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Casey: Chronic Pain in Multiple Myeloma

Casey: Chronic Pain in Multiple Myeloma
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Casey: Chronic Pain in Multiple Myeloma

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This is a 47 year-old woman who for over ten years, has been treated for Multiple Myeloma with chemotherapy. This cancer of the blood cells has a pervasive effect in bone mineral, causing long-term effects in the skeleton, very typically in the form of chronic back and neck problems as well as arthritis of the hip and knees and osteoporosis. She is followed in The Peregrine Institute for these chronic ailments, treated with mild pain medication, anti-inflammatories, spine support systems and orthotics, acupuncture, intermittent injections in her back, knees and hips as well as being supervised for an ongoing rehabilitation program. This regimen has allowed her to continue working as a veterinary assistant and lead a functional and rich life with her family. Two years ago, she had an acute episode of severe mid-back pain diagnosed as a compression fracture of one of her vertebrae, a typical consequence of the Myeloma-related loss of bone mineral. Although this sounds very serious, the main concern is typically the ruthless pain and not the stability of the spine. She was quickly seen and treated with an injection of bone cement in the compressed vertebrae. This is a needle-based outpatient procedure that can produce almost immediate pain relief and restore some of the structure of the bone. She had a great result and was back at work in less than a week. Once a spinal compression fracture occurs, one should be aware that there is a risk of more fractures occurring, so she was put on medication to prevent progressive bone mineral loss and her rehabilitation program was more aggressive towards posture and core strengthening. She has continued to do well.

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