Physical Therapist’s Role in Multiple Myeloma Care

When it comes to cancer recovery, Physical Therapist is a health professional who evaluates and treats movement, function, and pain using exercise, manual techniques, and patient education. For people living with Multiple Myeloma, a blood‑cancer that attacks the bone marrow, the demands on the body are unique: bone lesions, fatigue, pain, and reduced mobility. This article explains how a physical therapist fits into the broader care team, what interventions are most effective, and how patients can get the most out of each session.

Key Takeaways

• Physical therapists address bone‑related pain, fatigue, and functional loss caused by multiple myeloma and its treatments.
• Early referral-often at diagnosis-helps preserve strength and prevent falls.
• Tailored exercise programs improve quality of life and can boost treatment tolerance.
• Collaboration with oncologists, pharmacists, and nutritionists ensures safe, coordinated care.
• Patients should ask for a written home‑exercise plan and clear safety guidelines before starting.

Below we walk through the typical journey of a myeloma patient and pinpoint where the multiple myeloma care team welcomes a physical therapist.

Why Physical Therapy Matters for Multiple Myeloma

Multiple myeloma weakens the skeleton. Lesions in the spine, ribs, and pelvis create fracture risk, while chemotherapy and steroids can lead to muscle wasting. A physical therapist can:

• Reduce pain through manual therapy and gentle mobilization.
• Maintain bone health by prescribing weight‑bearing exercises that stimulate osteoblast activity (within safe limits).
• Combat fatigue with graded aerobic routines that improve cardiorespiratory endurance.
• Restore functional independence for daily tasks such as dressing, cooking, and climbing stairs.

Research from the American Cancer Society (2023) showed that patients who participated in a structured PT program reported a 30% reduction in pain scores and a 20% improvement in the 6‑minute walk test compared with usual care.

When the PT Joins the Team

Timing is critical. Below is a typical timeline:

1. At diagnosis: A referral for an initial functional assessment helps establish a baseline.
2. During induction chemotherapy: PT focuses on preserving strength and managing steroid‑induced muscle loss.
3. Post‑stem‑cell transplant: Gentle mobility work and balance training reduce the risk of falls.
4. Maintenance/relapse phase: Exercise intensity is adjusted to match energy levels and any new bone lesions.

Because multiple myeloma can evolve quickly, the PT re‑evaluates every 4-6 weeks, adapting the program as needed.

Core Interventions a Physical Therapist Provides

Each intervention is chosen based on the patient’s disease stage, bone involvement, and overall health.

• Exercise Therapy: Combination of aerobic (walking, stationary cycling), resistance (elastic bands, light free weights), and flexibility work. Sessions typically start at 10-15 minutes and progress to 30-45 minutes as tolerated.
• Pain Management: Soft‑tissue mobilization, ultrasound, and education on proper body mechanics to off‑load affected vertebrae.
• Fatigue Mitigation: Energy‑conservation techniques, paced activity planning, and interval training to boost stamina without overexertion.
• Bone Health Support: Low‑impact weight‑bearing exercises (e.g., standing heel raises) that stimulate bone remodeling while respecting lesion locations identified via imaging.
• Balance and Fall Prevention: Proprioceptive drills, gait training, and home‑environment assessments to reduce the chance of fractures.
• Functional Mobility Training: Practice of ADLs (activities of daily living) using adaptive equipment when needed.

Evidence‑Based Outcomes

Multiple studies reinforce the value of PT in myeloma:

These figures illustrate that PT isn’t just a “nice‑to‑have” add‑on-it directly improves measurable health outcomes.

How Physical Therapy Fits Within the Multidisciplinary Team

Collaboration is the backbone of effective myeloma care. A typical team includes:

• Oncologist - defines treatment plan and monitors disease status.
• Pharmacist - manages meds that affect bone density (e.g., bisphosphonates).
• Nutritionist - ensures adequate protein for muscle repair.
• Physical Therapist - translates medical goals into functional movement.
• Social Worker - addresses psychosocial barriers to exercise adherence.

The PT receives updates after each chemotherapy cycle, adjusting weight‑bearing limits according to the latest imaging reports. Open communication ensures that exercises never jeopardize a healing bone lesion.

Practical Tips for Patients and Caregivers

1. Ask for a baseline functional test. Knowing your initial strength and balance scores helps track progress.
2. Keep a symptom diary. Note pain spikes, fatigue levels, and any new bone pain before sessions.
3. Use the “talk test” for aerobic work. If you can speak comfortably while moving, you’re in the right intensity zone.
4. Stay hydrated and wear supportive shoes. Proper footwear reduces impact on fragile bones.
5. Schedule follow‑up appointments every 4-6 weeks. Adjustments are essential as disease status changes.

Remember, the goal isn’t to become a bodybuilder; it’s to stay functional, pain‑free, and able to tolerate cancer treatments.

Finding the Right Physical Therapist

Not every PT has oncology experience. Look for these credentials:

• Certification in Oncology Rehabilitation (e.g., APTA Oncology Clinical Specialist).
• Experience with bone‑metastatic conditions.
• Familiarity with the hospital’s electronic medical record to review imaging reports.

Ask your hematologist for a referral list, or check with local cancer support groups. In Canberra, several private practices partner directly with the Canberra Cancer Centre to provide on‑site PT services.

Future Directions: Tele‑Rehab and Wearable Tech

COVID‑19 accelerated remote PT models, and they’re now being refined for myeloma patients. Wearable sensors can track gait speed and postural sway, sending real‑time data to the therapist. Early pilots (2024) showed a 15% increase in adherence when patients used a tablet‑based exercise app combined with weekly video check‑ins.

As technology evolves, expect more personalized, data‑driven PT programs that adapt instantly to pain spikes or fatigue, keeping patients safe while pushing functional gains.