Scared I have Multiple Myeloma

[Dee1003]

I am a 39 year old female.  I have been having back pain for 3 months.  It started mainly in the upper/middle section of my back. Now it seems to be all over but still hurts the most in upper/middle, as well as my sholder area.  I now also have rib pain and thigh pain. My back pain has gotten much worse.  I have had theraputic message and acupunture no help.  I had an MRI done of my cervical and thoratic spine but I had it done when my symtoms first started, they were normal.  My Dr. Did blood work a month ago as well as a SPEP and a IPEP she said they were all normal.  I am really scared I have Multiple Myeloma.  Should I ask for more tests?  If so which one would totally rule out Multiple Myeloma, I know a bone biopsy but I don't think my Dr. will order that now is there anyother test to rule it out?  

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
There are specific criteria for diagnosing Multiple Myeloma. (see link: http://en.wikipedia.org/wiki/Multiple_Myeloma#Diagnostic_criteria)
It seems unlikely to me that you have MM, although there is a rare entity known as "non-secretory" myeloma where electrophoresis may not show increased levels of immunoglobins.
Please consult a hematologist or an oncologist for a physical check up and advice.
Good Luck!

[Dee1003]

Thank you for answering my question. Ijust have a follow up.

First I know my SPEP is normal and IPEP but what are the chances that they are normal and it would still be MM?  Could it just show up in my Urnin or Just on a bone biopsy?  I am scared becasue my back and ribs hurt as well as thighs and my hip area of the right thigh it feels like a swollen ligament.  You said at the time I don't need a bone biopsy, when would be the time I would need it?  It just seems weird I have all the classic symtoms of MM.  THhanks

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Musculoskeletal problems are much more frequently the cause of back pain as compared to myeloma.
You are 39, and have undergone MRI, and electrophoresis, all reports are normal.
I think we can reasonably rule out myeloma at this time, and look for other causes.
A bone biopsy is perhaps not indicated at this time.
All the best, and God Bless!