Many things can cause bone pain during breast cancer treatment. These include side effects from hormonal therapies, bone fractures or breaks, and cancer itself.
To find out the cause of your pain, describe it to your healthcare provider. Write down which symptoms you have and how long you’ve had them. Rate your discomfort on a scale of 1 (not at all uncomfortable) to 10 (the most uncomfortable you have ever been). Be as specific as possible, and let your team know how much bone pain impacts your life.
Here are some of the major reasons for bone pain:
TreatmentsHormonal therapy can cause bone pain. It is very common to feel bone and joint pain from aromatase inhibitors, or AIs. Up to half of women who take AIs feel aches or pains in their joints, bones and muscles. You might also feel general stiffness. If you have a history of arthritis, ovarian suppression can cause similar side effects. It’s also possible to feel bone and joint pain from tamoxifen and from growth factors given for neutropenia such as filgrastim (Neupogen) and pegfilgrastim (Neulasta).
If you feel jaw pain, tell your doctor right away, especially if you are taking a bisphosphonate medicine. Bisphosphonates can cause a rare and serious problem in the jaw bone called osteonecrosis of the jaw.
FracturesSome fractures do not cause pain. You might not even know about them until your providers see them on a radiology test. Even though these fractures don’t hurt, they raise concerns about your bone health.
Serious bone loss, or osteoporosis, weakens bones to the point they might break more easily. This can cause pain. Broken bone pain can become chronic, so it’s important to report it to your team. Depending on the level of your pain, fractures could impair your ability to function as you normally would.
If the bones in your back weaken, compress and collapse, you may have a spinal compression fracture. This can cause severe pain and take a long time to heal.
Talk with your providers about your pain. Since bone and joint pain are so common with hormonal therapy, your team may have good tips for you. You may be able to use over-the-counter pain relievers or prescription medicines. Studies suggest acupuncture can be helpful for joint pain related to AIs. Exercise, massage, yoga and stretching may also help. You could also discuss with your team whether glucosamine and chondroitin, a supplement, may be appropriate for you.
If bone and joint pain from hormonal therapy is severe and ongoing, it may be possible to switch you to a different medicine. The AIs work in similar ways but different medicines may not cause the same side effects for you.
If you feel bone pain, your doctor may send you for a bone scan to check for metastases, or cancer spread, in the bone. This test does not look for bone mineral density or osteoporosis. Getting a bone scan does not mean you have metastatic breast cancer. Depending on your doctor, you might get a bone scan with an early-stage breast cancer diagnosis, to rule out metastasis.
If you have metastatic breast cancer, learn more about ongoing treatment and bone pain.