabeth
When were you/they diagnosed?: 25 MGUS, 28 SMM

Re: Help! Leg Pain after Bone Marrow Biopsy

by Eric Hofacket on Thu Aug 30, 2012 6:29 pm

With the symptoms you described, my advice would be to talk with your doctor about it first. I have had lots of tingling sensations and still due that could have orginated from multiple myeloma and some was definaltey from the Velcade I was on. I am seeing a Neurologist to track and monitor this condition, not much which can be done about. My bone marrow biopsies were painful but I had no complicaitons, other have though. Again my advice would be to see a doctor who can examin you and sort it all out.

Eric Hofacket
Name: Eric H
When were you/they diagnosed?: 01 April 2011
Age at diagnosis: 44

Re: Help! Leg Pain after Bone Marrow Biopsy

by elizabeth104 on Thu Aug 30, 2012 7:21 pm

Thanks for replying!

I actually have been to my PCP a couple times since my biopsy....for various reasons but i did tell her about my leg. She just said to ice my leg and take advil. As far as the numbness/tingling she thought it could be due to stress. I just feel like it's been going on for almost two months now and I want it to stop! Grr.

I have an appointment with my hem/onc next week Wednesday. Maybe he'll have more insight.... besides just suggesting cocoa butter twice a day!

elizabeth104
Name: Elizabeth
When were you/they diagnosed?: 25 MGUS, 28 SMM

Re: Help! Leg Pain after Bone Marrow Biopsy

by Eric Hofacket on Thu Aug 30, 2012 9:54 pm

If the numbness and tingling is from Peripheral Neuropathy (PN) be prepared that there may not be much they can do for it. I got pretty severe PN when I was on Velcade that I was taking Morphine for. It started as numbness and tingling and developed into real pain and eventually damage to nerves that controlled my blood pressure. I was told the best thing to try and alleviate the problem was to stop what was causing it, in my case Velcade. There is no drug or treatment that I or my doctors are aware of that can heal the nerve damage or make it go away once the damage is done, it has to heal on its own and the pain or numbness and tingling may never go away completely. I was told there was some evidence that taking vitamin B6 while on chemo that can cause PN can help reduce the nerve damage and associated numbness, tingling or pain. In my case after stopping Velcade eventually the pain largely went away except for the occasional sensation of a needle big stuck into my feet, and there is always some minor numbness, tingling, and burning in my feet and hands that I have learned to live with and do not need pain killers for. I needed the pain killers I was taking but they cause a number of side effect complications and I am glad to be off them. Anti-depressants were brought up by my doctors that have the incidental side effect of helping reduce PN some, but those drugs also have their own complications and I was not keen on taking anti-depressants when I did not have any depression disorders I only used them for a brief period before electing not to use them anymore. Maybe try compression socks, the kind used by athletes and go up to the knee. For me they noticeably help pain and I was always wearing them at night to try and get to sleep.

Eric Hofacket
Name: Eric H
When were you/they diagnosed?: 01 April 2011
Age at diagnosis: 44

Re: Help! Leg Pain after Bone Marrow Biopsy

by toridon on Fri Aug 31, 2012 1:31 am

What you seem to be describing is Sciatica. I am a Physical Therapist , very familiar with Sciatica. I had it following my BMB but only for a very brief period of time. It could be because the pressure they apply to your sacrum during the BMB irritated the nerve. Most cases of Sciatica are due to a herniated disc and most cases clear in 2-3 months. I also had an episode of Sciatica a few years prior to my multiple myeloma diagnosis and it resolved in 3 months. I would suggest you see an orthopedist and have him give you a diagnosis, and if appropriate, refer you to a Physical Therapist who can teach you ways of preventing exacerbation of symptoms. Usually sitting and bending at the waist aggravates the condition.

toridon

Re: Help! Leg Pain after Bone Marrow Biopsy

by elizabeth104 on Fri Aug 31, 2012 4:51 pm

Thanks for all the information! I really appreciate it.

I have read that people with MGUS can have Peripheral Neuropathy. Blah. My numbness and tingling has been coming and going, though.

I had thought that my leg pain was due to sciatica...I just hadn't read much about nerve damage and bone marrow biopsy. I have been exercising and icing my lower back.... doing gentle stretches. I just want it to get better!

elizabeth104
Name: Elizabeth
When were you/they diagnosed?: 25 MGUS, 28 SMM

Re: Help! Leg Pain after Bone Marrow Biopsy

by Dr. Edward Libby on Mon Sep 03, 2012 2:16 am

Hello Liz,
Sorry about the late reply. In general I would not be too concerned about the numbness and tingling at the monent. It is hard to directly connect them to the biopsy which was 2 months ago. Unless these symptoms get significantly worse I would simply watch them and discuss them with your primary care doctor and oncologist the next time you see them.

On another note though you are very very young to have a plasma cell dyscrasia (MGUS,smoldering (asymptomatic) myeloma or symptomatic multiple myeloma).
Because of this I STRONGLY RECOMMEND that before any therapy is ever given to you that you get a second opinion from a major myeloma center. In my opinion your oncologists must be very very cautious about when and if to treat you.
If you are not sure how close you are to a medical center with extensive and deep expertise in myeloma please ask us at the Myeloma Beacon and we will be glad to advise you.
Best of luck !
Dr. Edward Libby
University of Washington & Fred Hutchinson Cancer Research Center

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Edward Libby
Name: Edward Libby, M.D.
Beacon Medical Advisor

Re: Help! Leg Pain after Bone Marrow Biopsy

by elizabeth104 on Mon Sep 03, 2012 5:56 am

Hi Dr. Libby,

Thank you so much for the reply, I really appreciate it!

I was diagnosed with MGUS by a hematologist my PCP referred me to. About 6 weeks after my initial diagnosis I went to Dana Farber in Boston and have been going there for the past 3 years (Dr. Paul Richardson is my doctor). I feel very fortunate as my husband and I live close to Boston. This past July, when I got my biopsy results, my doctor said he always supports second opinions - particularly since I am so young and want to (if possible!) start a family.

Dana Farber has a lot of "myeloma experts" - should I still get a second opinion?

I have heard a lot of great things about the Mayo Clinic in Rochester, MN but that is a little far for me.... Any centers closer to Boston?

As far as treatment....I'm not sure what you mean, do you mean my doctor needs to be cautious as to not start treatment too soon, or too late?

Thanks!
LIz

elizabeth104
Name: Elizabeth
When were you/they diagnosed?: 25 MGUS, 28 SMM

Re: Help! Leg Pain after Bone Marrow Biopsy

by PattyD on Fri Nov 02, 2012 7:45 pm

I started having burning tingling pain in the left outside part of my foot and up my leg in my calf and ends behind my knee. I am wondering if it is from the bone marrow biopsy I had. I felt the pain on the way home from the procedure. It went away the next morning, only to return 2 days later with a vengeance! It is quite painful. Do you think it will go away?

PattyD

Re: Help! Leg Pain after Bone Marrow Biopsy

by Dr. Peter Voorhees on Thu Nov 08, 2012 9:56 am

This is likely nerve injury from the biopsy, perhaps from a hematoma (blood collection) pressing on the nerve. However, depending on your circumstances, we always worry about myeloma lesions pressing on nerves or compression fractures in the lower spine causing nerve root irritation that can produce the same symptoms. It should get better over the next few days to few weeks if it is from the biopsy. If it gets worse, notify your doctor asap.

Pete V.
Dr. Peter Voorhees
University of North Carolina at Chapel Hill

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Peter Voorhees
Name: Peter Voorhees, M.D.
Beacon Medical Advisor


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