Myeloma Bone Pain

[Music] how is bone pain managed in myeloma to divvy up bone pain first we got to figure out is there a particular spot that's bothering you is it your shoulder is it your back is it your pelvis is there a particular spot or is it everywhere or is it a combination if you can get a local control for a local symptom that's better if you can do spot radiation to spot on the pelvis if you can inject cement into a spot on the vertebral if you can put your hand where all the pain is and cover it with a lighted erm patch maybe that's all you need and that's fabulous a lot of my patients have systemic bone pain it's everywhere and their myeloma is out of control and they are miserable and these patients need a combination of treatments both opiates some nonsteroidals some acetaminophen or Tylenol and also some local injections etc with vertebroplasty and kyphoplasty for affected 40 brought all of these methods should be brought to bear to try to decrease pain improve quality of life [Music]