Bone and Joint Pain – Part 1

According to our 2018 patient survey of over 2,300 leukaemia patients, 20% of people experienced bone or joint pain as a symptom prior to their diagnosis.

Depending on where it is felt, bone pain can be a sharp pain or a constant dull ache in one or more bones. It differs from muscle or joint pain because it is present regardless of whether you are moving or not. Bone pain caused by leukaemia is most commonly felt in the long bones of the arms and legs, or in the ribs and sternum of the rib cage.

“I did have some bone pain which I didn’t quite understand but I wasn’t concerned.”

Joint pain in the wrists or ankles and swelling of large joints, such as the hips and shoulders, is usually experienced later, sometimes weeks after bone pain first begins.

“I was doing a bit of physical work, but nothing out of the ordinary… The following day, I felt a bit stiff and aching, mainly in my ankles and wrists. Putting this down to the physical activity of the evening before, I thought nothing more of it.”

“After three days, the symptoms became worse and my ankles and wrists swelled and became more painful.” 

Bone pain is also one of the most frequent symptoms to develop in childhood leukaemia. It has been found that bone or joint pain occurs in up to nearly 60% of children with acute leukaemia. Your child may start to complain of painful legs or an aching lower back. As well as this, children might develop a limp due to pain in their legs. This is a crucial sign to look out for, especially if the child is unable to talk.

“She said her leg was hurting, patting the side of it. After a week of pain in her leg, I took her to the doctors, but it was suspected she just had growing pains.”

Leukaemia is cancer of the bone marrow. Bone marrow is a spongy tissue found in our bones that contains stem cells, which have the ability to develop into all the various types of blood cells.

Leukaemia occurs when cancerous white blood cells form in the bone marrow and start to divide uncontrollably. It is this build-up of cancerous white blood cells that causes the bone marrow to expand in size and put pressure on nerves within the bone tissue, causing bone pain.

Alternatively, leukaemic cells can also start to pool close to the surface of your bones or inside the joint, leading to joint pain in some people.

If you have already been diagnosed with leukaemia, and then start to experience bone pain after treatment, don’t worry! Bone pain doesn’t necessarily mean your cancer is getting worse, as it is often caused as a result of the cancer treatment itself. For example, chemotherapy, radiation therapy, surgery or certain TKIs (e.g imatinib) can all cause bone pain as a side effect. In fact, painful bones or joints are more likely to be reported as a problem after diagnosis than before diagnosis. (33% compared to 20%).

Usually, it is possible to tell the difference between treatment-related bone pain and pain that would come with a relapse of leukaemia because treatment related bone pain is usually widespread soreness felt in multiple regions of the body. On the other hand, pain caused by the leukaemia itself is more likely to be in distinct parts of the body.

We recommend that you visit your GP if you experience pain in your bones or joints that is severe, won’t go away or is worsening over time.

In adults, bone or joint pain is commonly mistaken for arthritis, and in children or teenagers it can easily be misdiagnosed as growing pains. For this reason, it is especially important to push for a blood test if you or your child is also presenting with any of the other symptoms of leukaemia.

Connect the dots between the symptoms of leukaemia and spot leukaemia sooner.

For information on the other symptoms of leukaemia, click here.