Multiple Myeloma in Hyderabad: Bone Pain, Kidney Changes, and When to See a Specialist

By Dr. G. Stitha Pragna, MD, DM, Consultant Hemato-Oncologist and Bone Marrow Transplant Physician, Hyderabad · October 21, 2026

Multiple myeloma is a cancer of plasma cells, the bone-marrow cells that make antibodies. Abnormal plasma cells can weaken bone, lower healthy blood counts, strain the kidneys, and raise the calcium level in the blood. Many people are first told they have a vitamin problem, age-related back pain, or “weak kidneys” before the protein pattern of myeloma is checked.

Dr. G. Stitha Pragna, MD, DM, consultant hemato-oncologist and bone marrow transplant physician in Hyderabad, sees this delay most often when bone pain and anemia are treated separately for months. Putting those clues on one page is what a specialist visit is for.

How does myeloma usually come to attention?

Some people have no pain and are found when a blood test done for another reason shows anemia or a high protein level. Others notice:

• Back, rib, or hip pain that is persistent or worse at night
• A fracture after a minor strain
• Tiredness from anemia
• More infections than usual
• Foamy urine, swelling, or a rising creatinine
• Thirst, constipation, or confusion from high calcium

None of these proves myeloma. Together, or when a report already mentions a monoclonal protein, they are a reason to see a hemato-oncologist rather than collect more pain prescriptions.

What is CRAB, and who uses it?

Clinicians use the letters CRAB as a memory aid for myeloma-related organ damage: Calcium high, Renal impairment, Anemia, and Bone lesions. Newer criteria also include specific blood and urine protein levels and MRI or PET findings, so treatment is not withheld until a bone breaks. CRAB is interpreted after tests. It is not a score to calculate at home.

Which tests confirm the diagnosis?

The work-up is stepwise. A serum protein electrophoresis, immunofixation, and serum free light chains look for the abnormal antibody. Urine protein tests add information the blood test can miss. A complete blood count, kidney function, and calcium show organ effects. Imaging looks for bone lesions. A bone marrow examination shows what share of marrow cells are plasma cells and allows genetic tests that guide intensity of treatment.

A related condition, monoclonal gammopathy of undetermined significance (MGUS), shows an abnormal protein without myeloma damage. MGUS is monitored. It is not treated like myeloma. That distinction is why a single “high protein” comment on a report needs a specialist reading, not immediate chemotherapy and not dismissal.

How is treatment planned in Hyderabad?

Plans depend on age, fitness, kidney function, genetic risk, and whether organs are already affected. Many patients start with a combination of targeted and immune-based medicines, plus medicines that protect bone and support the kidneys. People who respond and are fit enough may be offered an autologous stem cell transplant, which uses their own stem cells after a conditioning regimen. It is not required for every patient, and it is not the same as a donor transplant.

Supportive care sits beside cancer medicines: pain control, vaccination advice, infection precautions, and kidney review. The myeloma service page and the transplant overview explain those paths in more detail. Follow-up blood and urine protein tests are how response and later relapse are tracked.

When should you book a hemato-oncologist?

Book a review if bone pain is new and persistent, a blood report mentions an M protein or free light chains, anemia has no clear cause, or kidney function has fallen without a known reason. Bring every prior report. A first visit at AOI Hospital, Nallagandla, or S&S Clinic, Manikonda, is for sorting MGUS from myeloma and mapping the next test, not for starting treatment on the same day unless an emergency such as severe hypercalcemia, cord compression, or kidney failure is already present. Those emergencies need a hospital the same day.

Questions patients ask

What are the early signs of multiple myeloma?

There is no single early sign. Doctors look for persistent bone pain, unexplained anemia, kidney impairment, high calcium, or repeated infections, especially when a blood test shows an abnormal protein. Some people are found on a routine test before pain starts.

What does CRAB mean in myeloma?

CRAB is a clinical set used in myeloma: high Calcium, Renal (kidney) impairment, Anemia, and Bone lesions. These features help decide whether treatment is needed. They are interpreted with biopsy and protein tests, not as a home checklist.

Is every bone pain a sign of myeloma?

No. Back pain is common and usually has other causes. Pain that is new, severe, night-time, or paired with fatigue, kidney trouble, or an abnormal protein on a blood test should be assessed rather than treated only as muscle strain.

Can myeloma be treated in Hyderabad?

Yes. Care may include targeted and immune-based medicines, supportive treatment for bones and kidneys, and autologous stem cell transplant for patients who are fit enough. Dr. G. Stitha Pragna plans this at AOI Hospital, Nallagandla, and S&S Clinic, Manikonda.

Related care in Hyderabad

• Multiple myeloma treatment page
• Bone marrow and stem cell transplant overview
• How blood tests help spot cancer relapse early
• Anemia: when to consult a hematologist
• About Dr. G. Stitha Pragna

Sources

• National Cancer Institute: Multiple myeloma
• National Cancer Institute: Myeloma treatment overview
• World Health Organization: Cancer fact sheet

Disclaimer

This article is educational. It does not diagnose a condition or replace a consultation. Fever, bleeding, severe pain, or breathlessness need direct medical care. Read the medical disclaimer.

Book an appointment with Dr. G. Stitha Pragna at AOI Hospital, Nallagandla, or S&S Clinic, Manikonda, Hyderabad. You can also contact the clinic.