Bone and Joint Pain
Pain in the bones and joints may come from treatment and medications, non-cancerous sources, or metastases from cancer spread. Sometimes the cause of bone and joint pain may be unknown.
Treatments include medication and strength-building exercises. Time, too, is a good healer because some bone and joint pains go away by themselves in a few weeks or months.
Metastatic bone pain
When cancer spreads into the bone, it usually creates pain. If there is one or just a few areas of significant bone pain, the best way to gain relief is to get rid of those areas of cancer.
Local external beam radiation therapy effectively treats painful bone metastases. This treatment provides substantial or complete pain relief in more than 85% of people for a significant period of time, without the sedation and constipation associated with opioids (pronounced OH-pee-oydz; also called narcotics).
Pain from diffuse bone metastases (many areas of cancer throughout the bone) is best treated with an opioid and an anti-inflammatory agent. Chemotherapy or tamoxifen can be very effective at getting rid of cancer cells in all areas of bone involvement. External beam radiation therapy can be given to one or just a few areas that are causing the most pain.
Diffuse pain can also be treated with bisphosphonate medications such as Zometa (chemical name: zoledronic acid) or Aredia (chemical name: pamidronate disodium). These medicines help stop bone destruction caused by metastatic disease, reduce pain, and keep blood calcium levels normal.
Keeping the painful area from moving is sometimes helpful. For example, you can wear a sling until you're done having radiation to a painful shoulder metastasis. Some people need orthopedic surgery to prevent or repair fractures that result from bone weakening caused by cancer.
Non-metastatic bone pain
Some people have long-term, persistent discomfort in the long part of the bone, in the muscles surrounding the bone, and in joints. Breast implants also may put pressure on the sensitive surface around the bones of the rib cage.
Chemotherapy produces pain in hips, legs, and arms. These discomforts happen during the time you're receiving chemotherapy and may worsen with each session. The pain may persist for a long time—months or even a year—after treatment ends. The good news is that, sooner or later, it WILL disappear.
Such pain is linked to nerves, muscles, joints, and ligaments. It can respond to antiseizure medications and tricyclic antidepressants, as well as NSAIDs (pronounced EN-seds) and opioids.
Occasionally, the pain may persist. If this happens to you, ask to speak to a pain specialist.
Tamoxifen treatment may produce arthritis-like aches and stiffness. NSAIDs help with this pain. If you don't get adequate relief, your doctor might prescribe opioids.
Non-metastatic bone and joint pains also respond to heat, massage, and swimming. Yoga helps stretch and strengthen muscles, which reduces pain in the supporting muscles and soft tissues.