Multiple myeloma

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7101.186 (Published 19 July 1997) Cite this as: BMJ 1997;315:186

Surgery is often more effective than analgesia for mechanical pain

  1. S J Krikler, Consultant orthopaedic surgeona
  1. a Coventry and Warwickshire Hospital, Coventry CV1 4FH
  2. b University of Manchester, Department of Orthopaedic Surgery, Clinical Sciences Building, Hope Hospital, Salford M6 8HD

    Editor—Charles R J Singer's recent discussion of multiple myeloma and related conditions in the ABC of clinical haematology includes a radiograph of a vertebral crush fracture due to myeloma with a caption saying: “Bone pain from mechanical effects … often necessitates long term treatment with strong analgesia.”1 It is well recognised by surgeons regularly treating such patients that the most effective solution for mechanical pain may be a mechanical one—that is, surgery. My colleagues and I have shown that this is a good option in many patients with vertebral metastases.2 We appeal to all physicians to refer any patient with vertebral metastases to a …

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